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18-102963City of Federal Way Applicant Contractor Community Development Dept. DENNIS C. AUSTINBETHEL LOUIE NEWHOUSENORDIC 33325 8th Ave S OWNER IS LENDER CHRISTIAN CENTER Federal Way, WA 98003 9618 MIDVALE AVE N Ph: (253) 835-2607 Fax: (253) 835-2609 9618 MIDVALE AVE N SEATTLE WA 98103 Project Name: BETHEL CHRISTIAN CHURCH UNIT 115 Project Address: 115 SW MIRROR LAKE PARK Building - Single Family Permit #:18 -102963 -00 -SF Inspection Request Line: (253) 835-3050 Parcel Number: 072104 9003 Project Description: REP- Fire damage repair to roof system and replace lower roof like in kind. Owner Applicant Contractor Lender DENNIS C. AUSTINBETHEL LOUIE NEWHOUSENORDIC NORDIC SERVICES INC OWNER IS LENDER CHRISTIAN CENTER SERVICES INC 9618 MIDVALE AVE N 414 SE 312TH ST 9618 MIDVALE AVE N SEATTLE WA 98103 FEDERAL WAY WA SEATTLE WA 98103 98003 Census Category: 434 - Residential alt/add - no change in number of units Includes: #1 #2 #3 #4 Occupancy Class: R-3 Construction Type: Type V - B Occupancy Load: Floor Area (sq. ft.) Additional Permit Information Occupancy # 1 -Construction Type ......................... Type V - B Mechanical to be Included?..................................... Yes Mechanical Work Valuation? .................................. 4000.00 Is this an Online or O.T.C. application? .................. No Plumbing to be Included? ........................................ No Occupancy #1 - Use................................................ Residence (1 or 2 fly) Comprehensive Plan Designation ........................... SF - High -Density Residential Total Valuation: 69,500.00 Furnaces Subject to field inspection with CONDITIONS: SPECIFICATIONS) PERMIT EXPIRES Wednesday, 2 January, 2019 Permit Issued on Friday, July 6, 2018 I hereby certify that the abcglve information is correct and that the construction on the above described property and the occupancy an a use will be in accordance with the laws, rules and regulations of the State of Was ' ton and the City of Federal Way. Owner or agent: Date: crrr or THI5 CARD IS TO REMAIN ON-SITE �1� ,. Federal WayConstruction Inspection Record INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 18102963 00 Address: 115 SW MIRROR LAKE PARK Project: DENNIS C. AUSTIN FEDERAL WAY WA 98023 Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence: On-going inspections are logged on the back of this card. 0 SWM Precon Site Mtg (4400) 0 Initial Erosion Control (4365) 0 Footings/Setback (4110) Approved To be done PRIOR to breaking ground Approved to place concrete By Date 1By Date 1By Date Underfloor Framing (4235) El Floor Sheathing (4105) © Shear Walls (4245) Approved to sheath floor Approved to install flooring . Approved to install siding By Date [By Date 1By ._ Date Rough Electrical Final Electrical Right of Way Approved . Approved J1 Approved By Date By Date . --- By Date DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8t° Avenue South PO Box 9718 Federal Way WA 98063-9718 253-835-2607; Fax 253-835-2609 www.city_off�ederalway.com INCIDENT DAMAGE CHECKLIST Case# t 1ta ';`1�~14` Owner's Name: hone: _ Date of Incident: .�t}li Date of Inspection: .2� Site Address: _i. V. 9 S is I, Nature of Incident/Scope of Damage: &I: r-0— w. o16 (If the value of the damage is greater than 75 percent of the assessed value of the structure, a site plan is required.) Building Posted: P'NO OCCUPANCY ❑ DANGEROUS BUILDING O OTHER ❑ NOT POSTED Permits Required: BUILDING O PLUMBING "ECHANICAL Uj�ELECTRICAL O DEMOLITION Plans Required: O Yes O No Plans to Show: Engineering Required: O Yes N No Specifically: Demolition Complete: O Yes ❑ No D N/A 2"d Inspection Required: O Yes O No Permit Application Information Provided to Applicant: O Demolition Permit Application O Building Permit Application O Submittal Checklist O Electrical Permit Application O.Other s 4 (253) 835- 2 Inspector Phone Number "APPLICANT: PLEASE BRING THIS FORM TO THE CITY WHEN APPLYING FOR PERMITS" "Ie Maps Google Mads Bethel ° park https://www.google.com/maps/@47.323651,-122.3398951,18z FIN 1,tI5 m'krrc>c- Ltd FK h4prror ake Park s V ac o a ffi x a a, "1 cr g Gong` �„x-) �-h S't' Map data 02018 Googte 100 ft s 1 of 1 7/6/2018,8:01 AM om 3m n Opper level u Pew -Fly Pty, ?IN 0-7 z-joLA- q([z i k 15 IfY rOb,c c" L%/, P ke-s !.IAM 15' 4'9"- 3' 2t' 16'4" Closetl (1) Closet (Pp ' M l � Upper East Bedroom � Upper west Bedroom 1n _ 00 5 p o 0 _ M Gill, r haliv¢a 717" --+ 6' 7f' 1 _ T t ' 00 ao 1 1 13' 10" —91101, 915" Upper level Main [..._ou-�� -Flou- flan F 1N of ZAv4- Ck z-- 23'5" 2' 2" oset Lower East bedmam Utility Roorn 0 7'5' 9'7'rlll� T sp Landing `t OA-ki a.\ �w � koc," o: wv%r* J 1 - h Kitchen (V 14'6" p i rQ— lde)re-s 1 Nq Main 5(15e?wV, p t N C) I z k 64-c vW lNurfor LY-- T�K- ') `R -'n> Grw,J1 I ven Roof t � � M:i rrt� LK Ptd 1 MR Roof Job SPACING- 2-0-0 CSI. OWL in Plate Grip DOL 1.15 TC 0.80 Vert(LL) -0,26 Lumber DOL 1.15 BC 0.93 Vert(CT) -0.46 Rep Stress Inor YES WB 0.95 Horz(CT) 0.13 Code IRC2015/TPI2014 Matrix -SH ss PLATES GRIP MT20 220/195 Weight: 177 Ib FT = 0% LUMBER- BRACING - 1802403 T01A COMMON 8 1 Mi7ek recommends that Stabilizers and required cross bracing be installed during truss erection, in accordance with Stabilizer Installation guide. REACTIONS. (size) 7=0-3-8 (min. 0-1-8), 12=0-38 (min. 0-1-15) Job Reference o tion.! '""". ^',, ",••`•o,o, ,••'w�'^• o.G IV S MOU 40 LV 10 MI 1 W InGUWM, InG. I nu Jun zl 7D:ze:zu zule Y 7 ID:pynL? KRaE_uTBP4zW4cOuz9PTR-dOFWIZdkXNXWR2g6HiwPXJcHgTxWFn7QheLz?Az m 735 13 8 15 20-2-8 26$ 1 331-11 40-" 735 59 9 6 Scale =1:65.8 3.75 rW V LOADING (psf) TCLL 25.0 TCDL 7.0 BCLL 0.0 ' BCDL 8.0 SPACING- 2-0-0 CSI. OWL in Plate Grip DOL 1.15 TC 0.80 Vert(LL) -0,26 Lumber DOL 1.15 BC 0.93 Vert(CT) -0.46 Rep Stress Inor YES WB 0.95 Horz(CT) 0.13 Code IRC2015/TPI2014 Matrix -SH (loc) Udefl L/d 8-9 >999 240 8-9 >921 180 7 n/a n/a PLATES GRIP MT20 220/195 Weight: 177 Ib FT = 0% LUMBER- BRACING - TOP CHORD 2x4 DF No.2 TOP CHORD Structural wood sheathing directly applied or 2-2-0 oc purlins. BOT CHORD 2x4 DF No.2 BOT CHORD Rigid ceiling directly applied or 2-2-0 oc bracing. WEBS 2x4 DF No.2 Mi7ek recommends that Stabilizers and required cross bracing be installed during truss erection, in accordance with Stabilizer Installation guide. REACTIONS. (size) 7=0-3-8 (min. 0-1-8), 12=0-38 (min. 0-1-15) Max Horz 12=76(LC 12) Max Uplift7=136(LC 9), 12-233(LC 8) Max Grav7=1392(LC 1), 12.1830(LC 1) FORCES. (Ib) - Max. Comp./Max. Ten. - All forces 250 (lb) or less except when shown. TOP CHORD 1-13=-317/624, 2-13=307/897, 2-3=-2185/156, 3.1 4--205 211 9 7, 4-14=-1985/207, 4 -15= -1985/200,5 -15-2053/190,5-6=-3082!387,6-18=-38471328,7-16m-3927/317 BOT CHORD 1-12=-595/324, 11-12--137/1083, 10-11=122/2082, 9.10=-180/2721, 8-9=-33713511, 7-8=-272/3875 WEBS 2-11=-67/1030, 311-2721112, 3-10=-363M11, 4.10-311805, 5-10-1011/177, 5-9=0/458, 6-9-698/177, 2-12--2343/359, 6-8=01380 NOTES - 1) Unbalanced roof live loads have been considered for this design. 2) Wind: ASCE 7-10; Vult=110mph (3 -second gust) Vasd=87mph; TCDL=4.2psf; BCDL=4,8psf; h=25ft; Cat. II; Exp B; enclosed; MWFRS (envelope) gable and zone and C -C Exterior(2) 0-0-0 to 4-0-8, Interior(1) 4-0-8 to 20-2-8, Exterior(2) 20-2-8 to 24-30 zone; cantilever left and right exposed ; end vertical left and right exposed;C-C for members and forces & MWFRS for reactions shown; Lumber DOL=1.80 plate grip DOL=1.60 3) As requested, plates have not been designed to provide for placement tolerances or rough handling and erection conditions. It is the responsibility of the fabricator to increase plate sizes to account for these factors. 4) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 5) ' This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 34-0 tall by 2-0-0 wide will fit between the bottom chord and any other members. 6) Provide mechanical connection (by others) of truss to bearing plate capable of withstanding 136 Ib uplift at joint 7 and 233 Ib uplift at joint 12. 7) This truss is designed in accordance with the 2015 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSI/TPI 1. LOAD CASE(S) Standard J00 13:0-3-0,0-3-01, 5:0-3 0 0 3 C 1-11 a 9: -0 0- 0 1: 3- 3-0 1802403 T01 COMMON 8 1 DEFL, in (loo) I/deft Ud PLATES GRIP ob Reference o tional wawa i rasa. Mu., r -T—.. — aocro mziu s Mar za Gulp MI rex inau8NB5, Inc. inu Jun z1 10:zwi i gulp pme 1 ID:pynL7_KRaE uTBP4zW4cOuz9PTR-=7EUW4fc0osgeNFJFIfQkowz3epo5dff_BBz4 nv 7 3 5 13 8 95 20 ? 8 26 8 1 33 1-11 40-&0 735 65 $Cole =1:65.8 3.75 rT 4104 41 -12 1-9.2 20 28.3.14 96 1 4 12 i d Plate Offsets (X,Y)— 13:0-3-0,0-3-01, 5:0-3 0 0 3 C 1-11 a 9: -0 0- 0 1: 3- 3-0 LOADING (psf) SPACING- 2-0-0 CSL DEFL, in (loo) I/deft Ud PLATES GRIP TOLL 25.0 Plate Grip DOL 1.15 TO 0.61 Vert(LL) -0.11 9-10 >999 240 MT20 220/195 TCDL 7.0 Lumber DOL 1.18 BC 0.50 Vert(CT) -0.21 8-10 >999 180 BOLL 0.0 • Rep Stress Incr YES WB 0.51 Horz(CT) 0.06 8 n/a n/a BCDL 8.0 Code IRC2015/fP12014 Matrix -SH Weight: 177 Ib FT - 0% LUMBER - TOP CHORD 2x4 OF No.2 BOT CHORD 2x4 DF No.2 WEBS 2x4 DF No.2 REACTIONS. (size) 12-0-3-8 (min. 0-1-12),8-0-3-8 (min. 0-1-11) Max Horz 12=76(LC 12) Max Uplift12=-228(LC 8), 8=-212(LC 9) Max Grav 12=1654(LC 1), 8=1580(LC 1) BRACING - TOP CHORD Structural wood sheathing directly applied or 4-0-14 oc purlins. BOT CHORD Rigid ceiling directly applied or 6-0-0 oe bracing. lTek recommends that Stal5illiters and required cross bracing be installed during truss erection, in accordance with Stabilizer Installation guide. FORCES. (lb) - Max. Comp./Max. Tan. - All forces 250 (lb) or less except when shown. TOP CHORD 1.13--317/624, 2-13--307/697.2-3=-1820/136, 3-14-1605/140.4-14--1538/155, 4-15=-1538/147, 5-15=-1605/137, 5-6=-1939/152,6-16-28W$43,7.16--29&571 BOT CHORD 1-12--595/324,11-12--137/887,10-11--121/1719, 9-10--73/1824, 8-9;107/1310, 7-8=-545/304 WEBS 2-11--51/845, 3-10=400/111, 4-10=0/538, 5-10=-505/126, 8-9-0/523, 2-12=2094/345, 6-8=-2322/376 NOTES - 1) Unbalanced roof live toads have been considered for this design. 2) Wind: ASCE 7-10; Vult=11Omph (3 -second gust) Vasd=87mph; TCDL=4.2psf; BCDL=4.8psf; h=25ft; Cat. II; Exp B; enclosed; MWFRS (envelope) gable and zone and C -C Extedor(2) 040-0 to 4-0-8, Interior(1) 4-0-8 to 20-2-8, Exterior(2) 20-2-8 to 24-3-0 zone; cantilever left and right exposed; and vertical left and right exposed;C-C for members and forces & MWFRS for reactions shown; Lumber DOL=1.60 plate grip DOL=1.60 3) As requested, plates have not been designed to provide for placement tolerances or rough handling and erection conditions. It is the responsibility of the fabricator to increase plate sizes to account for these factors. 4) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 5) • This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 2-0-0 wide will fit between the bottom chord and any other members. 6) Provide mechanical connection (by others) of truss to bearing plate capable of withstanding 228 Ib uplift at joint 12 and 212 Ib uplift at joint 8. 7) This truss is designed in accordance with the 2015 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSI/TPI 1. LOAD CASE(S) Standard JOD IrussN ype CSI. DEFL. in 1802403 GE01 GABLE 1 1 Plate Grip DOL 1.15 TC 0.80 Vart(LL) 0.00 8-9 Job Reference o floral wuva nuaa, ,rw., ronw-ro, vrn aosw u.Z10 s Mar 25 2015 MITek Industi", Inc. Thu Jun 21 15:25:43,2015 Papa 1 ID:pynL?_KRaE uT8P4zW4c0uz9PTRSpBDyQv97RQFib5X72goyA3F8aA8Lkp_)PhJLz4_rQ 7 3 5 13 8 15 20.2-8 Z6 8 1 33 1-11 40-50 Scale -1$5.8 3.75 Fie 31 W 29 28 27 26 255 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 y� d LOADING (psf) SPACING- 2-0-0 CSI. DEFL. in floc) Vdefi Ud PLATES GRIP TCLL 25.0 Plate Grip DOL 1.15 TC 0.80 Vart(LL) 0.00 8-9 >999 240 MT20 220/195 TCDL 7.0 Lumber DOL1.15 BC 0.40 Vert(CT) 0.00 8-9 >999 180 BCLL 0.0 ' Rep Stress Incr YES WB 0.25 Horz(CT) 0.00 13 n/a n/e BCDL 8.0 Code IRC2015/TPI2014 Matrix -SH Weight 282 lb FT = 0% LUMBER - TOP CHORD 2x4 DF No.2 BOT CHORD 2x4 DF No.2 WEBS 2x4 DF No.2 OTHERS 2x4 DF No.2 REACTIONS. All bearings 31-5-0 BRACING - TOP CHORD BOT CHORD (ib) - Max Horz 31=76(LC 12) Max Uplift All uplift 100 Ib or less at joint(s) except 25=145(LC 12), 19=-110(LC 9), 13=-144(LC 13), 31-252(LC 8), 8=196(LC 9), 30--239(LC 23), 9-117(LC 24) Max Grev All reactions 250 Ib or less atjoint(s) 20, 21, 22, 23, 24, 26, 27, 26, 29, 30, 18, 17, 16, 15, 14, 12, 11, 10, 9 except 25=480(LC 23), 19=515(LC 1), 13=577(LC 24), 31-927(LC 23), 8=706(LC 24), 8-704(LC 1) FORCES. (lb) - Max. Comp./Max. Tan. - All toms 250 (Ib) or less except when shown. TOP CHORD 1-61x-268/612, 2.81=-255/685, 8-84a-232/640, 7-84m-243/568 BOT CHORD 1-31--584/276, 7-8=-542/255 WEBS 3-25=436/119, 4-19s-407/62, 5-13--469/120, 6-13=-258/136, 2-31--832/272, 6-8=-794/282 Structural wood sheathing directly applied or 6-0-0 oc purlins Rigid ceiling directly applied or 6-0-0 oc bracing. MiTek recommends that Stabilizers and required cross bracing be installed during truss erection, in accordance with Stabilizer Installation guide. NOTES - 1) Unbalanced roof live loads have been considered for this design, 2) Wind: ASCE 7-10; Vuft=110mph (3-seeond gust) Vesd-87mph; TCDL=4.2psf; BCDL-4.8psf; h■25ft; Cat. II; Exp B; enclosed; MWFRS (envelope) gable end zone and C -C Exterior(2) 0-0-0 to 4-0.8, Interior(1) 4-0-8 to 20.2-8, Exterior(2) 20-2-8 to 24-3-0 zone; cantilever left and right exposed ; end vertical left and right exposed;C-C for members and forces & MWFRS for reactions shown; Lumber DOL=1.60 plate grip DOL -1.60 3) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind (normal to the face), a" Standard Industry Gable End Details as applicable, or consult qualified building designer as per ANSI/TPI 1. 4) As requested, plates have not been designed to provide for placement tolerances or rough handling and erection conditions. It is the responsibility of the fabricator to increase plate sizes to account for these factors. 5) All plates are 1.5x4 MT20 unless otherwise indicated. 6) Gable studs spaced at 1-4-0 oc. 7) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 8) ' This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tell by 2-0-0 wide will fit between the bottom chord and any other members. 9) Provide mechanical connection (by others) of truss to bearing plate capable of withstanding 145 Ib uplift at joint 25, 110 Ib uplift at joint 19, 144 Ib uplift at joint 13, 252 lb uplift at joint 31, 196 Ib uplift at joint 8, 239 Ib uplift at joint 30 and 117 Ib uplift at joint 9. 10) This truss is designed in accordance with the 2015 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSI/TPI 1. LOAD CASE(S) Standard CITY of 'A Federal Way PERMIT NUMBER 19 _ 10 Zq G -�3 - PERMIT APPLICATION PERMIT CENTER 9D33325 81h Avenue Spout j�(ay 8003-6 253-835-2607 ®FAX 253-835-2609 ®er It a corn JUL 0 6 2018 TARGET DATE CITY OF FEDERAL WAY SITE ADDRESS SUITE/UNIT # N6 _M'mr La -Ke, FaAK PROJECT VALUATION ZONING ASSESSOR'S TAX/ PARCEL �7'�6� 5C)/ ) V tiC# a 0— � _7__ TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT f3e+heA C�nC'i �fi P ire ir h npo F -sq s4-eivi PROJECT DESCRIPTION Detailed description of work to — O t4 , Eloori a_ze_o be included on this permit only NAME PRIMARY PHONE /_5'3 834 Zy�r36 PROPERTY OWNER MAILING R S E-MAIL CIT STATE ZIP NAME ©,_`�i % PHONE "75 R 5 (® MAILI A1D�,DRESS ` / "�1SSv Iav� ave— N E-MAIL CONTRACTOR CITY < � STAT$ ZIP C7 N/ Q VV�ROC; ��/ e7' r F ()CC/JO 5.ZZ_ �7 �TRACjOR'S LICENSE # EXPIRATIONDATE 1Q FEDERAL WAY BUSINESS LICENSE # NAME Louie- N1 PRIMARYPHONE G MAILING ADDRES ; j v �l v e w 4 �V E-MAIL APPLICANT CITY C�') STAT�xI ZIP FAX PROJECT CONTACT NAME �U e- �v 1�'>� L PRI Y P ONE p 9 Z l P (The individual to receive and MAILI ADDRESS ` t 6 • 3 ��V 0-`e— 0,ve, E-MAIL respond to all correspondence ctrv�--�� yam_ s AT�y D FAX concerning this application) PROJECT FINANCING NAME [ V as OWNER -FINANCED When value is $5,000 or more (RCW 19.27.095) MAILING ADDRESS, CITY, STATE, ZIP PHONE I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of such claiml which may be made by any person, including the undersigned, and filed against the city, but only where such claipr rises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied tot a ty as a part of this application. SIGNATURE: v� DATE 1'V.- U PRINT NAME: Lnv � 4e_ N PW �pU5e, Rnllatin #1flf1 Tpmian7Q 1nlA Pon. 1 nf7 4•UAondnnte\Ps ;t An fli ti, MECHANICAL PERMIT CRITICAL AREAS ON PROPERTY? WATER PURVEYOR I I , u. !.� boo , Tv nn Indicate how many of each type of fixture to be installed or relocated aspart of this project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial) Area in Square BOILERS �_ FURNACES HOT WATER TANKS (Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST - LAVS (Handsin DUCTING GAS PIPING WOODSTOVES R SYSTEMS GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS v LUMBING WORK PLUMBING PERMIT LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? AREA DESCRIPTION Area in Square 91ves M No :e es a No # of Additional Informatiol Indicate how many of each type of fixture to be installed or relocate art of this project. Do not include existing fixtures to remain. BATHTUBS (or Tub/ Shower Combo) - LAVS (Handsin — TOILETS WATER PIPING DISHWASHERS R SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS ADDITION DRINKING FO —� SINKS (Kitchen/ Utility) WATER HEATERS (Electric) H BS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/ PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? AREA DESCRIPTION Area in Square 91ves M No :e es a No 1 I' 11 s. i a<� ` )" r w a� :y v e� 2' r ,x�',..�.. FIRST • •R (or Mobilee COVERED ENTRY GARAGE .t CARPORT ei Area Totals TOT �Ib I PROPOSED I / Z -3-v ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in Square Occupancy Group(s) Construction # of Additional Informatiol Feet Type Stories ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Group(s)Construction p y Type # of Stories Additional In form allot TENANT AREA ONLY RnllPtin $1 M - T�nn�n, 70 11711A Aonn 1 of') A-1;-6.