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By UNDERFLOOR FRAMING Date By ................................................................................. $HEAR WALLS Date By PLUI1i1• • • AOLJGFI:IN Date By GASPIPING Date By MECHANICAL.ROUGH-IN Date By MECHANICAL (OTHER) Date By FRAMING Date0,7/.93/ft By(- INSULATION y(- INSU:LAcTI:ON ............................... . . Date By GWB; 1ST LAYER Date By GWB2N):LAYER'; Date By SUSPENDED CEILING Date By PLANNING FINAL Date By .................................. .. .. .. .. ENGINEERING FINAL Date By FIRE FINAL Date By BUILDING FINAL Date /2/274,;" By(, OTHER Date By OTHER Date By • CD0193 `� m if ".�... . t,,._ _____,._ _.. _ ii t Z 0\ -n CO C) z n 70 : G') 7o G7 G-) -.) G-) TI n •• p •- -1 -• o n --1 07 if f X 0 tj ON CD U 1--4 m m 'S' IS a - 3> 3> Cw7> C 11 n -J -C •J n rn -C r SS .,.........-,....,^Tt to C-.. o i x- Do 7o I. 1i cn z OD o a can 7o un m1 ft n - n a v ry n a rn to 3> >E O . t1 {- CI Us -i 0 r--. 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FLn -L ) Li;A 9 g 0 2,3 Tenant (if known) , Lot # Assessor's Tax # ,rtee-S -4 <,2s Tun/ GRA-V r i rti c, Building Owner Name Addres -- S Aryl 3 3o Li 1 /6 rtf lei.►ate 5,r.+// City )9612✓} ., vJr9-� 14441State � f Zip crg Z3 Phon42v 6) Cly-676 Z Nature of Work ,4Lv44 IWvA-i e,4 ri O Covet- 2 3 k I) APPLICANT Name (F M,L) /� t7nii,tes A, 612►9VIriry Address 330&J I / 6 .t74 /'L_r 6 S,(,(), City J JY3 01Lv}-L, ( J vetld1 State j,j 4 Zip R' g6 Z Contact PersonD y Pho e Other Phone Fax crm41 c 641- ViVwv6 (Zu6) `ISZ—Swop Fier- 56S- 1.41,,M7LI -6?62 - /'J p ` — BUILDING CONTRACTOR Company Name n --L/ f��m� .LC f (�-O�"S l- /�U�t F� J'YlP Address 2 ) J 2 ,a i' r8 s.. 5i i re_ A City C oil yD ! Statettivi Zip 9s)q qq- iSc r Contact Person Phone Fax Ei FActiAkCzYK - setiu3yt1viiv Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No COASTf-Il O8 ' pk/ ARCHITECT Name � o— Address !�/ City State Zip Contact Person Phone Fax LEGAL DESCRIPTION • Please Complete Reverse Side 0 CD0492(Rev 4/93) / STRUC1 URE Existing Use Proposed Use Permit includes: Z Building ❑ Plumbing LI Mechanical ❑ Other Type of Work: ❑ Residential New ❑ Remodel El Number of Units_ ❑ Deck El Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other Enter 1st Floor sq ft 2nd Floor -_sq ft 3rd Floor sq ft Existing Floor Area sq ft Area Basement_ sq ft Decks Z sq ft Garage sq ft Proposed Total Area_ sq ft Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation 3dOFj Zoning Lot Size Existing Bldg Valuation $ LENDER Name Address City State Zip MECHANICAL CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUMBING CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUMBING FIXTURE COUNT Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains Total Fixture Count MECHANICAL UNIT COUNT 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 Total Unit 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,including its officers and employees, upon the accuracy of the information supplied to the City as a part of this application. .1 /, / Owner/Agent: ,&Lwv""- 0 - * Date / !!Z /S / �,S