00-1007951p�BuimNGDIVISION
#CfffCF A:• 33530 First Way South
E C; Fedcral Way, WA 98003
(253) 6614000
Fax (253) 6614129
CjfY'U,- FLLi-.�,AL WAf
"i BUILDING PERMIT
APPLICATIO
PLE4SEPNNT ite address APPLICATION #
S
S 2-2651
Tenant name Lot # I Assesgo Afax
Building Owner's Name owzqw- Address SDO i n 233 j�j_ 5�
City �aoL Staten b"A zip lPhone
Descriotion of Work LV Ar- � leel- hDA 1,),*kr k-y
Name (F,M,L)
&1)
City
Address—
Zip
�-Al
Ci ty - rak
LL -)u
-TState
IA
zip
Contact Person
Day Phone
q
Other Phone
Fax
Fouiprzkl W=v Rticinpqc I it-pnqp &
Company Name
Address
City
State
Zip
Contact Person
Phone
Fax
Contractor's # (card must he presentedJ
Expiration Date
Verified 0 Yes 0 No
LEGAL DESCRIPTION
Mmm Gffm--jzkte &-vA= SUR
. . .............
... . ... . ......
.. -sting Use
Contractor Name
roposed Use
Address
Permit includes:
/Urk
0 Building
Plumbing
0 Mechanical
13 Other
Type of Work: 16Residential
Fuel Tanks
Now
0 Remodel
El # of bedrooms
0 Dock
0-3 Tons
mmercial
Addition
0 Repair
0 Garage
0 Shed
Enter 1st Floor
sq ft
2nd Floor
eq ft 3rd Floor sq ft
Existing Floor Area
sq ft
Area Basement
ag ft
—
Decks
scl ft Garage sq ft
Proposed Total Area
sq ft
Water Availability 0
Sewer Availability 13 On -Site Septic System Availability —
Project Valuation
s 4-ql
For now residential only -
Name
Contractor Name
Contact
License #
. ............. .......... ....
.... .......
...........
d selling cost: $
Address
Address
State Zip
Phone Fax
Eyniration Date Verified
51FT-M M
Water
Lavatories
M M,
MECHANICAL EVALUATION ONLY
Fuel Type (gas/olootric/other) Gas Dryer
Contractor Name
16-30 Tons
Address
Ci
/Urk
State zip 5P e03 V
Contact fbi
50+ Tons
Phone Fax
QNB
Miscellaneous -
Fuel Tanks
—8
License #
Above Ground
Expiration Data E3 Yea 0 No
60 Verified
I -
Water
Lavatories
M M,
MECHANICAL EVALUATION ONLY
Fuel Type (gas/olootric/other) Gas Dryer
Air Handlin < = 10,000 CFM
16-30 Tons
Length of Gas Pi in Rene
Air Handling > = 10,000 CFM
30-50 Tons
Fum <100K BTU9 Gas Log
Unit Heater
50+ Tons
Furn > 100 BTUs Fans
Miscellaneous -
Fuel Tanks
Ga. Hwt Hood
Boilers
Above Ground
C..nv Burner Duct Work
0-3 Tons
Under round ......
DISCLAIMER: Icartifyun rj
ora the wed
the above premises =ru= - =11.6
attorneys' fees 6urrea in investigation
where such c"J"m arises out of the relia,
Owner/Agent:
BULDMAM
REVtM 6118199
Wood Stoves 1 3-15 Tons IT
Owinformation famished by me is true and correct to the best of MY knowledge, and further, that I am authorized by the owns Of
nit an) ,cation is made. I fintheir agree to save harmless the City of Federal Way as to any claim (mpdudiqg costs, expenses, and
'such dIaN, which may be made by any person, including the undersigned, and filed ofPcileral Way, but only
as
including its �fficers and employees, upon the of the information supplied tctc4tas this application.
a Date: tffi