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SETBACKS& FOOTINGS
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
GWB 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
.................................................................... ..
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL;
Date 5-if- By {wry
OTHER
Date By
OTHER
Date By
CD0193
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Q, RECEIVED
G City of Federal Way
APR 101995
NS FPI/Erzra� APPLICATION FOR BUILDING PERMIT
CITY
FEG EPT AY
PLEASE PR/NT
APPLICATION #:sLLD q5_0 C t -O
SITE LOCATION Address `q Z.& it...0*.----- bly ,"5'A/
Tenant (if known) Lot # Assessor's Tax #
F — b 'fJ r
Building Owner Nam 2 Address
it,-- _ /c47/0.---7)a-fl .....-"X
Cityc/' �j State . Q__, PhYl Qd O c,`— 4_4/
Nature of Work �/V::
APPLICANT
Name (F, ,L) , ie_i(...,,,_X.
Addres
-1'4 „.it i
City /'4j7.��` �L State j d. Zip 7 f�,g,-..z.,
Contact Person Day Phone Other Phone Fax
,f d . 3 2 6 Q_,/I
BUILDING CONTRACTOR
Company Name
Address
City St Zip
Contact Person• Phone Fax
'
Contractor's J4(cardmust be presented) Expiration Date Verified ❑ Yes ❑ No
.--
/'-
///
7
ARCHITECT i'
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTIOk
Please Complete Reverse Side
CD0492(Rev 4/93)
STRUCTURE •iStin9 Use V ��raposed Use
Permit includes: ❑ Building Plumbing ❑ Mechanical ❑ Other
Type of Work: Residential ❑ New ❑ 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, ❑ , Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation $
Zoning. , , $ Lot Size Existing Bldg Valuation $
LENDER
Na� Address
City \ State .„,,..-1-Zifc
------------ p
--\
MECHANICAL-CONTRACTOR i
Contractor Name Address
City State Zip
Contact `� Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOXt
Contractor Name Address .
City State Zip--
Contact / Phone Fax
Lice Expiration Date Verified ❑ Yes `
e # 10 Nom
L i l6AS
PLUMBING FIXTURE COUNT 110 h
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains TotalFixturesCvun >:_...... ..._..;
................................................................
...............................................................
................................... ................ ..............................
..................... ................................................... ............
MECHANICAL UNIT;COUNT:.;:P:::..:......:
Fui' p (electric/other) Gas Dryer Air Handling <_:73_,J 0,000 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 od „„. ` - _ Boilers Above Ground
Cony Burner Duct Work -O-3-Tons Underground
B __— Wood Stoves 3-15 Tons -- - &4r ii 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 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/Agent: ; ' -! k. Date: ////4 S
,