97-104236 BUILDING DIVISION
IR E.(-;,...,
EIVED 33530 First Way South
• Federal Way,WA 98003
c;i,y u r..`Ecz's OE 1-71 AL WA (253)661-4000
IO/ 2 o 1997 Fax(253)661-4129
BUILDING DEPT. Y
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #
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sogoommegannowszesm Address .2,5--' ‘.-5-- ST .c-4:71/C. Zd--K-e--6-/ C"- ("/— fr/it.,..,.-7`", ":
Tenant(if known) ( i 2 —
Lot# -- /
,-; Assessor's Tax#
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Building Owner's Name' Address . -- .-
Ce,147e ' &coo e-1 .16,41(---04'
City State IA / ' Zip 79-:.-. .3"--. / PhoneitS3),57Z/
Nature of Work - „. , .‘„ 77'', . 4,-., /./;-V
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Contact Person Day Phone Other Phone Fax
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Company Name
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State ,-/:'..4" Zip -?e5/ 73
Contact PersonPhone Fax\
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Contractor's #(card must13,epresene6,:7
tedl Expiration Date, Verified 0 Yes 0 No
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Name
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Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
>� Existing F
tin Use
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Permit includes: 0 Building `p 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 Availability ® On-Site Septic System Availability 0 Project Valuation S 7--?0e)
Zoning I Lot Size Existing Bldg Valuation $
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IIII~CHAIIICA <Ct ... :,_., i:.?:.`:>z<s># '.>'.
Contractor Name I Address
City State Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUMBING:: IX<t' :::CON<'::::<:::::::::::i:i......
Water Closets
Co 1 Sinks /t) Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
» .Lavatories tal�ixxuceGaurf> > <:g:
MECH#....IAI... N ':CCI> N'I':.:::................... MECHANICAL EVALUATION ONLY $
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 Qs
Wood Stoves -
3 15 Tons
t lin t4n..nt::;::: ; :»:`:==::><»<::;:<::
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 applicatio ' 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 cla'• ,whic ay 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,incl •mg its offi> and employees,upon the accuracy of the information supplied to the city as a part of this application.
Owner/Agent: / - %!/. �/� Date: /Z / /�
BUIIDING.APP
ROMEO 13t28/97 v'
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