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CITY OF FEDERAL WAY
�- G '�Tr DEPT COMMUNITY DEVELOPMENT
3001 S FIE S I #14 131._194-_0-•69 .—
rr JJ NUBILE I1[i1E
CANTO, I'3111flfltil
06-16-94 —
/
qj DATE SUBMITTED 6)(1(p(U4 DATE APPROVED Z Y
J Q _0 APPROVED BY___4-----C----
•
/
4
/ r ` , — —,—l� ` Fit,r ' - ' �+
J FILE
(.2,
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7
Lo-f-
PLAN APPROVAL
• .0 Aetmit umber: --- Y C 6- q
r 6)-. _ Approvd By; 73
Date.
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I- - ___ "88 fl-4
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P Ip\r-1 CL/\t ITLJ
SKIRTING SHALL NOT BE
INSTALLED BEFORE BLOCKING RECEIVED
..>
AND TIE DOWN INSPECTION.
1 `'• JUN 1 61994
kV
0 .--�� IT-RE-MOBILE HOME SHALL DISPLAY A PERMANENTLY CITY EDEFiAL AY
��� ! AFFIXED DEPT OF L&I OR H.U.D.iNSPECTKM LABEL ¶ LCT
�2LLATION OF THE NOBLE HOME SHALL BE PER �+
MANUFACTURERS RECOMMENDATIONS.
ta l 03.PROVIDE A JOB SITE COPY OF THE MANUFAC LIRE CJJC�C 1 Cj •^ \ (.7:_23 S,FT UP BOOKLET.
36 THERE ARE TO BE NO DEVIATIONS
TO THE APPROVED DRAWINGS
•
• UNLES,l;THERWISE APPROVED BY
The,.r' AL WAY 81WI6t IN9(APT
RSA-417k°o
V.
• City of Federal Way •
•
v F=r��ir
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #: At% y- 0 vc z
ISITELOCATION Address 30o S, 9, F4ti 44/'-/ FFUEEA� v)A`) \'J T 7e 3
Tenant (if k own) Lot # Assessor' ba�y
j��p�lAN CSN it)own) z r X23
Building,9wner Name Address
:. /1c Lo7 59d f. 3ooI s , ago
City E D ,g t L \AA vV y I State AZip 9 6003 Phone 2 3c)
Nature of Work
PLIf
APw4P.ME
Name (F,M,L)
AD,e /-,' — C,-N7u
Address
3233 X974 Our S W
City S 4-7 7L EL , iv p State
wel Zip 9x/ a6
Contact Person Day Phone Other Phone (.)o6) Fax
/4DR- ,N C4%l77(.i ( a(>G ) ?. 33" 9 S/ X6 7- /9 k i
B .I)XN;G COWTRACTOR
Company Name
L_ 4.- S c. T2 :n 1 ,.ic.
Address 7P F:)t.)X417)-4q// "� y-,q
City `� M� (JUJ. Gjg4-4- -7 State h Zip /8`L'4
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified ❑ Yes ❑ No
( �C. C. I' lIko 61q -- ry -7.-22 . Tt-
ARCIIITEC'I`'?>
Name
Address
City State Zip
Contact PersonPhone Fax
LEGAL DESCRIPTION
C'�AMELo7 S 'uiv2 44- iy
RECEIVED
JUN 1 6 1994
• 40Please Complete Reverse Side CITY OF FEDERAL WAY
• BUILDING DEPT.
CD0492$ev 4/931
STRUCTURE ng Use s osed Use
= �'i�Tvk ,
,�
Permit includes: uilding ❑ Plumbing Mechanical ❑ Other
• Typd of Work: 'Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor -1C/1 ,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
i
Sewer Availability ❑ On Site Septic System Availability ❑ Project Valuapan 4. -
ZoningLot Size Existing Bldg Veivattort ti:>
L
UNDER..... `.... Sv l '04,(t
��
Name Address
City ....(...6c:—V-�N't ems- State Ca Zip 97o
MECHANICAL CONTRACTOTt
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR':.;is
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets '2---, Sinks ' Urinals •-'' Lawn Sprinklers ....-----
Bathtubs
, -Bathtubs Z, Dish Washers 4 Drinking Fountains --'f Other ,------
Showers i Electric Water Heaters j Sumps ./'
Lavatories -2 Washing Machine 1 Drains ,------- Total IFxture Count f'
uuAA��:*� ��T�
CJ�.JSOUCAJf�i T.CO VN
Fuel Type (electric/other) ,a,‘e„. Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range 1 Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUsaX./ Gas Log --- Unit Heater 50+ Tons
Furn >100 BTUs Fans .2 Miscellaneous Fuel Tanks
Gas Hwt Hood 1 Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves .r--- 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 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: c;��.--C.,.i•- - D O -, .., ,-- / �: - i "1 1 7