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CD0193(Rev 4/97)
BUILDING DIVISION
p*� • ! 33530 First Way South
EQ Federal Way,WA 98003
VV IAY (253)661-4000
Fax(253)6614129
JUL 2 71999
c;ii UF BUILDINGEDERAL
PAPPLICATION FOR BUILDING PERMIT
BUILDING DEPT.
PLEASE PRINT APPLICATION # b6161 - U`CV((_i
...........................................................................................
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j ::<:::>:>:>:>::>:»s::>::::><:::>:::>::::>::::>::::>:::s::::> Site address
Tenant name Lot# Assessor's Tax #
Building .wner's Name Address
c 4-1- (.,o rLrut (Auk.I c h y t O -t v - `i J t'` )
City t' 1l i C-;.( w( "1 State 1.0 a Zip c DO 3 Phone o) --.3 831 LPI,
Description of Work d cC (e1)IGic.e
............................................................................................
............................................................................................
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
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i^iBitai titCYNTB Tt3F3:>':; > EME: Federal Way Business License #
Company Name `
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
............................................................................................
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Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
istin Use
g litoposed Use
Permit includes: 0 Building El Plumbing 0 Mechanical El Other
Type of Work: El Residential 0 New 0 Remodel ❑ #of bedrooms El Deck
/
El Commercial 0 Addition El Repair 0 Garage 0 Shed
/ Enter 1st Floor sq ft 2nd Floorr. sq ft 3rd Floor sq ft Existing Floor Area sq ft
IX Area Basement sq ft . Decks t-{j i sq ft Garage sq ft Proposed Total Area sq ft
Water AvailabilitySewer Availability El On-Site Septic System Availability ❑ Project Valuation $
Zoning '„)''q•( (5 f f-1 f) I Lot Size l(D41!)O� Existing Bldg Valuation $ I LU
ENI'E:>:tis:;:;.'::>::>::::3::3::::?:::3:::::>::>::>::3::>::>::::s:::3::::>::>::::>::::s::>i:>::»>:
R::<:<::<::::::<:::::::::::::»::»:<:»>::>:<:::»»»»»>::»>:»::»»»::»»::>::>::»: For new residential only - Proosed selling cost: $
Name Address
City State Zip
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.............. ................ ...................... ..........................
............................... ........................................................
MECHANI AL t N Matin u
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes El No
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::PLUMBIN� :. ONTRA. T4:R >' iiis> <.M
Contractor Name Address
City State Zip
` "ontact Phone Fax
1-License # Expiration Date Verified 0 Yes 0 No
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LUMBIt GTIXTURCCE UNT < >>» n
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
m
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Lavatories Washing Machine Drains 'T'tstel:::N>ttffe>.'Qunt
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ME. HANICAL UNI COUN <>> >><<`. =' 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 Taterun€tGu!tfnt
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: L. -e , `—7 w6'cp/ Date: 7.-Di 7- 7
REVISED 5/18199
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Ci 'TEDERAL WAY t.
7---- s--- ?w!!TV DEVELOPMENT
1040 5W 295th PL BI D99-0466
!
Deck addition/replacement
i
MURPHY, LORENA 7/27/99 f
� I '
DATE SUBMITTE DATE APPROVED 1/011//1
APPROVED rr,
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