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Federal Way,WA 98003 RECE V E '-' (253)661-4000 Fax(253)661-4129 .APR 141998 WAS' APPLICATION FOR 11111tDING PERMIT PLEASE PRINT APPLICATION # I LD 9 ( - 9 OJ :�""""<::<:,;":v":::r>::::r"""»:::;>,i>>' > s»>> > »><>��� >>#'� >>..... dress Tenant(if known) *0 /// D Lot# Assessor's Tax# Building Owner's Name/'7` +'T /� Address Svyh� #(2/2f City State ff� // Zipp Phone�,/ " 7Z7_ 6°e'd Nature of Work /r'G�i� A l`/11 ki/ Oki/ /,,o T�'( axrry dGGt lert4 Gfrw l-t" fro/)? a ev,s-Y'/rz 9 Dace/ 71a Name (F,M,L) Address City State Zip Contact Person Day Phone Other Phone Fax Company Name riT is 1/e'' Address /?3 City S e-,rfi/ State Zip gc/174 Contact Person / ,vi �}-^ P ? v z7 Fax yj /'/'/-f e(, p� Contractor's # (card must be presented) 5'4,4/ /-;iiL r. Expiration pe Verified ❑ Yes ❑ No Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION • Please Complete Reverse Side • • ............................. ................................ ......................... ......................................................................................... ............................. ................................ ......................... �+ ExistingUse Proposed Use Permit includes: 0 Building Cd' Plumbing gl-'Mechanical 0 Other Type of Work: 0 Ij‘sidential 0 New 0 Remodel ❑ Number of Units 0 Deck q/Commercial 0 Addition 0 Garage 0 Shed 0 Other Enter 1st Floor /I/60 sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area �sgyfft�� Water Availability l� Sewer Availability N''' On-Site Septic System Availability 0 Project Valuation $ � V Zoning Lot Size Existing Bldg Valuation $ LENDER'> > ><' ><«<in:WO MEiM:> ........................................................................................... Name Address City State Zip ................ ................................................ ............... ............ ............................................. ........ ............... ................ ................................................ ............... ............ ............................................. ........ ............... Contractor Name Address _City .State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes 0 No ........................................................................................... .......................................................................................... ........................................................................................... .......................................................................................... .......................................................................................... Contractor Name Address • City State Zip Contact Phone Fax g License # Expiration Date Verified 0 Yes ❑)No .....: :i:::..........................................................:: ::::................ . ...... ................................................................................... ................................................................. ................... ...... ................................................................................... Water Closets Sinks 1/.. Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps .... .. ......................................... ..... ...................................................... ..... .... .... .......................................... ..... ...................................................... ..... Lavatories Washing Machine Drains ,010Fixture.Gnunt ... ................................................................................... ......................................................................................... ........................................................................... ............ ......................................................................................... MECHANICAL UNIT COUN MECHANICAL EVALUATION ONLY $ ........................................................................................... Fuel Type (electric/other) G{4 Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons Length of Gas Piping 4-0 Range ✓ Air Handling > = 10,000 CFM 30-50 Tons Furn <100K BTUs Gas Log Unit Heater 50+ Tons Furn >100 BTUs ✓ Fans v Miscellaneous Fuel Tanks Gas Hwt ✓ Hood / Boilers Above Ground Cony Burner Duct Work '/ 0-3 Tons Underground ............................................................... ............................................................... ............................................................... ............................................................... BBQ's Wood Stoves 3-15 Tons 'fataN';Unrt Catil3t.;:::;:;r<i iii _:%;:;....< DISCLAIMER:I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I am authorized by the owner of the above premises to perform the work for which permit application is made.I further agree to save harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. t V 1 Owner/Agent. �/ f f `A C– `)1 Z‘11--1 Date: ,0q— /J - / fit VISE o enei97 — ..f..'f: .......1 =a -,... --e. 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Date By ................................................................................................. ................................................................................................. 5 FOOTIN (DOWN; PO4J DRAIN; Date • By 6 Date By 7 SHEAR WALLS Date By 8 PLUMBJNG.:::ROUGH'415L:::::::::: ::::::..;:::;.............: ..m: Date By Date By 10 MECHANICAL ROUGH-IN Date By 11 -.A4-16-4---173,-)Inp. 4 j yp5 4.4,$1 otedAt., Date By 12 INS U. Date By 13 c 6 1ST<L 1' ER Date By 14 Gig 2ND.t AYER Date By 15 &1� 4 ED;GBIi«II�IG.. Date By 16 PLAI IN `FINAL>........... Date By ..... ....... 17 PU k.�G: QRKS.,FINA Date By 18 ..:: Date By 19 BUIL DING FINAL ':` Date By 20 ... Date By CD0193(Rev 4/97)