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98-100351
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CJ) O O .+ H H II !i 0 II II R II Cl1 C3 C3 O in H 'I H I If U 1110 H LP BUILDING DIVISION afOF G 33530 First Way South ' EDEI-ZF7L Federal Way,WA 98003 \ % FIY " r"` i `r-, (253)661-4000 Fax(253)661-4129 AFP 0 4 ; 8 APPLICATION FOR BUILDIN i?,FRMIT PLEASE PRINT APPLICATION # jLL 0()e----)1 :':<2:z€'Address >..i �:..�s��i$nr.:...::::::......:::.:::........: ::::.:..:.:.: 3603 6 ,,4 yE �5u> Tenant(if known) Lot # ^ Assessor's Tax# 302 1011 -9/,-0--041 Building Owner's Name , Address ,' at1-a+.s ti// ie/- 3‘6.03 6Th ME SW City FecA"ci/ Way //[state W25h/I6-if 7'011 Zip �^ 9gr02 3 Phone 2✓r'.�- 3Q.2e/0 Nature of Work (9-CGNGLg e C-c(1,`/./ 'en4 +- r�avio9 cT" D/rivP war APPOCAOirmnimmummumm Name (F,M,L) (labbey �- Gt�twtl� Address 3‘6'6'3 6Th A-VE y,W City Pe Ie' ( W47 Was , State WCc$4. Zip 9102 3 Contact Person / Day Phone Other Phone Fax ucc5ey, 206- 7250 -6880 23-3 -8 313-20/0 UI 111. EVim >"< f~ .INCA�t11VTf�A�Ti�FR..... .:::.:._:.:� Company Name ( wr Address City State Zip Contact Person Phone Fax Contractor's #(card must be presented) Expiration Date Verified ❑ Yes ❑ No ARCHITECT >``;>>': > iNi:M. : :<:> Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION Lel" / m1 Serf PLa1 #ge3©6� Al Recorcied (,intfe✓ ,4��I';-/ers Recor-GI h Jc ' 8y11918o 7-26 X45 (& ',7 c ed By The Sur ve yor`s HeT 74-v.ticti p15 Re t- cIh-5 ' 2 Y/12 ? e.,/g3 K/`vt ft dr.u,vcrty / Wasiak,ten, • Please Complete Reverse Side • ?� Existing UseProposed Use n � ���':LI..........::.:;.;:::.;.:::::::::.::�::.;�:;;:;:.:•.�::.::::.�:::. g S,n�/e �vnl�y ResJ7e5lc/cr��r' �/�LyE Permit includes: liK Building 0 Plumbing ❑ Mechanical 0 Other Type of Work: X Residential 0 New 0 Remodel 0 Number of Units 0 Deck 0 Commercial 0 Addition J83 Garage ❑ Shed 0 Other Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area 3" PO 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 $ M.000 Zoning I Lot Size /6/ r X 32 V i Existing Bldg Valuation $ 2 3 9//&oo '':< >»<'i `:' >`::>'i >>«>' giiiimg LENDE :<>< >>«:>:' Name Address Ex ec r c J i-e- 1-1-a2 use ,. i c.. 7517" Gre-eh wvoei /We City Sec. '/e State W1ai Zip 55 /61 3 MECHANICALMONTRACTORMEEN Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified 0 Yes ❑ No ......................................................................................... ........................................................................................... ................ ....................................................................... ........................................................................................... ................ .................................................................... ......................................................................................... Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No ................................x:i: ..... i::ii....................................... ..... ............................................................................. ........................................................................................ ..... ............................................................................. ....................................................................................... ............................................................................................ Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps ............................................................... ............................................................... ............................................................... ............................................................... Lavatories Washing Machine Drains Total ture.Cotittt : ............................................ i:i:i.................. :::: iii:::........... ....................................................................................... .......................................................................................... ....................................................................................... ........................................................................................ MSM EAN CALAINCtit UN'1'':>:<:<.'': <<> >< 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 TotalAiii t 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,ycl�including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. Owner/Agent: g,ttaig/ 1" � Date: C/ 6/, R[vaEo 8128/97