93-101544 a
93- to 1 5-Y
CITY
335300Firstt Way South F FEDERAL WAY BUILDING P PER ISSUED: 09/MIT NO: 15/ 9384
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/14/94
** REVISED PERMIT **
ADDRESS:37022 8TH AVE S
NO. : 322104-9142
PROJECT DESCRIPTION:NSF - CHANGE EXISITNG BARN INTO RESIDENTIAL USE, GARAGE, 6 STORAGE.
LOT 3 OF K.C.S.P. 878122
= OWNER - CONTRACTOR - LENDER
RICHARD DONDERO ***OWNER IS CONTRACTOR***
37022 - 8TH AVE S
FEDERAL WAY WA 98003
111.
874-2424
NONE
BLD?:X MEC?:X ALM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN •LDR FEES:
TYPE OF NORK:NEW USE:RES 1ST.: 0: 2100:sf STORIES • I REQUIRED PARKING..: 2 SPRINKLERS? •? PLAN CHECK DEPOSIT.* $ 638.63
CENSUS CATEGORY •101 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS •9 PUB WKS PLCK(SF)..93 $ 40.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 go' FINAL PLAN CHECK...* $ -34.13
:R3 :M1 OTHR: 2312: 0:sf EXIST..=: 18200 FRONT • 20.00 ft BUILDING PERMIT....* $ 930.00
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 189617 SIDE • 5.00 ft WATER SERVICE..:FED SBCC SURCHARGE * $ 4.50
:5N : DECK: 0: 0:sf REAR • 5.00:ft SEWER SERVICE..:SEP PLUMBING FIXT....93* $ 161.00
OCCUPANT LOAD GAR.: 0: 484:sf RECEIVED.:06/22/93 RADON KIT 93 $ 20.00
. 0: 0: 0: 0: TOIL: 2312: 2584:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N NEC APPLIANCE FEES.* $ 61.00
FINAL PLAN CHECK...* $ 30.00
FUEL TYPES.:PRO ELE FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 4 URINALS • 0 TOTAL FEES $ 1851.00
GAS PIPING.: 150 ft HOOD • 0 0-3 HP - 0 BATH TUBS • 1 DRINKING FOUNT.: 0
FURN<IOOK..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 3 SUMPS • 1
GAS NMT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 4 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP - 0 SINKS . 2 DRAINS • 1
BBQ • 0 MISC • 0 5+ HP . 0 DISH WASHERS . 1 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 1 OTHER FIXTURES.: 4
RANGE . 0 <=10,000 CFM: 0 ABOVE GROUND: 1 LAUN WSHR OUTLTS...: 1
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFO' .'ION FUR SED BY E I` RUE AND CO ECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS WILL BE MET.
/
ok OWNER OR AGENT _ , ../.ifi 4 /*4. DATE 1 0 -/ - q_X
ALE COPY
CITY
F FEDERAL WAY
335300Firstt Way South BUILDING P ER:M I T PERISSUED: 09/15/93NO: BLD93 84
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KC
661-4000 EXPIRES: 03/14/94
ADDRESS: 37022 8TH AVE S
NO. : 322104-9142
PROJECT DESCRIPTION:NSF - CHANGE EXISITNG BARB INTO RESIDENTIAL USE, GARAGE, & STORAGE.
LOT 3 OF K.C.S.P. 878122
= OWNER — CONTRACTOR — LENDER
RICHARD DOIDERO
Aliii22 - 8TH AVE S
WEAL WAY WA 98003
874-2424
BLD MEC?:I PLM?:X PLR--EXIST--PROP--- DWELLING UNITS: 1 COKP PLAN •LDR FEES:
TYPE OF WORK:NEW USE:RES 1ST.: 0: 2100:sf STORIES • 1 REQUIRED PARKING..: 2 SPRINKLERS' •' PLAN CHECK DEPOSIT.t $ 638.63
CENS`JS CATEGORI •101 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS •' PUB WKS PLCK(SF)..93 $ 40.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW 0 gpo FINAL PLAN CHECK...: $ -34.13
:R3 :M1 : OTHR: 2312: 0:sf EXIST..$: 18200 FRONT 20.00 ft BUILDING PERMIT....: $ 930.00
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...;: 189617 SIDE • 5.00 ft WATER SERVICE..:FED SBCC SURCHARGE t $ 4.50
:5N : DECK: 0: 0:sf REAR • 5.00:ft SEWER SERVICE..:SEP PLUMBING FIXT....93t $ 161.00
OCCUPANT LOAD GAR.: 0: 484:sf RECEIVED.:06/22/93 RADON KIT 93 $ 20.00
0: 0: 0: 0: TOIL: 2312: 2584:sf IIPERV SURFACE: 0 sf SENSITIVE AREAS?.:N MEC APPLIANCE FEES.* $ 61.00
1 TYPES.:PRO ELE FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 4 URINALS • 0 TOTAL FEES $ 1821.00
PIPING.: 150 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 1 DRINKING FOUNT.: 0
FORK(100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 3 SUMPS • 1
GAS HIT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 4 VAC BREAKERS...: 0
CONY BURNER: 0 FURN>100K 0 30-50 HP 0 SINKS • 2 DRAINS • 1
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 1 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 1 OTHER FIXTURES.: 4
RANGE • 0 (=10,000 CFI: 0 ABOVE GROUND: 1 LAUN WSHR OUTLTS...: 1
GAS LOGS...: 1 > 10,000 CFI: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
T CERTIFY THAT THE INFO( ,
RITION PIM)) B.� ME S TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE NET.
pW�E1 '. ,)
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FILE COPY
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$ CITY OF FEDERAL WADIMIT NO:SSUED: 09
Y BUILDING PERMIT PER
BUILDING
33530 First Way South /
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 03/14/94
** ..REVISED PERMIT ** .
ADDRESS:37022 811-1 AVE S
NO. : 322104-9142
PROJECT DESCRIPTION:NSF - CHANGE EXISITNG BARN INTO RESIDENTIAL USE, GARAtlf, E STORAQ;E.
101 3 OF K..C.S.P. 878122
INNER . . : CONTRACTOR __ w_�� LENDER --- --------
_ -._....�__.�_
RICHARD DONDERO 1110 K1 N IS CONTRACTOR*"
31022 - OH AVE S
0 FEDERAL MAY NA 9800:
874-2424
m
NONE'
BLD?:X HEC?:X PLM..?:X FLR--QST--PROP--- ...,DIELL1114 X11:+. 1 . CDNP PLAN •LDR FEES:
TYPE Of MORK:NEN USE:RES 15 � � 0: 21 sf STORIES. 1 REQUIRED PARKINS_ 2 SPRINKLERS ? PLAN CHECK DEPOSIT.* B 638:63
CENSUS CATEGORY 1CI 2ND.- 0 :sf HEIGHT ft '0,10$46
,��� � "' �`` 0� � �° ' L PUB WKS PLCK(SF),.93 40.00
OCCUPANCY GROUP-------777.-4414.4, a� sf , Y om - - RET r�� 1-147071'244
� FINAI. PLAN CHECK...* $ -34.13
:R3 :H1 . TI ; sf. S1. : tL':1:
° r, r"e ... . �e..: 2L ft p�T �m r @ 'INC PERMIT....' $ 930.00
TYPE OFCONSTRUCTION 1 ` P �� 5.00ftMATERSERVICE. :fEDSBCC SURCHARGE $ $ 4.50
:SNIL, w 06*REAR S.00:ft SEWER SERVICE..:SEP PLUMBING FIXT....93t 5 161.00
OCCUPANT LOAD ��� T 0 ' . ;. !?'1/ 3RADON KIT 93 $ 20.00
• 0: 0: 0: 0: ' f IMPERV SURFACE: 0 s SENSITIVE AREAS?.:N NEC APPLIANCE FEES.* $ 61.00
- _ - _ ---------------
—_.- --- ,... _ . .. ---,. .. ...._._.. FINAL PLAN CHECK...* $ 30.00
FUEL TYPES.;PRO (LE F' .i 0 BOILERS/COMPRESSORS NATER CLOSETS • 4 URINALS • 0 TOTAL FEES $ 1851.00
IDGAS PIPING.: 150 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 1 DRINKING FOUNT.: 0
FURN(100K..: 0 DUCT WORK • 0 3-1S HP.....: 0 SHOWERS • 3 SUMPS • 1
GAS HMT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 4 VAC BREAKERS...: 0
CONY BURNER: 0 FURN)100K • 0 30-50 HP • 0 SINKS • 2 DRAINS • 1
B80 • 0 MISC • 0 Si. HP • 0 DISH WASHERS • 1 LAWN SPRINKLERS: 0
GAS DRYER..: 0 • AIR HANDLING UNITS FUEL TANKS --- ELEC VTR HEATERS...: 1 OTHER FIXTURES.: 4
RANGE • 0 ::10,000 CFN: 0 ABOVE. GROUND: 1 LAUN NSHR OUTLTS...: 1
' GAS LOGS...: 1 , 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE 11 NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE Of ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNTSED 8941E I ,TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERtRA!_ MAY REQUIREMENTS WILL BE NET.
OWNER OR AGENT -'\ ,(it/-49 / — ----- --- DATE _.�=- �--` J V 4t�
5 1
FIELD COPY C 1340 6'7 Nei,
W WWWAWw71F ww-lrw*-v-
CITY OF FEDERAL WAY BUILDING PEI% VI I T PERISSUED: 09/15/9384
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KC
661-4000 EXPIRES: 03/14/94
ADDRESS: 37022 8TH AVE S
NO. : 322104-9142
PROJECT DESCRIPTION:ISF - CHANGE EIISITIG BARN INTO RESIDENTIAL USE, GARAGE, I STORAGE.
LOT 3 OF K.C.S.P. 878122
OWNER --_ -._.-_ -- _ ---------- — _._. — _. CONTRACTOR . ___ ..___ ______.._._.----- LENDER _..._ ---- ---
RICHARD DONDERO
022 - 8TH AVE S
DUAL WAY WA 98003
874-2424
_— .a-_ ._......
__-.�
BLD?:I MEC?:I PGM?:I FIR-H, �T if'I'1 -` l'�' t PLAN LOB FEES:
TYPE OF WORK NEW USE:RES 1ST ,. • REQOIIRD PARIllit,: , � 2 PLAN CHECK DEPOSIT.* i 638.63
CENSUS CATEGORY •10I 2NF. �: a <Is - �..�� �1IA S • PUB WK5 PLCK(SP)..93 40.00
OCCUPANCY GROUP lit, r k� ION I i......i S TMA .. 4 $RE F . 0 T q i ,� CRECE... -34.13
R3 :NI : JTZ. u,u 1<. t RROI'! P' t, - `-` `ILYI ERMIT....* $ 930.00
TYPE OF CONSTRUCTION ' M't; 0. sI PCU. .,I =P 63't 4= 1�.,........ 3. 0 ft WATER SERVICE..:FED BCC SURCHARGE * $ 4.50
:5N . . . 0. •.,s - R • 5.00:ft SEWER SERVICE...SEP PLUMBING FIX?... 93* $ 161.00
OCCUPANT LOAD GAR.1 t. s. If Y, 'AVE _2/53 tea RADON KIT 93 $ 20.00
. 0: 0: 0: 0: TOTL: 2J14 " 2584.41 IMPERY SURFACE: 0 sf SENSITIVE AREAS?.:N NEC APPLIANCE FEES.* $ 61.00
a
L TYPES.:PRO ELE FANS.... • 0 BOILERS/COMPRESSORS WATER CLOSETS • 4 URINALS • 0 TOTAL FEES $ 1821.00
• PIPING.: 150 ft HOOD • 0 0-3 HP......: 0 BATH TUBS • I !AWNING FOUNT.: 0
FORI<I00K..: 0 DUCT WORK • 0 3-15 BP • 0 SHOWERS • 3 SUMPS • I
GAS INT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 4 VAC BREAKERS...: 0
COIF BURNER: 0 FURN>I001 • 0 30-50 IP • 0 SINKS • 2 DRAINS.........: 1
880........: 0 MISC • 0 5t HP • 0 DISH WASHERS • 1 LAWN SPRINKLERS: 0
GAS BETEL.: 0 AIR HANDLING UNITS FUEL TANKS ELEC WYR HEATERS...: 1 OTHER FUTURES.: 4
RANGE • 0 <-10,000 CPM: 0 ABOVE GROUND: 1 LAUN WSHR OUTLTS...: 1
GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE OIE YEAR AFTER DATE OF ISSUANCE.
't CERTIFY THAT THE INFO TION F NISED ME S TRUE AND CORRECT TO THE BEST UP MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MEL
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stiIt HER OR AGENT 2: 4114247:0--- 'ATE ___12:/3:1-1,E_
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City of Federal `Vay II/ r(eUf 5 ( 0' APPLICATION FOR BUILDING PERMIT
n �� - (34y
dq3 � 4
PLEASE PR/NT
SITE LOCATION Address' k V SIO
N DATE
Tenant (if known) Lot # Assessor's Tax #
Building Owner Name Address EP 2 2
City I State Zip Phone
Nature of Work
APPLICANT
Name (F,M,L) C (", n
ehdfP 0
Address
3?o 2z k- Uc . o ,
City / wick toy State Lk) ) (� Zip 9 03
Contact Person / Day Phone Other Phone 1Fax
5q e_ 8- 7f - 212q
BUILDING CONTRACTOR,
Company Name
Address ,jr
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑1 No
ARCHITECT
Name , c
SCni— eeti 1 /C 1 0
Address
City • State Zip
Contact Person Phone Fax
RI -�/1u�� Q� e ,91-- 2129
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4(931
ST4UCTURE 'ping Use posed Use
Permit includes: J Building 10 Plumbing L Mechanical ❑ Other
',Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ 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 ❑ Project Valuation $
Zoning Lr,t Size Existing Bldg Valuation $
LENDER 1
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name /..ç
� Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT NO C6({1i! e 6014-1 C'x/S7/ fefr•ri*tio
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
NfECHANICAL UNIT COUNT
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 Count
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 cl,i arise out of t reli e of the City, including its officers and employees, upon the accuracy of the information supplied to the City as a part of this
application.
23 ?
Owner/Agent: ✓ / // Date: 9— �J
` • • Pipit # W C?3 D6411
J�3 22 1993 CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
;= ti` — Please Print— 01On Od
BOX 1 TENANT NAME: (9t— 7
OWNER i 2 `\ -r -` SITE LOCATION 3 2, 22 I= i vP• � , ,47
-�
OWNER'S ADDRE' fps-+-i e CITY /-PV'�o (1./1,‘( PHONE S 7'i - 2 4 2 /
DESCRIBE JOB vn akt EY-4-964 Ba.V/r 76 .Sr.
THE PROPERTY IS OWNED BY: SINGLE/MMiRIEDTNERSHIP � CORPORATION
BOX 2 CONTRACTOR'S NAME - -c:o e i• - CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
— OR —
II HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON R 1 tdi,iki)0'1 a nil PHONE ' -2-4 2 4
BOX 4 SEWER DISTRICT 3-1 4/ c WATER DISTRICT -
BOX 5 ESTIMATED PROJECT COST S01 co() EXISTING BUILDING VALUATION /kt 2 (Jo —
BOX 6 PROPERTY TAX ACCOUNT NUMBER 32 2/0 4 - 9/4 2 -a 3
LEGAL DESCRIPTION 1-ci- 3 k. C •r P- 8-71( / 22 /1-s (fie ev vi' c/ Oh/e rCcci .J, rc�
N� , (7 ) z ScC;oz VecotiS !_a f k. C . � �0, '
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (ExistingtR Ad) 1ST FLOOR 2/0 U/ 2ND 2A31 Z / S'kraVe
3RD FLOOR / EASEMENT / DECK / GARAGE 4 /
BOX 8 ()() SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) () ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. 4 WATERCLOSETS GAS PIPING, FEET /Sc' Prvf>ahe • $
f' BATHTUBS NO. FURNACE, ELEC. GAS $
_3 SHOWERS GAS HOT WATER HEATER $
.L LAVATORIES CONVERSION BURNER $
2- SINKS BOILER, SIZE BTU $
/ DISHWASHERS AIR HANDLING UNITS $
/ ELECTRIC HOT WATER HEATER b-9.6 a/• HEAT PUMPS, SIZE $
/ LAUNDRY WASHER OUTLETUNIT HEATERS 1 ecf'rr� z 40,(/ , l frit 'lvt(t
URINALS AIR COOLING UNITS, SIZEirVeir lrf.
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
/ DRAINS $
4 OTHER _ $
2 2 TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
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:
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