02-101459 • • •
. Federal Way •
c'rT Ce REC
•
APPLICATION FOR BUILDING PERMIT
APR 0 8 2002
PLEASE PR/NT CITY OF FEDERAL WAY
LDING DEPT. . _ � �
�Ii4LOOATIOl Q�,� APPLICATION #: � / lgs5g
Address .2(fit/ W 39 Tenant(if(if known)
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0 Assessor's Tax #
Building Owner Name +_ 3 O
Com Ull ��o Address
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Nature of Work Phone
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D 1 a-� .f Verified 0 Yes 0 No
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Please Coma/ete Reverse Side
COOe92(Rev 4/931
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Proposed Use Com/•
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Permit includes: 0 Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New Remodel 0 Number of Units_ 0 Deck •
• 0 Commercial •Addition 0 Garage 0 Shed 0 Other
Enter 1st Floor;Id2 3'lt)aq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area I sq ft
Area Basement sq ft Decks sq ft Garage eq ft Proposed Total Area eq ft
Water Avaiietbiiity 0 Sewer Availability 0 On-Site Septic System Availability0 "<18010`'""0.....''q''
iF:t�'.-.:1.:�t:�ta7wo.tcan>:;jt?2 300
Zoning Lot Size ` X74 #'JQ''BI#i" ....,.,...a:,;v : >?Y /1)4
Name • Address
City State • I Zip
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'S.t: '.::N�y>y:..,Y,Y:,,•/':4; .}iltY vitF .
•
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs • Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories :< 3;'~is,•.:;:; :;%:,.:•:::::...:,,.:..e-,,,.::.,^? -
Washing Machine Drains ' .ieji gx1(ft n:!E hilt:si: i :$ _ :
•
•
1 Fuel Type(electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tors
Ilength of Gas Piping Range Air Handling > _.10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
I Furn >100 BTUsi Fans Miscellaneous Fuel Tanks
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Cony Burner Duct Work 0-3 Tone Underground •
8BQ's Wood Stoves • 3 15 Tons : •,,. . au M:';,:>t inif::til, ;:zr:
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•
DISCt.AIMERt I certify under penalty of perjury that the information furnished by me 1s true and correct to the best of my knowledge and further that 1 am authorized by the owner
of the above premises to perform the work fat-which permit application le made,1 further agree to taw harmless the City of Federal Way as to any claim(including costa,expenses,
and attorneys'fee;incurred in investigation end defense of such claim),which ma be made by any person,including the undersigned,end filed against the City of Faders{Way,
but only where such claim melees out of the reliance of the City,inokidin. ' offi n a..a - -yea„upon the accuracy of the Information eu lied to the
eppllcation. /
ler/Agent: PP City as•part Io'yf this
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I Date: _ 42Cf/ /a0�