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SETBACKS & FOOTINGS
/ScdsSri7 /mfr./ f,e/?F,bv& ?a-04/:mAicr2T3 L✓�e /�//aivT�✓r�c�
Date By c-Hrf Tye eF 77) !/ten
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH-IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER);,
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1ST LAYER
Date By
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL •
Date By
OTHER
Date By
OTHER
Date By
CD0193
• 0 _,
6 City of Federal Way
�' �L ECEy4PPLICrt. ATION FOR BUILDING PERMIT
<< i VIAy 201994
PLEASE PR/NT j '^[
.'t 13APPL/CAT/ON#: . '
STt:::114.::ailom
LOCTION G ;tL1C4TJdressWAS
241.7
�0c, 0 a(.- ti, ,- Hwy .s
Tenant (if known) Lot # Assessor's Tax #
Building Owner Name Address
5, /vee S Gt d 0c4 h (Q p� a c '`
City.._e.d _" Qj pa State (,ta a Zip/ _`�ci 0Q "2," Phone 239 3 9 3
Nature of Work 4A pa/
aim e 7 ac W ( W C /e'1.: `/Q 1( W G y
4
APPLICANT...::; .:..:. ...;.......
Name (F,,N,L)
!//J c te , 0y
Address
/7CO0447 ittCt it / � S
City e4 —, W U' y State WL. Zip r' c. -
C ntact Pe=son Day Phone Other Phone Fax
It1
E (BUILDING CONTRACTOR
Company Name
5 A Pi a-Se 0 4 0 ti (i
Address
NI
• City
Pt
State Zip
Contact Person Phone Fax
0'1' Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT :
Name
, S / a
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/93)
a RUOTORE xisting Use —
'Proposed Use
Permit includes: k Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: 1 Residential ❑ New L1'.Remodel ❑ Number of Units ❑ Deck
N. Commercial ❑ Addition El 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 X On-Site Septic System Availability ❑ .Project.Valuation $
Zoning I Lot Size Existing Bldg Valuation $
......................................................................... .......... . .
......................................................................................... .
............................................................................................
LENDEI
Name 1;>,,I 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 Address
CityState Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
i
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAVUNIT COUNT
Fuel Type (electric/other) as 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 i 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 claim arises out of the eliance of the City, including its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application.
I mip
' /
Owner/Agent: ,) /
•• A A _rt Date: G / O (CtIC[[