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APPLICATION #: l-C. 'S7C SITE LOCATION Address 31430 �` 4� - PL. S.W. FED.v"AL ►: .: . Tenant (if known) Lot # r Assessor's Tax # .JAt, T ; _AV 5 , 2II55I -o52a Building Owner Name Address •Me ' AubVL S4 „— / ' Fov City State Zip Phone Nature of Work FouNc T OtJ E c .T RAL .C---: AA\- APPLICANT Name (F,M,L) VSA /4E t OLK6C C RAZO&OlJA ' Co svz t -Tl Dnl Ccs. Address - 5.2 VJc PA-2 c kvE. W. City SEyi i ILC State 4A, zip 9e3,09 Contact Person Day Phone Other Phone Fax 5/it/E.- -S ti-P ovE, (20(0) 587-Ot01 120(,) Co23-o?� AUDI VG CONTRACTOR Company Name P3RID&Ev!AY CONSTRUCTION Co. Address 3826 \Oo r>L-.AV i DARK WAY N. SEA-r S LE Wk. 96/03 city SEATTI--[ State \A.A, zip q8/03 Contact Person Phone Raiz Di6I AL PA6ER IL wAYn/g 1-1D4MES (o32-ogco S 7-990/ Contractor's # (card must be presented) Expiration Date Verified ❑ Yes Li No CCO! aRIDC1CC )81(R3 CIUTE :.:::::. Name lToIDD ?ActF-IC ENGril4EEIZINCt Address 820 M NoR hl • SurcE 2.00 City SEATTLE state WA. Zip 98/09 Contact Person Phone Fax 7 KEN SIMoNS 2-4)0 X82-1500 (2ae) 6E12-2023 LEGAL DESCRIPTION i3O r 1,41M/9 /Ay ' i 1/1- 0 ,Ar' ,-5--- Please Complete Reverse Side CD0492(Rev 4/93) •STRUCTURE sting Use Iroposed Use ( I Permit includes: ❑ Building ❑ Plumbing ❑ 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 lid` ewer Availability U On-Site Septic System Availability ❑ Project Valuation $ 284 Zoning K l '141,- Lot Size N. 2,-,,,,j, 9. Existing Bldg Valuation $ �� GQ AsSi .r•` E . ame Address G.E. ��41�1T 1_ ?0.13()){ 33(5 City CANTON y ' State 01-1 I 0 Zip 49-71,0-33 15 MECHANICAL":CONTRACTOR.: Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUMBING CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No .. .... .................................................................................. PLUMBING. IX URE COUNT:: ........ ... .......................................................................... Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains otal FixtureCount ........................................................................................... t ............................................................................................ MMECHANICALTTNA' 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 Totaluntt 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 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. Nt // \1 �^/, Owner/Agent: (/V (�( . Date: 9'?4