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SETBAC)CS & Fi9Q7INGS (i
•
Date By
FOUNDATION WALLS
Date By
PLUMBING GROURII?WORK.
Date By
.......................................................................... ...
........................................................................
.......................................................................
UNDER FLUOR FRAMING
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH IN
Date By
..... ... ........................................................................
..................................................................................
..................................................................................
..................................................................................
QA. SP)PIHIG
Date By
..................................................................................
..................................................................................
..................................................................................
..................................................................................
MECHANICAIL ROUGH-IN
Date By
...................................................................................
..................................................................................
...................................................................................
..................................................................................
ME�MANICAL (OT'HER)
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1ST LAYER
Date By
GWB'- 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING INAL
Date tO t 4 119 By
OTHER
Date By
OTHER
Date By
CD0193
• • • BUILDING DIVISION
33530 First Way South
t; � L Federal Way,WA 98003
(253)
0
BEeIEeV Fax(253)661-4129
� .3 f 1999
Af LICATION FOR BUILDING PERMIT
r.arr9 F C1 DEPT,-
PLEASE PRINT - AL APPLICATION # f7LD6(z -' 051 LI
lwelwatogioninomi Address 7"1i
Tenant(if known) Bpc/ Lot# Assessor's Tax #
Building Owner's Name Address
City State Zip Phone
Nature of Work &X%CA/2 3L4.-rr-t P c7 e'? P/46
WOMANCIENEEMIlinfilli
Name (F,M,L) /'? 7
Address 3(..Dv 412-Y WAV A)1---'City S E---9- L4:= 7 State SA/A- Zip 9>/e. 7
Contact Person 5-c , l Z � Day Phone �Q Other Phone Fax
(� 5(z/ -- 7g 3 7 py r•...194.-2 34. ge35/ ,oL, 5c5 7.2 5 Z
Company Name
Address
City Sc)9'PLZ-- State
WA- Zip ,.'k/c.) 7
Contact Person £ rK,2�43 A
J Phone Fax
® 5 "g 37 Fay 5V57.252_
Contractor's # (card must be presented) Q pA , , AJ v `v w Expiration Dat Verified 0 Yes 0 No
'"[ O 9/02(7/5 S-
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete deverse Side
0 I 1,
Ex's ' U
'�.......UOfI�.::::::::::::.:�::::::::.:_::::::::::::::::::. �::::::.: 9
iUn Use Proposed Use
Permit includes: ❑ Building 0 Plumbing 0 Mechanical Other
Type of Work: 0 Residential 0 New 0 Remodel 0 Number of Units_ 0 Deck
44 Commercial 0 Addition 0 Garage 0 Shed 5 Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement s. ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availabilit 0 Sewer Availabilit, 0 On-Site Septic System Availability 0 ` . Project Valuation $ �.3
Zonin. Lot Size Existing Bldg Valuation $
LENDER' M. .: ``» > :::.i;M' >
Name Address
City State Zip
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes 0 No
:::>:::::::::: i:>:::> : ::: is s:«;:
PUN.'PW
.. .::.. :ENG�"4�1`�'I`�1.�'''1'#�rt«: :' >< `i::::::.......:,.:.. .
Contractor Name Address
f City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
PLUM 13INGMIXTAIReCOUNIVENNO
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps •
...............................................................
Lavatories Washing Machine Drains 7ot61`.Fi)ttvre Geunt
;4.Eel At.IMAL , N.rett.UNIP;i .:,::,:;:.;:.;,,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 Wood Stoves 3-15 Tons Ttytal tlitCnt itat......
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 reliancelof thecity,including� its officers and employees,upon the accuracy of the information supplied to the city as a part of this application.
Owner/Agent: K .,_�J�/.Yt4'(/a---• Date: 7 .,2 /cd--
1311LDING.APP
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