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G City of Federal Way
vvFlY ErzR� APPLICATION FOR BUILDING PERMIT
GiTBOF FEDERAL A
UIDEPT. / n
0
PLEASE PRINT APPLICATION #: /5 PZ:D< — 77
SITE LOCATION Address /2- !
.j`f�l` S cde_r- Sit./ j' `edi ( RA . 9802-3
Tenantt/,{�(if//known) /A` . (s-n...f.2.) Lot # '2J AssessoS.ss Tax #
/ /2; ,
/ �-�- , A
`rte /`I _ ✓ ".i, --. G,.?4:1
Building Ovyner Name ,' N f✓ ,DAddress
City --0E,14,a_/ LSetat (/f/�, Zip vU�-j Phone 6,4j/- G 7 3.�
Nature of Work A• jj ( U� -
APPLICANT
Name (F,M,L)
/A-l'31-> SA-V1 D 6 ise'•-• IN44-6r0 ;FP_
Address
3q 4I/ 2- /S L6-` ,$/�li
City 'l f State r,_- j . Zip *00 2-3
Cont ct Person Day Phone i Other Phone Fax
�-1q.y A/04-7 ��/ �3-. 6.6/ -673s' h
BUILDING CONTRACTOR
Company Name _/i'—\ �` Oda J
�
Address
34-i 7 la / U� s AL-/
City .r.-x-72...e.fyi,A-( State 4/...,,ele . Zip -16 oz-T
Contact Person 1� . 440, Phor w.^ 6 7_� Fax es
Contractor's # (card must be presenteQ) Expiration Date Verified ❑ Yes C No
O74/Y2 [3///'/A4-1--- 14-790) $7 n-, -
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION '9
Please Complete Reverse Side
CD0492 IR 4/931
STRUCTURE (existing Use xifJ fo;osed Use S/171/1✓
Permit includes: La—Building 31---Plumbing (7d—Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ 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 sq ft Garage sq ft Proposed Total Area sq ft
Water Availability Sewer Availability L - On-Site Septic System Availability ❑ Project Valuation $
Zoning /t zJ Lot Size f'72, 52' ry` Existing Bldg Valuation $ , j/�L(J,:
,..1-1 G �
LENDER
Name I A _ Address
i
City L State Zip
MECHANICAL CONTRACTOR
Contractor Name �r tv� 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 Z Urinals t V Lawn Sprinklers *–
Bathtubs Dish Washers -- Drinking Fountains Other
Showers Electric Water Heaters Sumps r
. ........................
Lavatories Washing Machine Drains • Total Fixture Count
MECHANICAL UNIT COUNT 4. d - MECHANICAL VALUATION 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 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 1 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• 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: /
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SETBACKS.a FOOTINGS .
Date 75-0-5-4k:, By v,--- dLi•",/. A4-r4'
............. ............ .....................
......... ................................ .......... ..................
FOUNDATION:M.
Date By
PLUMBING GROUIII RK.
Date By
UNDERFLOOR FRAMING
Date 47-5-9.‘ • By /1-74/
SHEAR WALLS
Date 5 'G �j By
PLUMBING ROUGH:IN
Date �7 (-4( By
GAS PIPING
/(/4 (g By ,r /
Date ( /.,
MECHANICAL ROUGH-IN
—
Date -7 ( ,6 (/9 By
MECHANICAL {OTHER)
Date i�' By
FRAMING
Date 1---(,--g to By
•
INSULATION:
Date . ;3_ 94 By
GWB - 1ST LAYER
Date /�- tI By
GWB 2ND LAYER
Date By
SUSPENDED:CEILING
—
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL.
Date By
FIRE FINAL
Date By
7 '!7 L
7BUILDING FINAL LC%� iY(i 0k--p .-- `� Gr /LTi r�' IA We r
Date -,?‘ - • By
OTHER
Date By
OTHER
Date By
CDO193