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I-+ \ '0 do, 'OE A • �__.____ �. __ l U • • RIVED City of Federal Way JUN 2 71994 APPLICATION FOR BUILDING PERMIT dl f Y OF FE[ LrtAL WAY BUILDING DEPT. PLEASE PRINT APPLICATION ft: 13 L(...9q "0 L/ 7b SITE.L CATION • Address :11y, SW 9/ I 57, Tenant (if known) Lot# Assessor's Tax# Fnsc Jai,* ze).* .:sem Co2D 531-4/512 Building Owner Name Address City State Zip Phone Nature of Work yC75 /..// P 1 j COS ity 8a7 Name (F,M,L) CEJ/// Address 2 / 9/1ZZ. City �Zp//feva L4 ` AtoState Q Zip 9 Contact:7w Day Phone //' // Other Phone Fax ATALD*4 COtiTRA,CTO# Company Name ;'1 & 4'�,�� .5��4/%is Address City /1?(,//e ' State/Zia Zip ,9;5,6,s65,— Contact Person Phone J 7? C'�/�:/// //00 Fax Contractor's # (card must be presented) Expiratiop DateVerified El Yes El No P,rn� Sc�-4 Y /e2/02e)/9V ARCHITEG' Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION �C'vQ1 02.5" --efof ©t" Pe- 4 y>cs / st f Please Complete Reverse Side C00492(Rev 4/931 [ RUCTi' E g Use o "Posed Use Permit includes: ❑ Building ❑ Plumbing ' I Mechanical ❑ Other Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck ❑ Commercial LI 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 sq ft Garage sq ft Proposed Total Area sq ft Water Availability F7 Sewer Availability ❑ On-Site Septic System Availability © Project Valuation $ ::,.'':6;;'':> Zoning Lot Size ExistingBld Valuation :,� :.:<: : Y.PN...DLR. ii i;i; . Name Address City State Zip MECHANICAL CONT CTOR`'>:: ::::< 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 Unttt 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. Owner/Agent: Date: