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01/05/98 MON 09:15 FAX 2536614129 CITY OF FEDERAL WAY 01002
caloF 11110 • BUILDING DIVISION
E 33530 FlWay South
ejr3Federal Way,WA 98003
(253)661-4000
EC E i Fax(253)661-4129
JAN 2 3 1998APPLICATION FOR BUILDING PERMIT
I7Y t7F
F FEDERAL WAY'
PLEA EPAl4:Ai PAPPLICATION# �, O"0033
x *. .a:. .ice�
s m` a: 'fte1443 a s~ `^`��`�''"0 Address 2 0 8 2, 1 Po.c f � H igJkw,Ny So 4+111
Tenant(if known) Lot# Assa or's T #
R 5 7 Enterpt'ises x)77l0(A-C1UZt{
Building Owner's Name Address
City Federal W0./ I State WA ma q 700 3 Phone
Nature of Work T i re_ D O Q, 12..e..eck
;( (BO k To Orit,o.� Go-a—r tytrs#' r%)
Name(F,M,L)
Co-wri-e. Gid Gr..1Y"c C< C't/� ( � - l•S1"3 J\ -
Address
City
State Zip
Contact Person Day Phone Other Phone Fax
Company Name t
N c/Nor-14-1 � 0.
WeVw10.ge. ResI'orOTtOn Go.
Address
$2 11 Att,rora, Avenue Nor In
City Sea. k. state WA ,Zip 48/05
Contact Parson / Phone
h V1I 206-706-7600 Fax 206-106-9 q9
Contractor's #(card must be presented) NORT H DRo3o M2 Expiration Date Verified ❑ Yes 0 No
001�i:t•?>..Aki.WARTIOfib,"L>,.,.�...�.�.�,.
Name
Address
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION � �
Pet rce.A IN�r ttiwtiF"ee : O82lO4-`i021f
Please Complete Reverse Side
ng
Use i
c
osed Use
Permit includes: 0 Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New 0 Remodel 0 Number of Units_ 0 Deck
0 Commercial 0 Addition 0 Garage 0 Shed 0 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 0 Sewer Availabilit 0 On-Site Septic System Availability 0 Project Valuation $ (0.0,0 )
Zoning I Lot Size Existing Bldg Valuation $
..........................................................................................
Name j\j
x Address
City State Zip
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Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
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Contractor Name Address
City State Zip '
Contact Phone Fax I
License # Expiration Date Verified 0 Yes 0 No
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Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
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Lavatories Washing Machine Drains notal.:Fixture:Gount....:: '
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ECRN.C. L.SIN T.UUNE ......... ,. MECHANICAL EVALUATION ONLY $ , .(ICo 4-(0.0,3(t
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
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BBQ's Wood Stoves 3-15 Tons Tataf UnrtCount
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,includin4g its officers and employees,upon the accuracy of the information supplied to the city as a part of this application.
6
Owner/Agent: Date: V2-311 t
BVILDING.APP
REVISED 8/28/97