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•
• . BUILDING DIVISION
GCri33530 First Way South
Federal Way,WA 98003
�� F=AY (253)661-4000
: G j Fax(253)661-4129
dc_, 11 1998
APPLICATION FOR BUILDING PERMIT
,I.,ethlo NG OEC
PLEASE PRINT APPLICATION # 61_,: -00 6)`
illllllllLOCATION :.>;:::.>:x::::.::.:.;;:.:.:.:.;>;; ::>:>::.: dress ..5Aroe a..S 6e 104,0
Tenant(if known) Lot# Assessor's Tax#
Building Owner's Name CoAddress - 11
/ -.
Zte.Y'el brise( c-=eyer hett4ser (-4_,col S
City FGdera,/ et y I State W a_ Zip 9 hobo 3 Phone y, `%--(o 6 13
Nature of Work Diflittlf av4 - ► 1+ U4) v
Name (F,M,L)
UCLA n q 60-C.` I1 -Tr C ,
Address
131 O c Or o S-'ori i2 d
City i,t..r'tt n e V State CA.. y< Zip 9 '39O
Contact Person , , Day Phone Other Phone
5-61 mASb Z s 3 �1� 3 y r/S S Fax � 3 - 31l
iL .INC40.NIRAZIVA.::::.:::.:::.;:.;;:.;:<.:.;:.;:.;:.
Company Name
1`}e"1 C. G. 5 CL p P)r C AtAA
Address
City
State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
ABetirrEGTMENiMiiMiMMEN
Name
Address
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
P
1' f)
Please Complete Reverse Side V,S,
istin Use •roposed Use
::.............
Permit includes: 0 Building ❑ Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New ❑ Remodel ❑ Number of Units_ 0 Deck
❑-Commercial 0 Addition ❑ 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 0 On-Site Septic System Availability 0 �" Project Valuation $ /Q )u v
Zoning Lot Size Existing Bldg Valuation $
LENDER..m »? ><>mgmm » < <><»'«<
Name Address
City State Zip
............................................................................................
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
........................... .........................................................
........................................................................................
........................... .........................................................
........................................................................................
................ ......... ........................................................
..........................................................................................
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
.............................................................. .......................:
ii
PLUM I NtG`>I*I.:> >:z::.. GUN z`?'?'s':'<<>' 3>#
�... .f�Iw.C.....AIT.....:.................
............................................................................................
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
...............................................................
...............................................................
...............................................................
Lavatories Washing Machine Drains Tni:aiixttrre Giiint
..........................................................................................
.. ........... .................. .. ............... ..............................
..........................................................................................
0.Ec A i A`tm. treo..uNr ?':>>m 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 Wood Stoves 3-15 Tons :Total Uriit Cnuti:iii »>:;;:z'i i »:;»»>
...... .....................................................
DIS CLAIMER: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: "1/___.../ Date:RDILDING.APP
REVISED 8/26/97