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^ ���� ����
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Permit triM t`Iv11�-4 ll~.
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
-Plow"Print-
-
eg,x 1 TENANT NAME:
THE PROPERTY IS OWNED BY: 0INGLEIMARRIED _ __—_ PARTNERSHIP__ CORPORATION —
Carcl MUST be 'loci
-- UR--
|MAVEREADCHAPTERi027U{URELAT|NGTUDEF|N)T|ON80FGENtMALC0NTRACTORSANDGPEC|ALTYCON7RACTUAS AND
CHAPTER 1627110 WHICHPROHWTS ISSthN- PERMITS WITHOUT PROOF OF REGISTRATiON.
� ��� _
BOX 3 CONTACT PERSON ����_�' /�^���� __- _ PM
- � . - . '-_
80X4 SE�ERD|�TRi�T ___ --_____� - _ _ _ ___��TERU|STA|CT _ ___� ____
_������_ ' �
BOX 5 ESTIMATED PROJECT COST _______ EXISTING BUILDING VALUATION — _—
BOX 6
__SOX8 PROPERTY TAX ACCOUNT NUMBER ��7�����—L�;Y��yl - --' --
' _ � _ _
LEGAL O[SCR|P[ION _____--___ -__- _____ _ _____
_
If necessary, pease submit a separate page with the |nga| Uoucr(u}oo.>
__. K.C. Plat Recording __� _ ____ .__� _ � __ __ _ . ___.� _ ______
80X7 Bw|LD!MO SQUARE FOOT/WE: (Ex/oumy/pmpnseC) 1ST FLOOR / 2ND FLOOR
__ 3R$ FLOOR L. �__ BASEMENT_ -__L _ DEC _K /- OARAG --_--/-_-____
-_-_-_
BOX 8 ( I 8/NSLEFAWiiY < ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. 8FUNITS = ) ( ) EXISTING STRUCTURE
) COMMERCIAL/INDUSTRIAL __ � _�_�__|NOU�rH|AL TUTA��*�40ppR0PEATY SO FT
,--______-� --__
BOX 9 pI.unoathieFIXTURES(mooing muQn'Ine) mECMAN/CALAPPUANCEQ --BASIC FEE$
NO VwATEFICLuSeT5 GAS PIPING, FEET --__ ________
_DATnTum5 NO. i _FVRNACE. ELEC. _-_G ' ------
�|�VY�K� � GAS ---- $ --'---'
---- $ ___
' uvm*r0R)E3 __CONVERSION BURNER $
-_---S|NKS ______ __BOILER, SIZE BTU $ —
_DISHWASHERS -- ___A|RHANDLING UNITS $ ------
-__ � _����TM\CM�?WATERM�AT�H HEAT PUMPS,--
_'„ LAumonvWASHER CUTLET _--_'--_UNIT HEATERS ' -------
$ --~---~
URINALS _--' A|��V�L|NGUNO'�. G|ZG-_____.
m $
on|mK|NGF0UNT8/NS COMMERCIAL HOOD
$ ~~_
__SUMPS,SPRINKLERVASVVw8HEAKEH� OTHEB
._--_' . __-_ _______ -_-_ $ ___________
DRAINS
- ______ $ -_
OTHER
- _----__-__ - $
TOTAL
_ � -_ -__ _ $ _-' ,
TOTAL MECHANICAL PEE
$ __ .
(CERTIFY uNDER PENALTY OF PERJURY TH AT I HE INFORMATION FURNISHED gY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND FURTHER ThJ I AM AUTHORIZED BN THE OWNER OF THE ABOVE PREMISES TO PERFORM THE'WOMEN WHICH PERMIT APPLICATION IS
MADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCL MINS 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 Or 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,
Owmcn/AsEmT, _�����8��_ ') ---_�� �______DATE: 7.-
����.