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(SITE LOCATION Address SW &aCy l ' S}-• (3ss� S\ 3ansk Tenant (if known) Lot # Assessor's Tax # Qu� SA-6L36a•n is _ L33t03 qO) S c5% Building Owner Name Address eAt4.5 .\\ NGy\- s t ��4 1'. t(�� ls� ice, So City .ced4.��)� State ` ` 1; Zip ggo�3 Phone CILI .. A� �' Nature of Work \\ `C.�`t `P4 C\iS 1 ,APPLICANT Name (F,M,L) Address 3vt11\- �\ -Avc ,, VQ) . �Y 1-kA1-VA City _troy\ WO,?t State Zip CACr:C'13 Contact Person Day Phone Other Phone Fax �V 9y1- SES c1310 BUILDING CONTRACTOR Company Name Address • City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No ARCHITECT it4,,A Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION THAT PORTION OF THE NORTHWEST 1/4 OF THE NORTHWEST 1/4 OF SECTION 13 , TOWNSHIP 21 NORTH, RANGE 3 EAST, W.M. , IN KING COUNTY, WASHINGTON, DESCRIBED AS FOLLOWS: BEGINNING AT THE INTERSECTION OF THE WESTERLY LINE OF SAID - SUBDIVISION WITH THE NORTHERLY MARGIN OF S.W. 320TH STREET; THENCE _ NORTH 1' 45' 46" EAST ALONG SAID WESTERLY LINE 60. 00 FEET; THENCE SOUTH 88' 14 ' 14" EAST 165. 00 FEET; THENCE SOUTH 1' 45'46" WEST TO _ SAID NORTHERLY MARGIN; THENCE WESTERLY ALONG SAID MARGIN TO THE POINT OF BEGINNING. Please Complete Reverse Side CD0492(Rev 4/93) STRUCTURE •Istin Use C_'��C,, Q �`TriI kQ r Proposed Used Permit includes: Li Building ]R ❑l Plumbing Mechanical ❑ Other Type of Work: ❑ Residential ❑ New 11 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 LitCYS sq ft Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area Sayy\.Q,� sq ft Water Availability Sewer Availability On-Site Septic System Availability ❑ Project Valuation $ L,.� b,DO Zoning ©O Lot Size ' �,1 S 'T"Tr Existing Bldg Valuation $ R 4nQQ LENDER N'-P.i Name Address • City State Zip MECHANICAL CONTRACTOR N l b\ 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 NI I •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 (e 1, \.. 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 a Miscellaneous ` Pu Fuel tanks Gas Hwt Hood 4iliellew tjwkYtrS eZ 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 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 c aim 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. \ J.- • LAOwner/Agent: Date: \_\\ \c\ -_ ... .a, 1OZ1> tT 'TtWC� o c-> "" h �a w ncr+ -naE -n , -. pn -. w } ! 1 2) 0 © 0' CD W1-i r.. rn N' ' 3A as w d aC• ,�gyr C • * L"I < 6 g Et -r Y i .;.1. .4 -n w -n r..� M. 7"1".1. 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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 I GWB- 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