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1111, 33530 First Way South
Federal Way,WA 98003
vN) F1Y NOV 191999
(253)661-4000
Fax(253)661-4129
CITY
OF FEDERALY
BUILDING DEPT
APPLICATION FOR BUILDING PERMIT
-61PLEASE PRINT APPLICATION # � (�°I
-
Site address ^
' C
iiiiiiiiiiiithilaingallIE S / -) C
Tenant namegjJ t_///e7-7L.7_, �a/ r Lot # 9 i '7 Assessor's Tax #
Building Owner's Name &IA // _-
Address‘S>'7.51 /4\/ chti / S?' /c
11 ?f' City T', U JState J J Zip (Phone
Description of Work /1/S // j�J1) / AQ/i/C j y'.' i lJ Sl'Q-C 6 ft Z 1 7
met-KANTmiiminaimminmemmi
Name (F,M,L) '
074. /--F ZJi y f c
Address �" `'tel Afr /� . '
Okto/
City 4,./fjj,rz rti State A-4 Tip 9F-°-7X7
Contact Person Day Phonethey Pho
�" I �r:in �?„ ae, Fax l
BUalbiNN_> :«C O <` <> »€€€€€€€€>€ €€€iii
II�IC,E.. .0��ITR��TE3R............................. Federal Way Business License #
Company Name /�j j,))G A Z' /� )) d
Address ( J �C l //"/4.<2.7).T \ �1
J' �. esu /��ieigg. it �)/fe / e)City ,e, CJ i�-t.) A/A / State Zi1GIT�I p
Contact Person ril,a9, 76 tvil
Phonex,,� ti r Fax
Contractor's # (card must be presented//s Expiration D to Verified _ Yes 0 No
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
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Use• (kms ,.L.
11
Permit includes: Building ❑ Plumbing f
�] 0 Mechanical 0 Other
Type of Work: *Residential ..51fr New 0 Remodel 0 # of bedrooms ❑ Deck
❑ Commercial 0 Addition 0 Repair 0 Garage ❑ Shed
Enter 1st Floor /5i.,(9 sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks 4+fy sq ft Garage sq ft Proposed Total Area sq ft
Water Availability El Sewer Availability 0 On-Site Septic System Availability ❑ Project Valuation $
Zoning (Ad 3 6.69 0 I Lot Size Existing Bldg Valuation $
1(t
R:::.;.::::.;.::::: .:::::: :,::::;.:.,..;:::::::::::::.igi.:.:: For new residential only - Proposed selling cost: $ -
Name Address
•
City State Zip
............................................................ ......... ..........
MECHANICALOINTRACtattgamm
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
............................................................................................
..........................................................................................
............................................................................................
..........................................................................................
............................................................................................
Contractor Name .----... Address
City ,� State Zip
Contact '`7 Phone Fax
�n
License # Expiration Date Verified ❑ Yes ❑ No
..........................................................................................
............................................................................................
..........................................................................................
............................................................................................
........................................... .............................................
PL 1MBENGfixT lilt C(CEJ.SIT > >r>>;':;
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters, '' Sumps
Lavatories Washing Machine Drains Total-Fixture..Count
i
............................................................................................
..........................................................................................
...........................................................................................
nnE HAtgil Ailj ttbiliN >` << `<> > MECHANICAL EVALUATION ONLY $
Fuel Type (gas/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
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit Gottnt
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 def ,f such claim),which ma 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 ,including its officers d employees,upon the accuracy of the information supplied to the city as a part of this application.
ido
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Owner/Agent: / _ r v LG� Date: /)-1 / > /
E,uaoinc.nw
BEvisE0 b/18159
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y RECEIVED
1 ►lir _ •
NOV 191999
1 0-1Y OF FEDERAL WAY
D EPT.
I I • CITY OF FEDERAL WAY
-Y DEPT.OF COMMUNTTY DEVELOPMENT
c<'X>sh% icor f
?,�1� P 2101 S 324TH ST, #297 BLD99-0702
.t% / - A
%7CCeS � MH SEM'
moo'►�. ��U�/�ir2e P
I MARTLN, BE ITV 11/19/99
,,, � ® /�/f-ff� 1/--/i—79
, .
'.. ' CITY OF FEDERAL WAY PERMIT NO: BID99-0702
'` 33530, First Way South BUILDI NG PERM I I is-:.:;uLD: 11/19/99
‘, Fefleral Way, WA 98003 BuiLding Inspection Requests 253-661-4140 BY: 1C2
251-661-4000 EXPIRES: 05/17/00
47.49V/5470
l /!4/ el FLF
ADT S 324114 Sr Unit: 297
NO. : 162104-9037
PROJECT DESCRIPTION:MOBILE HOME SETUP - INSTALL 1568 SQ FT MORE HOME, SPACE 1291 ' Ranso) C-uvilizvrno.vfive-64hwi •;y•rreay. isliv/I,
)
(BELMOR MOBILE HOME PARK)
1 BETTY MARTIN MIDGE LIMITED
I 2101 S 324TH SI, 1291 1801 N VALLEY HWY STE 103
FEDERAL WAY WA 98003 AUBURN WA 98001
135-5575
OAKRIL*0641.2
*** CONIRACTORS, PLEASE M40E01101 CORE 032 4414 WORMS SALES TAX IAA PROJECTS RUIN ENE CITY OF FERMI WAY. TAX RATE : 8.6% ***
IBED?:X NEC?: PIM?: FLII-EXIW-PROP--- Nr'T1S wiT- I 1 COMP PLAN....,....:B FEES:
TYPE Of WORE HEW USE:RES 1ST.: %\s!Ai -,15613:sf $40p!Fr • 1 REQUIRED PARKING..: 0 SPRINKLERS/ ./ PLAN CHECK FEE $ 99.61
CENSUS CATEGORY •112 ?ND Afi-''' 0.q rAf„...:- Amin:, ,.,-,-, ',04, ,-,,,,,, ,,, -,-;,-Imag,tow, -,10,,,4r3, ,f,,-,,- BUILDING PERMIT $ 153.25
OCCUPANCY GROUP „vO p ,I. ' witait---,-,------‘-- REQUIRE*''',,'1 • , , -- , IRL ' -- 4 wit- --- siv SURCHARGE
s - s - ' ' ' !•Isltr '.4 4$04( JP $ 4.50
---.,., , : ;' '= --•• ,;-;.:" ---,s- -",x--- , ', ,-'a -'- •
I:R3 :? :? :? : OW ' ,., r' 'T, t .„: 41g.j$ 4,,,,,r;144t,Tf * " '" ,.."
TYPE Of CONSTROCTION--- RSAT: u. ;.....- RI-f I- -s' ISIDE ''' 000 rrWATER SERVItt..:LAK
91 :? ' :? :? : DICE: O. 1S:'“ REAR • 0.00:ft SEWER SERVICE LAK
OCCUPANT LOAD GAR.: 0: I) r AM :1,,';,,
0: 0: 0: 0; TOTE: 9, Ll :'j INFIRV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:? ? FANS • 0 BOILERS/CONPRESSORS WATER CLOSETS 0 URINALS • 0 TOTAL FEES $ 251.36
GAS PIPING.: 0 ft HOOD • 0 0-3 TON. * 0 BATH IUB • 0 DRINK/NG FOUNT.: 0
FURN<100K..: 0 DUCT WORE • 0 3-15 TON. • 0 SHOWERS • 0 SUMPS • 0
° Gill NWT....: 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES • 0 VAC BREAKERS...: 0
CUNV BURNER: 0 FURN)100K 0 30-50 TON. • 0 SINKS .: 0 DRAINS * 0
EN........: 0 MISC • 0 501 TON • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELF( NIP HERIERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 ::10,000 (FM: 0 ABOVE GROUND: 0 LAUN WSHR 00ILTS...: 0
SAS LOGS...: 0 : 10,000 (FM: 0 UNDERGROUND.: 0
PERMITS EXPIE 180 DAYS NITA MAKE If NO WORK IS SERRIED. PESTAINTIAL AND GOODIN PERMITS EXPIRE ORE YEAR MIER RATE OF ISSUANCE.
I COIR OAT THE INFORAATI VANISHED Al Al IS I AND COUTO TO THE REST Of NY KNOWING( AND IW APPLICABLE CITY OF MOW. WAY REQUIREMENTS VILI. RE NET.
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014410rOR AGENT ',' osi- -1414- 451 DATE LL.2.4"....9.....i
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