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BUILDING DIVISION '
.. 33530 First Way South
� EIZF n_ RECEIVED Federal Way, 98003
(253)661-4000
1\061 4 1999 Fax(253)6614129
,... y OF Fra?-.1.REPT.WAN
APPLICATION ` OR( 3�JILDING PERMIT
PLEASE PRINT APPLICATION # -----6 ,- (8 s-5---1
...............,:,:,:„,,,,„:„„„„„„„„„„„,„„„„„„„,„„„„„„,„„„„„„„„„„„„,„„„,,„„„„„„,„„4
ititgitOtATIONMEMENEMN.Address
/ Vy
Ten t(if known) ( Lot# Assessor's Tax #
•Grtr.,40JCk 1 r_...eAA.44( .01e-otvIr
Byyldin Owner's Nine I Address
<Ya v3R.� ( I vim.. /cc I t' Aile ?(Azo,„ r 4-, 5 OO
City`Ss�` e_ State -- Zip Wi /IPhone (Z66)ZT2 2211
Nature of Work S ,...It cf & ci
l
AP:::;:::><::;:>�::N>:;3'' «<>>> > > z ME f ma
. )r!�:,1�'>AIS'C` : : :::.::::.::::::::.
Name (F,M,L)
v.C_ i
if
��1451 uc(ii vi .-e,), I►. .
Add sv i 1 4ife, 5,-.
Citya l VJ"=j} State Zip IQe3
cza ttA-- Ir�a t S Day Phone_l4G-66 raih7e1`7^15% F 253 O
►::: :: : :::::: ::::::::::::::::::;::::::_::;::: _::::
1 D1. atOrsuR ACTDR >>> ><�`> »»> FEDERAL WAY BUSINESS LICENSE #
• Co any Name
tie as ,4 ��,1
Address
City State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
,....iZ(cc{ q2 L 6
........,::::: ............................ i::ii......................................
......................................................................................
....................................................... .............................
Aft .... CT.................................................. .....
............................................................................................
Name t
kr_
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
• Please Complete Reverse Side •
]: Exis'
w'�.� :�Cf�lWm.W. ::.:: i , : : .;:;: 9 UseCe,44n►y( /a42,,,, I Proposed Use tic_
Permit includes: (3 Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential /❑ New ❑ Remodel 0 Number of Units 0 Deck
lir Commercial 0 Addition 0 Garage 0 Shed 0 Other
Enter 1st Floor 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 sq ft
Water Availability 0 Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation $ JOOC.)
Zoning I Lot Size Existing Bldg Valuation _$
—
LENDER{«i>i{<{€><E `` >< ':_><f > > __< '``< `_ >:
Name Address
City State _Zip
MECHANICAVCONTRACTOREEMEg
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
License # Expiration Date Verified ❑ Yes 0 No
; LUM .tNGAFIXTUF I #CJ►ElN`!'.................:.....
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
.......... ...... . ........... ... . ...............
......................... ........ ....... ................
.......... ....... .. .. ...... ..... . ...............
Lavatories Washing Machine Drains Total,Fixture Count
M C:::,: IM.CA. :... .....COUN ' .,,:... .;,.;;; . MECHANICAL EVALUATION ONLY $
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons .
Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
............................................ .... .. ..........
BBQ's Wood Stoves 3-15 Tons `!`otelthiit Count
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,includi g its officers and employees,upon the accuracy of the information supplied to the cityas a
part of this application.
Owner/Agent:-4` / !? Date: 0:1`[ ^ !O
S
REM
fkIlLED 8/26 . •
flEV6ED 8/28/97