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4P City of Federal Way • RECEIVED
i -i-Ii= APPLICATION FOR BUILDING PERMIT
TUL 141994
CITY OF FEDERAL WAY
B • DING EP r
PLEASE PRINT APPLICATION#: Ci ( -6521
SITE LOCATION < Address 3 Co.2-O 23 2_p i tSo
Tenant (if known) Lot # Assessor's Tax#
Building Owner Name Address
•i---1 ,2k---\--- ``�`` \‘--37-L-3 clL S SL.r C 1_
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City F ..., o w�"/ State kms'A Zip Phone (21.4./(„_- 6s a_ _
Nature of Work ' `
APPLICANT
Name(F,M,L) e_0' !,...,,Aca_^
Address P� 'k >"‹ ::Cii 442
City ` State Zip ct 5. C(`,
Contact Person__c�O Day 7Phone t '- / / Other Phone 1 I Fax
BATT G•CONTRACTOR
Company Name
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Address 3„2,C Se, t52_,--) 0
City 6ir. 44N, ( State lA j( Zip G( / `r' cj
Contact Person t-e c o ' , ,^ Phone, �
- �l'�' Fax
Contractor's #(card must be presented) Eratipn Dal Verified 0 Yes 0 No
NG ��1-c tV0 o• i '-t - (` 1177 `` s
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Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
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/t`# 1► 41♦♦♦1 ► � 0♦♦♦§1�, � //♦`j♦§1 � � ♦ ►�, � l��1§♦e .401/4§t .1.11 4444040001
STRUCTURE-:,. sling Use Yyl,�yt �� .r Posed Use + .-
Permit includes: �-Building ►❑) Plumbing C Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units_ ❑ Deck
H-Qommercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability 0 Project Valuation $
Zoning Lot Size Existing Bldg Valuation fr
VENDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
PLUMBING OI< laRACCTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes 0 No
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total'Fixture Count
:,s:::::. .....................................:.r+...::::::........1�,................. .
MESCAL I .......T .:
Fuel Type (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 Caunt
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. l (\ -]
Owner/Agent: = ` �� Date: ` (y �c ..‘_...1