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SET[ImO R FOOT.INGS
i • > -
Date By
.....:............................................................................
FOUNDATION WALL S
Date By
PLUMMBIttG QROUNDWaRK
Date. By
UNDERFLOOR FRA11?IING
..................................................................................
Date By
SHEAR WALLS
Date By
............................................................................
.........................................................................
.................... ........................................................
PLUUMBING ROUGH�IN
Date By
..................................................................................
GAS PIPINI'x
Date By
.................................................................................
......... ...............................................................
................................................ ............ . ....... .
MECHANICAL ROUGH-IN
Date By
....... ............... ............. ....... ........................ ...
................................................................ .........
MECHANIC4LL ;QTHER)
Date By
.................................................................................
FRAMING:::
Date By
............ ........................................... ...... . ........
INSU.IATION
Date By
QWB<� '1ST LAYER A
Date By
GWB - 2ND LAYER--.........:•••••••••••
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
......................................
BUILDINFIN L 'j
Date 1 1.. .111 By ; <�/
OTHER . I
Date By
OTHER
Date By
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City of Federal Way •
amu ' APPLICATION FOR BUILDING PERMIT
Jo ® 9 199
PLEASE PRINTGIi'! iai G DE,PLiLIRALTvAiY
APPLICATION #: '
SITE LOCATION Address7�
3173tiY� 1 ?— L S
Tenant (if known) Lot # Assessor's Tax #
9/ ialsyo6
Building Owner Name Address " '
3 J
S�Y�tC � 3173V P- 1/9/314 s cc) � "
City re CI J (,0. 1 g, State iv Zip c?0 3 Phone 9 a('_d8/s)
Nature of Work �y votfe d cLe
APPLICANT
Name (F,M,L)
a
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUILDING CONTRACTOR
Company Nam
g.
2® 7 e L°v
Address
Ex'/1"/ 13/x- aur s
City b M
5 i Ioi14,r+.S State W/¢ Zip qc/ if
Contact Person Phone Fax
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Contractor's #(card must be presented) Expiration ate Verified 0 Yes 0 No
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ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
JAN ® 9 1997
Please Complete Reverse Side L(-ry GF F DE AL WAY
BUILDING
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CD0492(Rev 4/93)
STRUCTURE ting Use De GK posed Use 7\
Permit includes: (K Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units_ igt Deck rzirort f Y
ElCommercial ❑ Addition 0 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 q4. sq ft Garage sq ft Proposed Total Area sq ft
Water Availability A Sewer Availability ( On Site Septic System Availability ❑ Project Valuation $ j c)dO �'
Zoning Lot Size Existing Bldg Valuation $
LENDER .
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address/,
t
a /
City Slate Zip
Contact ,hone Fax
License # Expiration Date Verified 0 Yes 0 No
/
PLUMBING CONTRACTOR
Contractor Name /N)
ame
' 1�ddress
City \ State Zip
Contact / Phone Fax
License # // Expiration Date Verified ❑ Yes 0 No
//
PLUMBING FIXTURE`COUNT` 1
Water Closets Sink Urinals Lawn Sprinklers
Bathtubs D. h Washers Drinking Fountains Other
/
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL UNIT' COui)77/
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. �-y / /. !
Owner/Agent: L� L ��". Date: '/I .../',r‘