97-103640 CD
MI 9 '
De n70 u 47 77 Cn n G> -n c> -n II •• CO -r ... O n H 170 a r, X7 0 t� CYt Cl) Lt3 !--1
m m 3 CD 3> 3> 3> by CD 9 c 3> C H n J -G co n m -C r Il ti CO r N rn CC
70 70 rr 11 on a On o = On 7D On m n n -o n z -o t) It Il Co m O --4 = O : v CO L; In -4
-C -C n On C = r 11 C m C 4= 1'n •J n i! C' C .-4 rn = r
O r-r H 'I r rn t7 x 4 'o II 'n n7 C •- 11 11 , m N '[7 r*) '-4 " i j
7D T ii O 7D CO 7E .-a H F CD 3? CD 3> CO O x N Hco 77 x 7D iT rn Q\ -1 0 .
-C m Il G> -G C ---1 C)O '- -< n •• _ •- -n .• Z 1-1'1 SI II 3> on m
3> 244, !I Cr) 7) • O `-+ 'O II -I •J .J n n {t l{ 0, r • = ii i7) -'w1 CO as. DI 0
GDCr) m
G> ..-1 'O `{ . z • 7'C = m =I n -G D> >E i{ !1 1 n �^
r,'1 7C 1.-1 11 rn . an Cn 11 r CD -9 CD CC 1 fl A 3E 00 c c 11 W (JO H. 'r-` 77 77
- . 7O n 70 n O = O m 7o rn I: Il Cs -< CD CD 11 ,., { cc.
-•, -•1 m �f • -• J it O CV CO 7D C1 . n H n h7 ^C CO S 11
H .• o CO .• •J n n co z = n �7 1\i ,J +°' 71
+1 r-� ii n ,• •J 7D •J C 7D 7> •• ti 11 3> C7 GO Il
7C CO n pop opo CD n c -o -< r7 • .) f 11 3> o I r CO CD OD.I N rpt
m o ii p ii -ni C' ii II w rte- = II
(.� � f-` O : rt"
u p u n p . c Is K I{ o Il (� j 3 O.. !In
a n -h •J n O -•
cm 'O 11 W ll CD 1!
-_,-, ..t If ,-r- II .J z •J nn r n N {I O 11 O Z in
O (n !l n , . •• 3 it II Cr) 11
DC 27 n 11 ; c.> rn -• 1l o it I1 17 PJ i> 4 r`
a -n n it O i 4, Un •J N 7C 1 It
--1 -1 II II •• .. n -{ Il a -•4 O CO
.-1 m !i 11 n 70 II {I
CD 70 n n II a II {I 1-n 0 CO CO .=
MC it n fl n 11 it
Y•) t! ii 11 C7 �l ii 0Z Z 0 C
,:!.
•TI Cwn .i D - m 7E CO C) T ti -4 G> nn D7 O CEJ N N rn 11 O
4 C r~ r-r C O C O z II O 3? r.9 On H CD Z Cr) r n
t 2C C 11 v .. 7D Cn = CO n o z i{ •--, • n - s C'7 . • 7o II CJS n I! ss b 0 Ct"
.4 a II „ n = C7 H !� CO if r • Pc H o • 4 u it 11 7D
cm▪ : n 1-4. x v f .. .. .. .. .. •.. .. .. n n tl rn CO
C C n 1E O CD 3> CD -4 CD N m n •- IS 11 -q
.N..\.,:)
m m 11 - - = CD 0 CD II >< n r- n s:
MI 11 CD CD v CD 0 7o n .-1 n m r{ at � r-
NN;) 10,00 r-111 CD CD r 7'C G . -• • if O n a if {! n
-n Il O O .--C • m --+ 11 cry ti !1 m
RI GD Cn CD CD CD CD CD p p • 1 11 m 11 1:
CD n T A, n 50 !i C ii 11 14 z
= ll •• 3 C nII
7D f! {.r) it co
m = 1 = 4 O n m 1 F
.4 70• n H n 1 31 _ n nn
it cc
Cr) pe it CD CD On CD CD CD CD CD CD ii CD CD CD CD CD 0 0 CD 1 n O n Il 4.7..
II
17 •- 1 n r•1 n i1 a
..y r.4 {i II
N N N N N •t-r4'.4
N N 11 a fl if 77
'! 1l n COII i{ r.�
rCi-, N i{ n n O E{ U
D7 a II ,i a • , ii X
Z 70 li '•'1 DO :? 7D
no on C 3C On C7 II (^') lS li H
CM --•1 i C O 'i m 7D X rTl H E FI O II n on
MI 11 C 3> m C.o C.J ,--. c0 O .--i I{ n O .-r r .. CD m f{ p 11 IS --.I
n 11 = CO r CD CD Co 4 r n on no Cn C G4> 7D r n m n n r_.,
CD • f C7 cn -hi 11-4 W rn 1! .ti • -4 3> - 1--, r 1t { ..._.-....<-._..,,«..-...�.....-.......,...yl =
70 ii rn m -4 Co Cr) Cr 72 11 •- - H -1 m 1--1 n -.4 'F n G2 tt
70 1 70 m 3> -4 p O -1 Cr) {I m - CD on = n V n C
m 70 1! O Z CD -1 CD�. 11 CD -, f. O O n ct1 n O CD
-4 m 11 70 G> >C 7c H H CD = n 31 •• z 1 h7 11 = CD m t""
-4 Ges n CD 70 un • O O z • CO 1E •• C n n = = on '-'
$ --
1-••, 44 C O • = Z • • 3 it CD Z I = {I rn H -fir
-1 a f Z C • C- s {I .- .---1 I{ 2 n 7D 7D C
O m II 0 z70 11 `•-) U Cn n m 11 3>
7C n C7 nn 11 N 31 = n .-r n 'r-'• ' =%-Al.
• rr n on n co • • n 70 11 O 0 k.. '-
m a fI CD n - O p 11 m I1 n 7o r _
CO r Il CD CD CD O CD CD CD 77 n --J OCD CD CD CD II •O n CD
II un 1! n O n n
m 3> 13 ac
n -h -70 11 n -
Cn x 'f n rr 9 -i II 7o ii 1-.0
-4 CP n n n rr 1l 3? H
O CA 11 ... n n f7'! 1l H !! Ul %
-r! 70 tl r rn C7 cin r- CO OD 4C n .-+ 77 77 n HI! CD n
a r- 31 n .-4 .--. 3> 3> 3> If 11 on rn CD
7C C 4= = C COH H IS 'C
I C rn Cn ] 77 un .O 0 - a I1 n 1! 73 1.4
1, d Yea II Z n x a 7E x so rn 11 rn rn .-C 7D c_ C 'rD n r- n n
X COn Cn -N m 70 II 7D 7> 0 O c. .-+ 1l m I! 13
m = On 11 U) H 4= n n H m r 4 7C a CD 7D H C 7o m = 77 7D 1! OM 11 n ,,
I{ Cn 3> 7D on C rn - 0 n 11 C-¢- c.f94c.
CP
Q O rn 7D
!: x 7o cr.35 .--107 r it on d 0 3> 11 -•y it II
A f� n 7D s m rn O t{ C .z 11 a it II N'-=?_
0
1 r 70 Il s m [n to ti 7D V9 'v Il __ ii n Cc,
{ m DM 1! m n 'n rn 3> n {3 l{
C M•+ HC to H H A H n7 n i1
! G'! --C !1 -� H Cr) 1: n Dd �c n O i n
•444( 1 m cm tf r- m 11 m 35 n 70 n 1
n -4 77 n •• n 35 GD n 11 31
i' Y! n c /'f CO 11 • 01O •I 70 Ii EI �S
Cy pl •O n If it O 11 11 �D r
37 ,..a n t! .• . it em 11 11k
--+ -1 70 ti •• •• • •• •• •• Il O CD CD J ll m n II =_
rn CC m n 11 . • • n n IF 0 C
m 11 n O CD C7 1l -4 n 11 D ��
O n 0 CD CD CD CD CO CD 0 1f CD CD CD C7 CD 11 U) n `I -
1 a = it I! •• II ii tl
•O m 11 n N -h -C• -r, 11 = II II ~
j\ -cs n 1{ --h e+ CF c•- 11 44 It fl C't- sr
f- if n n ti it I{
en▪ m Ei I! it S n !t (.{�
I f7 70 n O r C7 C on C, C n rn (Ti -n 3> Cn 1 r••1 ! n
a 7D I! -4 2C 70 3? C 70 77 n rr, m y .-r 3> o ii 710 Il n
k CO n S CC 3> n no .--C 7C n z rn o-1 77 7D 3 1 n 1\,.) z
t_\' r St n 70 z ,-+ - z z it U) m 73 on 3>7 .+ ii 77 if II
m T, n 77 Z Ci> cm 7C 37 n r-1 7D 7D CD = I! x 11 i{ _
-i n On CJ> 73 35 r n H -n C� x II m n ii
n m n -.l 'O 3> _ (n If .4 to f r> r- r II Lil
.`� 1--1 70 11 .-4 77 D On If G 1-n m O n m {l en it 16 R
V -4 Ng
!{ x_ r-+ x 1 m 7<> a7 ]E r n rr {! it
a 11 C Pc rn
7D CD i4 3> C H un J Ii ig...,... ...,.-.«,._.......,.....«.._::..,.:.:,a..,,.».ji 0\
O .-4 l- 7) r Cn C II 7) n r7 • Cn II if II LN
•1I In `t m m a II rn m rn n O n i....!
IE to 70 • -4 I1 D - •- • 11 -x7 EI r-
-in
-n O ISCn 11 On • Is Il rn 1
MM
m ,y .. .. .. n -J n -n 0 =0 I{ -
•D •) •J i! m ff t.0m r.r n II • • I{ Cy 11 m
70 on {i O O CD CD CD CD 0 11 -J CD J 34 m Il 7D }'''
a GM n it I. 77 I! -
r- C C n 11 CCs 33 a 11 it 0
3> a 11 11 11 r- n 11
= 7C n li 11 13II
a n 1f f1 !1 = 11 11
...:a.,,,ew.a..fw..._.,..........._,.:....,K........:.....,:..,,...s.,....,... II
70 n n • n n
MM f{ n n n
C ft ft o rn ft -/ n it
1.4 ti H rt n 77 Il II
70 lE 3> un n 7C n n
CM n r un co l -• is 11 n
_' I{ CO .0it 70 11 it
m II -n n -C r 7> 11 a II {I
y '! on C7 n m 11 it in 1---i 7J
um ii CO CO C= )(n it 35 I: r T 3
f CC n 1 1 n 11 it
= II 7D G7 on n n it
.4 lI n n n CO tl 11 ID OD H
r- n x 'o n 11 • 1l n
r- n 70 77 T1 li ♦r `I 11 20 r
00 It O7 CC nn n n n
m ii m .4• m it N n IS M td el Z •` ,%
Z It - - n N '1 CO -< •• O V
-1 11 • - 11 n ii
11 II 3+ . ii ii ift i O m O W `
••••- � )
It
u ��� II ii 4, �.n iv d
II ti ii it 1-''' }-- %0
II II II II CO 'J kc
ii w h7 ii ii 11 c., CO 1
ii II
ii ii `0 O oD cn p w cN
11 CD CD CD CD 11 n 1l CO Ul
II III II 3i H-
4...
- a-3 ./..,-V.: -'-
___,--....,, ----7., z --) J .-7,,, 'w 1, • .
:".'
7/....•••••••••••••••••'.....*** -..r ,...., - ..4 ..-. 7 ,.
_.... —.—
* ee-s '-` „''' e• ..er'
.......
0
..., -a Ca g `',.-,i. "."' cz'''') ,-1'1) I .,•'"" :, .7.7,- ' ' - .'":- ' .1
-...--""""*"7— ..... . -4 .. .i? -4 777 ' ,....); I r., .0 le..n -4 mi 4.;,`,e"". - -
.m 4 '.' ',...7; , -4 "'7 ,.., zim -77 !cs, r ,, ,c, ,, .TT, :,..., c.,,
r---", .-.X 7"----ov -a, g - 4*, ..e' '7: cr) r" .. -', 4 .0 s;.- If) !"-." .., .-', - ,-,
.--4!. iZ
. ra, 7 ,,,-.1.` r't *C7 4= )4 7 g -7' 0-- • '-•'''- '"„ '1 ,:. ,
-.•.'74 et = 7 g rh" Z i it 4." . *-- ,- .r, •-ez ..4 z> ce, ' ' ',' 4 07. •-i ••,... -, -
,•i ; it .... ,- t.t. --4, ..- ,, -, .._, ,,., cr.> g,>: .. 4,- : 2: .,,,. ? ..-- '#), '''''' II :C,, , , N. Z *'•7 ..
....0 rg ...* ,.. r." 4•5,... ac- .§.. .... ....c N •• ....+1 ••,) , .....0 .....' ,.4.5 = :,,,3 c,, LP .,..0 1,4 a 0 .,, r,,,,2 •.,. .... ,...,/ r•-",
, _ . ,.
...... „z, tf.
4— ^". t.,rt
'N w, X C; '"'" ,... ,..,•, ,`"",
*4 ii ar.: . -‹ ,. - c r", tl - 4-' 2:: 4 ,-., , ," IIC 'tn (,:3 g , , , ?..",....„. ,./
, 40: . = • • ,; u, , c> u, =, c, .4 ., 3,
Z' *'" ''' , ..•''", 7
.•N ' • , •"-' • * 15 ,= ='* _4 •- a ,,,, .- •• 7 r
* ••* '''' . ' : • '''': ... •. " :...,) St •• ti" :.44 c0 -.-> ..c. -c !=' !" i' '4
'4 '.. - '''''' - Z
4 , = C77 4 ,„,
44.
., ......
mg ,,..„ '....... it
•
O 4*,
1, 44 .
-72 ,,..... -,C- 44
=
' 410 N
,=. CZ,' ,, i, . -"" t . C: ,r, P
t..3 t t•••* k...` ' '''''•
,.... P = ,=$ =• ,.... .,...,„„. ; ••••• " , . 4,e,' ,,.... ,1 •. l','
...! p (=>
•
„ ,.,„,,, a,4
\A 8 1,
o i"•.'''' - gi'' --, : - •• z,. tl ..-, r
, „...
r'.
- , z
\
4.
- 4., : , ,- 4's =''' :r t RF !,-..
, ,„....) r"”` „, t fA .
.....
,r•e'. * .7.>
4-- ,
, ...- c,"
„ ....
' r ,
. i !A .. ,
;.. •, ,
•
a vi ,,!:,
-, -- -
.: 4 t.• - .......,
,...: 7".
'''
O ,
...„ ..
t .
t rn,
:.....• ....*= 7
N ••• C •Ti
,( „ Sr g 5; ,*.7, Jg C: ..,, CO '''' f! f44-,'-..,,,,44, ,4,•, ,,,,,, ,•
a ,... ,,, --,..-. , .5 - - • ,• --,- ,-,:,4,-, • -,,,-, -, -4.‘,. • .
,t r- 4 4=1 •S' Z o CZ' -e,- 4... „ -,,,,-,,,,, ,,,,,,_-, ,, ,,-,,, ,...... .... et„).„..,-.--,,,,ob,„ = ,,,,,,
,\s„,_ 4''' r., =,, -. -8 .,,, • ',F. ....- -- ; -;;,e-, It, ,‘,....,--x_....kaot# ct •1*- ..„ 1',-kg 4
a: , ..= ,- • , , , ‘,„,,,,„ .,,t,,4,,, ,r. ! ,- , ,,, ,,-J,, (AT.43=1,
t M.1
t Z=
..=, ••^••• Y, a =, -- : . ,,- --4,. =,,-,- -;,%,
. . • -
4 =
-' ''
•
• 41)L 4 =c. FF, '37 - - - 4iii.-',,,, 4 4t, .:' 4 4 •. : 1,-, y
., ••,-,
Pk 0 4 *- 7* c:,,, c4:-.,,lp 4:7',---,,. , „,-,4,4:-',,-*• , 444 crs .;, .1
P rv't
f.
-.4-4
ft
r14,i•,:,.-,„,,',-,-,,',,,,-,--L,,,,,)-,",--4,-•'t,,",',te-*,o-t.r-e;k,,-,,,ei',v-"',-4-,''--e-,:,,'•.":",.64i1 ; - ,,,•, e.'...e-'v-1.'x,..'.i.,,?‘i•,A,.'t11'-'.-'-.,?,.,,‘.c--.,-
4-
—.,-
^—
Z..t0C=-v".A.e-"..,....A••1,
:
,.,
.
''-,• =-''
4- 44
„r - „ = - '
4-) C- , , - I. ! 4 1 v $'U. 44 , .
a , .. :W = 4I , f
, - c _ ca - LoG 14- - ,, .y -.,
.=
• 2> .4 = t -,' • W '
‘ . , •
0 t” . (, • -, X: i* , .
„ , g „ * r • • =C - ;-AL f ' N • ,, _ „
X .
:. ! — * 4 ',7.....,.,,.._-'....'„..,,.'..
.,,
,..,•.,,
-- ,
•- ,,
r0-0
1'V.'•,',"
.F2.sZ=7•!,,"›*•,*-.••r.-..0".4...-:.1.!'.,*,../.
..
,
-'-,=-:-.-.c..-,..-..7;„;,...-.-..•,•=•,
,
•-,2-=c.=.Cs
-•T,., z"e..
7.--.....•..:M-,--.,t.'.-
**.,.•. ..7
'-97'•*-1-, -f,I''i'4t
....4 3; N . -' - 4.. '" C -:
, DF _ . k ! % 4.
..r,“-i1,-0..'4Je.,,•..'.
j.x
. ,„ „,"F = . ...4 . 7 ''' t .
-I .44 * . = P'' 1 - Zr ' 4
. 14') -4 eT '' rn I r 4 '7 4 ‹ AR 7e vrr
I - .;; — . .” = 4 : , ' , ; pi ,
" i 74 t,,, 1* 0f, - 7 , . ' , .4 ;
. . tR, t = 4 , i, I-,, ,.6 : ,,, • ,▪ . Z ' 4 „ -'*.
,',L•
,..-,.,•
.••,.
.•,
c),I•""f*,.ir•.•.a.
.;T.'.•.-.‘ro ,, 4= 4— , - • i ,
0 • - 4= 1") • 7 , ' "4 4 : s I s
. . 4 ; ; 2 , 4
m :7; " " . ' ,, . . . - . -t 4'
< - ., . 2• ' : A . a N t
,-) . . g . • $4 1 44
' '
•S, ! 1
Cg , = c , 4 s = 0 4= ,. . = iFt,0 • , .. aa
. .. = „ - tz-:-
34 . R ? . .•! 7"N,,, erZ , Er, t 4 .,•A ,,.. Zr„ P
, - r . 35 = 1 -• rZ . , ,e g
. . Q , „ g ,
A4 „, = . .. , 'n , r1 *% O ' = * f ,„
'.. ” z c„, rh . ' ! g i ? -
. ($424 7,g - 4 ..44 ler ' w , 4-
N. : . .. 1 . ,,, 01 , - !
, ; .. xj .g , 44- i-4 , t , , e, t
.4 — „•K - 4 ., p . ? ,,
' r4, '' rs .4 5 & "I ,
= X 7 ' , : t 4
, a : „-4. ft r, 1
1*
iX,' . .: • r"
" ,:.
Ei, • "
- fi • • 4-
4.4') ft', = „ , , Z = " -''
0 1i4 V t
1, T4 U ,.
* - P ; Cr -
.iv*•"-71a.4:
r ',,,,* ......... --. 4 ..
Si
,;
/..
-
'I1
5=
•
=0..L
.-=:(.0.
M"
”044
t-'
4ww1* r0
= r , u„I• 1'PItq'1'
Pv,4„tX,
„'--,
, ,'7.,.-.-Z-•.,.,'.
0t1iL1•i.”
.' t , 74 D „.
r- . r,4 , .r =
•* - • “ i , '-4 1. ==
V , 3-
4 ' * n
R 4 '., .
.3
l 4; . '"Jci .„ ,, ,„, u :' ''
.: .. PL '4 * , 1 ,, *”
• ' , N II ' , 4i t
A ; :.0
„_- _,-- .. - ' . ,4
4
*
., ,...,
1 SETBACK &F=O TFMC,S
Date Gds/3//q7 By
Date By
..................................................................................................
...............................................................................................
.................................................................................................
...............................................................................................
3 PLUMBFNG:GgOUNDWCRK>>: :'
Date By
.................................................................................................
................................................................................................
.................................................................................................
4
.................................................................................................
.................................................................................................
Date By
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
5 FL CYr114 jD 111INSPOUT DRi%1NS >[> > >[>[ :*
.................................................................................................
Date By
.................................................................................................
.................................................................................................
.................................................................................................
6 UNfFrLQFi`FfFA1Y11NG:::`.>:> > `.
.................................................................................................
.................................................................................................
Date By
............................................................................................ ..:
.................................................................................................
.................................................................................................
................................................................................................
7 SH1=3ti1`'11VI�iL "
Date By
.................................................................................................
...............................................................................................
.................................................................................................
...............................................................................................
8
................................................................................................
.................................................................................................
Date By
.................................................................................................
.................................................................................................
9
.................................................................................................
.................................................................................................
Date By
................................................................................................
.................................................................................................
10 ME:CiiitNICAL R:OU1RH 1N>...:: .:._::............: ...:
.......................................... ...................................................::
.................................................................................................
................................................................................................
Date By
................................................................................................
11
.......... ..........
Date --2--[1—q By
...............................................................................................
.................................................................................................
...............................................................................................
12
...............................................................................................
.................................................................................................
Date By
......................................................................................:.........
................................................................................................
................................................................................................
13 .1..
F�ViI� St I.AY R................
................................................................................................
................................................................................................
Date By
................................................................................................
14
.................................................................................................
................................................................................................
.................................................................................................
<: .
.................................................................................................
Date By
...lF
.............................................................................................
................................................................................................
................................................................................................
1
5
................................................................................................
.................................................................................................
.................................................................................................
Date By
.................................................................................................
................................................................................................
.................................................................................................
................................................................................................
16
................................................................................................
.................................................................................................
Date By
.................................................................................................
................................................................................................
.................................................................................................
17
.................................................................................................
...............................................................................................
.................................................................................................
Date By
.................................................................................................
ID ................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
Date By
...............................................................................................
.................................................................................................
................................................................................................
.................................................................................................
19
.................................................................................................
.................................................................................................
.................................................................................................
Date "7-i1-{cf By 6C...
...............................................................................................
20
Date By
CD0193(Rev 4/97)
/�'"; � BUILDING DIVISION
ipte33530 First Way South
FI'i .J100 Federal Way,WA 98003"
\)\> F-iY (253)661-4000
EQ Fax(253)661-4129
0-13;);‘,6.0G°
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION # ,,L n g) -C c I
:`<'• Address
Tenant(if known) Lot# Assessor'sTax #4),_ 0020
Building Owner's Na a AddressA. V
jog
City R4-/ "LA)q-y / State (,J/1" Zip q/<P00_ Phon
Nature of Work R'eeG46 .- ?4RJ�f j.LS-4-/ Di-c
APPLICAN. »>>:> > >;> ,>< »» «<<.:._
Na
"7 ,4' ! S,od,gv a ,ss_0 ,J
Addresses o/A sO6;? f nG-/
City .v 4 � ( A y State fA Zip cqaPC30_
Contact Person a ne O erPhone 5Fax
IL .11110 tb1tIIRACTO Fi.............................
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
AlitiiittatnaMMOMMENNE
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
Existing UseUse
Proposed U e
Permit includes: ❑ Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: XI, Residential 0 New 0 Remodel 0 Number of Units Deck
0 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 $ AS-00
Zoning I Lot Size Existing Bldg Valuation $
...................... ......................... ....................................
.................... ................ .............................................
...................... ......................... ....................................
.................... ................ .............................................
...................... ......................... ....................................
.................... ................ .............................................
ENDER:;:<;:€:€»:€:»iii:.::>::>::><:«:€<:€:::>€:>i:::::::::»:>:: > »m:::
Name Address
City
r-)74-- State Zip
.........................................................................o::::......*m:
...........................................................................................
.........................................................................................
IVIECHANICAWCONTRACTORMMEM
Contractor Name Address
City N(A- State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
•
..........................................................................................
.......................................................................... ...............
.........................................................................................
..........................................................................................
.........................................................................................
Contractor Name Address
City i`.' (j1)--- State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
....................... ...........................................................
........................ .................... ... .................... ..........
....................... ...........................................................
........................ .................... ... .................... ..........
..�y....y..,+..i.�.y....t.K.+../.�.........+.�.y.��.�..�.y..y._+./,.4..R..t.��.....y..«......................
LU.NI Btlo.k7 FIXTti:f!1�.i C UIV::ti `R :; Y
............................................................................................
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
.......................................................... ..
............................................................
............................................................
...........................................................
............................................................
Lavatories Washing Machine Drains Total Fixtute.tounf .:....:... _...
................... ...............................................ilii: ..........
............................ ...... ............ .....................................
................... ...............................................................
............................ ...... ............ .....................................
................... ...............................................................
MECHA ICA 1NSVCf U1V't' ?< :>` < 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 ficstal Unit CQunt ; :.;
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.
Owner/Agent: Date:
BUILDING.APP
REVISED 8128/97
in u ECEIV ED
h
co) 291991
011 BUILDING DEPT•AY
1� 1
Drivewq
. . N
F iti ARIEL iitlf i Nil
'sO
THE CONTRACTOR SHALL VERIFY 1
aIRED THE PROPERTY LINES AND
UPON CaCOMPLETION,,,�����
SETBACKS FOR THE PLACEMENT i
OF THC BY THIS PERMIT.HORI�E�
OF WORK
Y
!o Pt•"Ei�,b/`
/ i. .�.yo,, UP"�� �f it
THERE ARE TO BE NO DEVIATIONS
TO THE APPROVED DRAWINGS
UNLESS OTHERWISE APPROVED BY M
TME MAFIA!.WAY BUILDING DEPT.
-,,,i
CITY OF FEDERA , W Y
DEPT. OF COMMUNITY DEVELOPMENT 1
PERMIT NUMBER 8(-6 _ 059/ i
ADDRESS 2-012
S 30 24-,d p L
PLANS FOAL j
i
OWNER ----:- ri,,----„
DATE SUBMITTED dj-�'� DATE APPROVED_
APPROVED BY �� il,4T
SL
k 71 `
/VcK )/