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SETBACKS& FO TINGS
Date (� By 4
Ft)UNDATI�11 WAII.�
Date B y
PLI.MBING G,ROUNDWOR.K
Date. By
..................................................................................
UNDERFLOOR FI 4MMIG
Date By
...........:......................................................................
—• WAIS
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
GING '1ST LAYER
Date By
GWB 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
...........................................
Date By
........................................................ .. . . .. .
ENGINEERING FINAL
•
Date By
FIRE.FINAL
Date By
....................... .. . . .
BUILDING FINAL;
Date By
OTHER
Date By
OTHER
Date By
CD0193
•
�n� City of Federal Way RECEIVED
vFUY
- APPLICATION FOR BUILDING PERMIT MAR 1 5 1995
()CITY OF FEDERAL WAY
PLEASE PRINT APPLICATION #:;DL '-1 b 1q...._
SITE LOCATION Address 756 / /4-1/E Z( Wil ,?,z3
Tenant (if known) Lot # { sessor's Tax #
Sr,-79hi / feet- (3ix t, e ; / q` (ofl_,1 -o3
Building Owner Name Address
City -q:;• ¢.yJ/ State f()4-- Zip 9702_3 Phonee.-74-f—/Zee L
Nature of Work 7L7 61,7LC?c
. .... ............................
.................................
..................................
.... ..............................
APPLICANT 'I
Name (F,M,L)
c-T�� A(
Address
3c702-0 /C2 /41l6
City [j,09- Zip c?. 'v? Z 3
Contact Person Day Phone Other Phone Fax
5 :7f 6ZZ-p0-0 (?Y-l2(2 Z
BUILDING CONTRACTOR
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
LCmTECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
T .2 �i 2, k 1 64 J /rMA,/elL, /9 -v/)J7 i-7> . "44,7- i�-/�i2c-zn=
/az o stir 117M(46-. y v---- /6-t-i3 4 3 3‘1; / /Lvr 6,77--- /4htCawty,
S Please Complete Reverse Side
• CD0492(Rev 4/93)
istin Use
STRUCTUI�I+ 9 Proposed Use `'tw �_ 4j)D '
Permit includes: ❑ Building CI Plumbing CI Mechanical ❑ Other ,1
Type of Work: 0 Residential CI New ❑ Remodel CI Number of Units_ ❑ Deck
❑ Commercial lAl- .Addition iEf Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor . sq ft Existing Floor Area sq ft r3, 16
Area Basement sq ft Decks sq ft Garagesq ft Proposed Total Area sq
Water Availability CISewer Availability CI On-Site Septic System Availability 47iProject Valuation $ `-67
f
Zoning ..•(, ].„, j. (0,, Lot Size , ,) / '8,5 Existing Bldg Valuation $d/75 )O
LENDER`'
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PI UMBING CO ITR#CTOR
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 C U.NT
..........................................................................................
.......................................................................................... .
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 Urit.Cottnt;
DISACL IMER: 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 clai a ises o.ut 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: /� / nlikDat / ! C