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SETBACKS& FOOTINGS
Date By
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FOUNDATIONWALLS
Date By
PLUMBING GROUNDWORK:
Date By
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UNDERFLOOR FRAMING
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH;:IN
Date By
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•
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GAS PIPINi"a:;.
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL(OTHER]
Date By
................................................... ............................
•
•
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Date By
INSULATION
Date By
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 FFIINAL /
Date
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OTHER //--
Date By
OTHER
Date By
CD0193
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City of Federal Way •
r
Frz�
NW ' APPY TION FOR BUILDING PERMIT
CITY
SEPOF FEDE 13 1995
R
. . REVIEWED UNDER 1994 UBC
PLEASE PRINT BUILDING DEPT AY APPLICATION #: 07 C..[c
SITE LOCATIONI Address a 1 6 H. A E �+ Lk)
Tenant (if known) Lot # d Assessor's Tax #
114n nni S E-.EF AcbeK m4. \i_ 4 S 0/04(50-
Building Owner Name Address
SAME S 6 k4 Av€ 5,w,
City t-E QeQq L +NState t-4.7 A. Zip R$Da 3 Phone $ .C49 5'b
Nature of Work REC Rat, ['��e. 1
APPLICANT
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUILDING CONTRACTOR
Company Name
A001-<CE .fiIwin NG CL
Address
?e O. Sox c9i
City State [.cyA 'Zip c 33b
-.7153
Contact Person Phone Fax
LOA t.T 2 c 77— 1,165- X17 - 433 t
Contractor's # (card must be r-esented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT
{4ama
Address
City State — - Zip
Contact Person Phone —`
LEGAL DESCRIPTION
A-6- b .e_ 4(zoo \VISI 13
•
Please Complete Reverse Side
CD0492(Rev 4/93(
STRUCTURE ting Use .je (t posed Use
Permit includes: L Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units _ A' Deck
❑ Commercial ❑ Addition ❑ Garage CI Shed CI 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 4,OS" sq ft
Water Availability $Y Sewer Availability [1 On-Site Septic System Availability ❑ Project Valuation $ 11.( 00Ob
Zoning /,_,1 )_ `./'5'i1 Lot Size 4:— -..'.4" Existing Bldg Valuation $ (7f coo
/ t /l i �
LENDER s.;. i.7 ,
Name Address
•
City -. State Zip " . .
MECHANICAL CONTRACTOR ,
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 AXE 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:COUNT:
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 Burpr Duct Work ' 0-3 Tons Underground
BBQ'/ 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'fear-irreurred 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 wherersuch claim`aI�'rises 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/Agent: a Date: _ w.n /4' /99