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A CU CD J tl C--• C O E- in L CO 1=I O Cl) o o If Ii A > W V 40-4 CCC >7- ..r) V it CO o CC .2¢ a ¢ n = w w f-•i CO Qj if) Q 0 a:: A it it as 1- U co .. C-- .. O CD U aD CD cc co !t CIC V Z V00 LZ N Ci £L m .. .. . ... n :x•...__.......•_+....�.,.._...... ...•^...._® ,... ..-.....,.»,_........._.......^,.....,,.4.m,4, �r.e . ,c> 1111111dllo •tips•, - BUILDING DIVISION «rroF 33530 First Way South —•- Fn1_ Federal Way,WA 98003 vV �Y (253)661-4000 Fax(253)661-4129 APPLICATION FOR BUILDING PERMIT PLEASE PR/NT APPLICATION # .B r C 1 7 ddress r I_' Tenant(if known) Lot# Assessor's Tax# Buildin ligisniner's Name Addressa��i- AO+� 14 City Pt-CAt /L i/� Ay p Stlite ul,]a _ Zip itc 7.,, Phone 2i bin— c3ci—i%1 Nature of Work �ltelW(V rl;2�ir Name (F,M,L) Address City State Zip Contact Person Day Phone Other Phone Fax :;I_L 1N ONTRACTO�Miiii > ': e I Company Name fal Address City > .f .k v 4- State LA A Zip el t02.4i Contact Person Ve V:" �� A g N4DC` C .2 .--3i 1-(274(0 425ST7^ !�1 Contractor's #(card must be presented) lT Expiration Date Verified 0 Yes 0 No ;MRC.... C'I'.............................................................. ............................................................................................ Name i [ ,, ,� �/� 'VSsr.Jl 1. -Yl_.Q Y�"fL. ( .A-,....fG 'q.. s -,,..cf.,_ Address �City `\ IZ_%-'ds- State LAINA Zip 1 vobi. Contact Person 4)t'%.1 V �1Pho (jilt-3G41.r Fax _ � 28 1a lG� LEGAL DESCRIPTION • Please Complete Reverse Side i $Til 1101gib li .::• :::: :.::•:•:•;: •.:•;:;;>:•>:;::.:;::;::< >.::::::: xisting Use I Proposed Use Permit includes: 0 Building 0 Plumbing 0 Mechanical 0 Other Type of Work: fic Residential 0 New 0 Remodel 0 Number of Units_ 0 Deck 0 Commercial 0 Addition 0 Garage 0 Shed Other '24-.4j102/441 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 $ij Zoning Lot Size Existing Bldg Valuation $ Name Address City State Zip Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No PLt1M BWM4ONTRACTORMEEMEM 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 Fiittrre Count 5:ii: `:i*iilVIMH.ANICALMNI '::<::: y::: :::...:. 'ii 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 Tota(Unit Count: 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 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. OwnerlAgen3 ��X.-- ' • Date: ��( Pg BUILD NG.APP REVMED 8126/97 I