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BUILDING DIVISION
33530 First Way South
�,Of
Zi
Contact Person �\ Sn A A A�
Day Phone- n ��
0- �7�L
RECEIVED 1 V E D
Federal Way, WA 98003
(253) 661-4000
Fax(253)661-4129
APR 2 11999
AY
APPLICAt�ON11fOR BUILDING PERMIT
PLEASE PRINT
APPLICATION # L
Add
Q
1 b
Tenant (if known)
r'`
SEdJ
Lot #�O
Assessor's Tax #79 (o � q 3�
_i
� R� S
Building Owner's Nam
f,
S 0�
Address
-�' •
c
n,i aDg-� 1
_ ��i State �� I.k
Zip qM ,
Phone
Nature of Work
Name (F,M,L)
Address (,l � 1 ��S
Cit H 1bC� ,
State
Zi
Contact Person �\ Sn A A A�
Day Phone- n ��
ther P�or�e,^'t ^ �0
FEDERAL WAY BUSINESS LICENSE #
Company Name I''S NOV
Address
City State Zi
Contact Person Phone Fax
Contractor's # (card must be presented) Ex 2t n at Verified ❑ Yes ❑ No l SSC. � ��� D- 20 0 �
NameASY�,
Address D ®
Cit
State
Zi
Contact Person
Phone _ 31
1-7o(, Z
Fax
LEGAL DESCRIPTION I 1 \, , V I' 1���S(— �, X 1 I � "Oi f w'
,� ,K
L r'" W v� V I"1C
Please Complete Reverse Side
r-11
%ri
?::><><>.><:><>:
Existin Use
g
State
Proposed Use r�
Contact
Permit includes:
Fax
❑ Building
❑ 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 Floor3A_ sq ft
Decks sq ft
3rd Floor sq ft
Garage sq ft
Existing Floor Area
Proposed Total Area
sq ft
sq ft
Water Availability
❑ Sewer Availabilit
❑ On -Site Septic System Availability ❑
Pro'ect Valuation
�2
Zoning
Duct Work
Lot Size
Underground
Existing Bldg Valuation
$
..... } :.:.::::.::.........
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
I*1UN�.t ..G.i'C1tFi :CkUIT.;;;;;:;;:;;;;<;;;.;.;.;
Water Closets
Sinks
Urinals Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains Total'Fixture Count
IVl,..k,,. LLC.E.. UN1t {"?UV'..:..:.....,..;...
MECHANICAL EVALUATION ONLY $
Fuel T e (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
Fu > 100 BTUs
Fans
Miscellaneous
Fuel Tanks
Gas Hwt
Hood
Boilers
Above Ground
Conv Burner
Duct Work
0-3 Tons
Underground
BBO's
Wood Stoves
3-15 Tons
Total Unit Count
DISCLAIMER: I certify under penalty ofpedury 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 erform 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 incurre my r tr n 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 ari of reli cf 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:
BUILOING.APP
BEV6E0 8/26/97
Date:
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