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A8 alea >ta+ snaNrl4s �'JNEOWnId ...........>:.................................................................... 1 -^ -- A8 oleo $13HM NOI1 tfE1.... % A8 SJNI LO(1� '$ S �a813S ....................................................... ....................................................... ....................................................... ....................................................... BUILDING DIVISION crrY of G . 33530 First Way South Federal Way, WA 98003 uv �y (253)661-4000 4QQi Fax (253) 661-4129 f�g"('Y L7s ('fyiJ�.F:ria_TvliS APPLICATION FOR ~SBUILDING PERMIT PLEASEPRINT APPLICATION # 1� `Y ��� ` 0 `i d ess «<»> Ad r A A.l .:::: vvv;:ii+:'ii.'yjj? ;. ;.; .?:{ i!}:::::?::::?::...... ,v'. r I Tenant (if known) r� �� r Lot # k (: S )� Sd23 Ase or' a # 7 Building Owner's Name J 011 a_ -A d L I t-,- / 9 it r-Address3 � ' Ci � � � , S cl Cit jr" n State W A i Zi j Z Phone -Z S - cj 3 �l q6 Nature of Work nlrll iJ v-v1A Y1 IAA -d1 (,A_r:? A in A ✓V) p w � � I/1 -� i"l_1T Q_ 2_ 47 X 40 61jL a C, e_ Name (F,M,L) of e �} . �2_,r z n LA r Address (kA (-rL (� �� � E 417`I C) (r in 0 State "' Zi [ContactPerson , �. r Li State Day Phone 4-s 3 - q5' l-4°)ivyin Other Phone u Fax B#IDIl11C�[tNTR...,.::..:.:..:..::...,......... Company Name Ovv el e r C a -Y4 ra t-I4r Address ^_,( „ � C o S J � 0 Cit Fax State Zi Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No ............................................................................................ ........................................................................................... ............................................................................................ ........................................................................................... ............................................................................................ ........................................................................................... Name n V Address City State Zi Contact Person Phone Fax LEGAL DESCRIPTION Please Complete Reverse Side r1 ....?.�r AE: ...::::.:......:::::........:::::::::::::::::::•::::.::. Existin Use g �/I o�- Zi Proposed Use IV Permit includes: Luilcling License # ❑ Plumbing Verified ❑ Yes ❑ No ❑ Mechanical ❑ Other Type of Work: Residential ❑ New ❑ Remodel Fans ❑ Number of Units _ ❑ Deck ❑ mmercial ❑ Addition Hood ❑ Garage Above Ground ❑ Shed ❑ Other / Enter 1 st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft Area Basement sq ft Decks *Uqj.sq ft Garage sq ft Proposed Total Area c- C% s q ft Water Availability Sewer Availabilit On -Site Septic System Availability ❑ Project Valuation $ Zonin Lot Size i Existing 61Valuation $ (Jv 21 -vii I� l��trff ftv2L1 } Name Address State Contractor Name Address City State Zi Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No Contractor Name Address City State Zi Contact Phone Fax License # ----Expiration Date Verified ❑ Yes ❑ No ...:... FYI...8. S,I!„7„t�TV--UFN..: .. Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories WashingMachine Drains Total fixture Goutrt.....: 771 11RCHANLC...E<,.N...Cf)U>11......................... MECHANICAL EVALUATION ONLY $ DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and ;orrect to the best of my knowledge, and further, that I am authorized by the owner 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 (including costs, expenses, and attomeys' fees incurred in investigition and defense of such claim), which may be made by any person, including the undersigned, and Sled against the City of Federal Way, but only where such claim arises out of 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. Owner/Agent: Date: 7 BVIIDI-AW REMED 6/28/97 Fuel TVpe (electric/other) Gas DrVer 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 Conv Burner Duct Work 0-3 Tons Underground BBQ's Wood Stoves 3-15 Tons _ ... Totg1..►Jrut Cauit DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and ;orrect to the best of my knowledge, and further, that I am authorized by the owner 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 (including costs, expenses, and attomeys' fees incurred in investigition and defense of such claim), which may be made by any person, including the undersigned, and Sled against the City of Federal Way, but only where such claim arises out of 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. Owner/Agent: Date: 7 BVIIDI-AW REMED 6/28/97