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r02/10/99 WED 14:46 FAX 2536614129 CITY OF FEDERAL WAY CI00`
�� • • • BUILDINGDIVISION
error G 33530 First Way South
013EriAL Fcdecal Way,WA 98003
HY (253)6614000
Fax(253)661-4129
41
X11 , .ICATIGN FOR BUILDING PERMIT
PLEASE PRINT --t '-
:WNz'00 . APPLICATION, P.Rsc -I - m ,c
L,v FE, :>�q,t €r � Gr �. ' u aadreae l�fC.'b t• 3.0 5�. . - . � 4
Tenant(if known) -Lt� `4.0 5 ILA A I co— Let# Assessor's Tax#
Building owner's Name]� `J Address
City State Z I Phone
Nature of work ' 9 • {tet• '
,: :.. teiM,?" 7r`. tan 'r r`�t3`7
^"1 •y is • r r,.. crr xx3..
µp�.g
Name (F.M,L) j/aj/ „ p - ?,,, jtm fri`
Address l• VU�f d``���
Cit State z-
Contact Perec Army Dam P anep�-Q p.5_ other Phone Fax
v� FSDIRALH NE LICENSE 4 I
:°l'R..,1'. ,. ,.3"Y .:., $` \y,r:< 7 f^ WAY IISI SS
Company Name
X1 Addreae —
City State Zp
Contact Person Phone Fax
Contractor's 0(card must be presented) Expiration Date Verified 0 Yee 0 No
Vitli7^ ' . x. j7— s �.iF R. f .:y6
Name
Address
City State Zap
Contact Person Phone Fax
LEGAL DESCRIPTION
pleest Complete Rey.,r• - :1. _ ._.
a. 02.110/99 WED 14:47 FAX 2536614 9 CITY OF FEDERAL WAY la003
t_,:. e,-1;;.-,:iit-.c-: f . ?
; ".4.E Existing Use� Proposed Use
Permit includes: 0 Building ❑ Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New 0 Remodel 0 Number of Units 0 Deck
❑ Commercial ❑ AddItion 0 Gam.* 0 Shed 0 Other
Enter let Floor eq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement aq ft Decks eq ft Garage sq ft Proposed Total Area eq ft
Water Availability 0 Sewer Availebiiit 0 On•Site Septic System Availability 0 ArrItellftl 8 % Z -
Zoning Lot Size , Existingilia Valuation ,$
•
NameAddreae
CityState
Y s JLM\4 /
Contractor Name Address
City State f-- Zp
Contact Phone Fax
License# •iretionData Verified 0 Yee 0 No
IG is'l `f••,5 k�,, r:•1 f '�- F :.� ' .w,�".D3:ia T t ,,• .• &I
1.
Contractor Name Addr
C)P\
City State Zp _
Contact Phone Fax
License# Expiration Date Verified 0 Yes 13 No
n., s F..,,S;R 9 R ?q
cKo; n ': i' P:'k I:`,.,>:,',4,,.:.Y• .i 1.?. -x3"
Water Closets Sinks Urinals_ Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other _
Showers _ _ Eleotilo'tiNeter Heaters _ Sumas _
Lavatories
Witching Machine Drains T iiMaa>�ip ,n n
..zrs`- .,.., sQ3n: • 4w;h,c:-,R.R , K.'.1 e:c
` � ;t`Y `fsk; Y MECHANICAL EVALUATION ONLY $
Fuel Type(electric/other) �.�'� Gas Dryer Air Handling < = 10,000 CFM 16-30 Tons •t
Len• h of Gas Pi•in• - Ren•.a Air Hendlin. > = 10 000 CFM 30-50 Tone
Furn <10OK BTUs /f Gas Log • Unit Heater _-_ 50+ Tone
Furn 100BTUs '� Fans Miscellaneous _ Fuel Tanks •
Gas Hwt /! Hood Boilers Above Ground
Cony Burngr Duet Work 0-3 Tong Underground i
BEM's,/ Wood Staves 3-15 Tones ¢]"p:[s. �t i4:`'
DISCLAIMER:I certify under penalty of perjury that the information furnished by me is au a and correct to the best of my knowledge.and further.that I am authorised bythe cane of
the above premises to perforin the work for which permit application is made.I further agree to save harmless the City of Federal Way as to any claim(mcluding costs,expenses,and
encamp'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 Fedatil Way.but only
where such claim aria=out oldie
�reliance ofthe city,including its offices and employees,upon the accuracy of the information supplied to the city as a past ofthis application.
•
Owner/Agent: /L"w"r/�- Date: JL h ...T_____.--
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