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Z O' U7 Z to O ¢ O W ¢ ¢ ¢ ti G:J V W C9 � CD z LW J J_ Ln I-- 2c W W OC r-•1 O W W Y $ 'S Q cc N 1••.1 W A H O H Q O t cc W 1-4 Y O., t W d l O Q W W x w I - 3K 4' W Q Ln A E O=G J Q O t S € ac iL t� =cc t CFJ O t A I.- t Q a t J i hQ••I ES t EEC ~ I A >= t C'm i f1J N 1 EY t A V t W GQ=C 1 C.m cc t d' fe•1 r'>� � t O S = W { Ie•1 A t W i Ln i Ln t' CJC O H MC a cn o t cc z i r-1 fi ►.•1 .i W Q I-- C9 w a- ¢ ta. s NI --•I O Lw Or k j a W 3C cL a O U J Tenant (if known) q O MBuilding Owner's Name . `'LN -- Cit -i tate W19— Nature of Work (Ari N CL n BUILDING DMSION 33530 First Way South Federal Way, WA 98003 (253) 661-4000 Fax (253) 6614129 Low#� � � �Q � _ � � � I Assessor's Tax # Address j ^•,��`� � C rl Name (F,M,L) Address City State Zi Contact Person Day Phone Other Phone Fax FEDERAL WAY BUSINESS LICENSE # Company Name JL � _G (A 0 &A — Address , n ri 1 C" ulty 04LA 3 fLl vv State Zi Contact Person Phone Fax PC Y) y Contractor's # (card must be presented) Expiration Bate Verified ❑ Yes ❑ No Name Address City State Zi Contact Person Phone Fax LEGAL DESCRIPTION 0 Please Complete Reverse Side .f...i........>..>......:::.:>.:> :::::::::::::: Existin9 Use Proposed sed Use» Contact Phone Permit includes: License # Building L( Plumbing ❑ Mechanical ❑ Other Type of Work: , Residential ❑ Commercial ❑ New ❑ Addition ❑ Remodel ❑ Garage ❑ Number of Units _ ❑ Shed ❑ ❑ Deck Other Enter 1st Floor Area Basement sq ft sq ft 2nd Floor Decks sq ft 3rd Floor sq ft sq ft Garage sq ft Existing Floor Area Proposed Total Area Underground sq ft sq tt Water Availability ❑ Sewer Availabilit ❑ On -Site Septic System Avaiiabilit ❑ Project Valuation $' Zoning Lot Size Existing Bldg Valuation S Name Address State Contractor Name Address City State Zi Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No Contractor Name_ 1 Contact License # i?�z:;}EpEpE:>:$i�Ez+??iE�s i?s>?<>:bb,.�.«.. _ _.��.:vv..,....` ..a.,..�.:.;......................;� ............ f4G:;4 J,ll .::.............:.;:.;:.;:: Addr"eS State . Phon Expiration Date Fax Verified ❑ Yes ❑ Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories WashingMachine .... .; .: ... Drains Totaliztrxre Count::::;::::;::::::>: [;kE4y;ISA`a)11TTpUV ................... 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 Conv Burner Duct Work 0-3 Tons Underground BBQ's Wood Stoves 3-15 Tons Tatal Unit Cotrnt 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. Owner/Agent: 711?/ C`�+/ Date: IICyI / 6UILDIN BEvrs[o 6/26 8/28/97 • ___.. ..,