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SETBACKS & FOOT'iNGS
0 i
Date By
FOUNDATION WALLS
Date By
.................................................................................
PLUMBING:GROUNDWORK.
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS
Date By
.................................................................................
...................................................... ..................
.................................................................................
PLUMBING ROUGH:-IN
Date By
GAS(PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1ST LAYER
Date By
rniiiiGWB>- 2ND LAYER
Date By
SUSPENDED CEILING •
Date By
PLANNING FINAL
........................ .......... . ..... ..
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL /f)// /Z/S'//c67
Date 1 ? By----i
OTHER 'l
Date By
OTHER
Date By
CD0193
RECEIVED_
•
�,� 0 City of Federal Way
EDEJ NUG261996
W APPLICATION FOR BUILDING PERMIT
iTY OF FEDERAL WAY
Dt �n"' 1 BUILDING DEPT,
A.
PLEASE PRINT APPLICATION #: V� il Y CP — 05"'v
SITZ: LOCATION Address 319, rI 1).:444. f L _qd
1 Tenant (if known) l Lot # Assessor's Tax #
45 ii-agYGoOr?
Building Owner Name Address
tit ', tc Li Li rtiri v
��--, +.`
City t 1[1'E UY. State 03 Zip Phone (S,4)(3w"'7NL
Nature of Work Ail i-bcy) 4t&ic._ if] 0Ctrij_k,
APPLICANT
Name (F,M,L)
N(-t K.iiiu K i N1
Address
31911I>` 1 Pt,. -5(0
City Fedelg UJI'&l State 4 Zip 9f30) )
Contact Person Day Phone Other Phone Fax
(. c )N4 724(, C,rc ie44-9190 .
.......... ................. .
BUILDING CONTRACTOR
Company Name
CJ W V wI
Address N/114 City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECTI
Name
Address
N/4
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
• r,y,,�
.5*-- (2_„(9--/ ,—.41- 7?-1-,.9-tc_s file,se_ 2L-- &C7 0 71( e.) ,...r--c-D
Please Complete Reverse Side
CD0492(Rev 4/93)
STRUCTURE 1sting Use 5((L oposed Use F\1 G
Permit includes: Building ❑ Plumbing Mechanical El Ot r
Type of Work: R Residential ❑ New El 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 lI Sewer Availability L On-Site Septic System Availability U Project Valuation $ 1., 0406
Zoning it. 5- '7- 2--- CS-)C/5) Lot Size A 2-6,,f- Existing Bldg Valuation $ r2)6
6 Z)
LENDER
Name / Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name !Address
City State Zip
Contact ,�f � Phone Fax
License # ///%'t/` Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name / Address
A
City 'State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets /� Sinks Urinals Lawn Sprinklers
Bathtubs
N/4 f�' Dish Washers Drinking Fountains Other
Showers 1! ` Electric Water Heaters Sumps
Lavatories i;mashing Machine 'Drains Total FixtureCount
MECHANICAL UNIT COUNT 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 BTUsGas Log Unit Heater 50+ Tons
Furn >100 BTUs
NIA-'
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: 1 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/Agen `� Date: Of?,t (414