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BUILDING DIVISION
arroi' 33530 First Way South
EDS_ Q icov Federal Way,WAa 98003
Vv FlY (253)661-4000
Fax(253)661-4129
MO 2 7 1998
APPLICATION FOR B L `FERMIT
PLEASE PRINT } q APPLICATION " p O0c
[itir•}Y.C::}:;{::{isi`{}:•:•:°'}).:0'{y�;v..yi:m'.v..:•,�}72''•.h�:'}}{;M.',v�,XfyS �� y+
«i `'M'O a___::>{:<. .'x:..xx . 'S..:.:: ,M_Address
Tenant(if known) 5 kuto Lot# Assessor's Tax It
pivie‘tes5
.....j
0 /919< s >14 £'T
BuildingOwner's Name Address /�
City - 044 W/��L? 1 State (i �'` Zip J 'Pho4e ' 8,1—ct.iro'_.
Nature of Work �i�i�� 6' �.�"'�SZfI'ta✓J .S'�%
Name(F,M,L) `/a 1 " J IJa
\J\
Address Up / /274,0k/45,4
2 %L�.S y ��
- i/74 /)
City -7-1-4/419(f/P-- State gin- zip
Contact Person Day Phone ,,) ,�" _y� Other Phone Fax 6.
Veli 'S" N t' J 7�s3r- ,s----...)o-6,6
ti
MadittottotortniAcittionagivas
Company Name / /p...61.46,),„ (/e.2—__.3"./-, :t<3-,„ ///rI/,//L/1/
J �.rw..,^ / / Gam^,
v Address /�" ..Sv/
//� City 7j�/�`�C,�/(J�l State 0, Zip 6,61/226.‹
Contact Person `i. C Phone Fa
Contractor's#(card must be presented) /3)-.13/4e -, Expiration Date _,b, . Verified
0 Yes 0 No
>-1+ 0 /e,—A,
`ARC HtTE }•,$.,;a:i,:}::f S$> .:x.: 5.aw.. miii...
}:Ux:i.,•nrLi.: f}}}j.::S.M1:iv::•i::•:{:`:in
Name
Address
City State Zip
Contact Person • Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
fia? �!M ".-----"----.)..1121111#.;;11111.11.1.1:11.11111.
fin L{ yt , -, x `
• xisting Use IIIroposed 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 ProposTotal Area sq ft
Water Availability 0 Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation $ , /,';,68 -
Zoning I Lot Size Existing Bldg Valuation $
Name Address
City StateI Zip
Contractor Name 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
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total.Fixturo.Eriti l
M AJCA N .'.COafi k?;; .._ 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 'I 0.tal.f;1t1k'!k',`oullf..:.... ......
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,' • 1,•ng the undersigned,and filed against the City of Federal Way,but only
where su h claim out f the reliance of the city,includ';g its officers and employees,upon th .,• racy of the information supplied-to the city as a part of this application.
Owner/• e Date:J
BUILDING.APP
Revae0&28197