99-104691 T Ad03 Slid
r
"" _______.__-_- _ Ail:0111111P 66
a .0 a3NM0
Ile
'1314 38 11IN S103N3HI0030 AVN 1d8303i JO Al!) 318a)Ilddd 3H1 amu 39031NONX A14 JO 1538 3H1 01 1)314801 QNd 3ffl SI 30 : •3HSI1 11 IIlUHHOJNI 3H1 1VHl AMIl83) I
"3)NUOSSI JO 31va 831id Hd3A 3N0 311IdX3 SlIHH3d 90i0V09 QNN 1VIlN3QIS38 '031HVIS SI HON 'N iI 3)N@(ISSI N31id SAVQ 081 38IdX3 SIIWS3d
0 :'0N0OHSH3QN0 0 :Wi) 000'0T < 0 :"•S501 Sag
0 ' '5111(10 HHSM NI1V1 i 0 :MOH3A08V 0 :Wi) 000`0I:> 0 • 39NVH I 1
0 :'S311f1XI3 d3H10 0 :"'SH31V3H HIM 0313 SXNV1 13f1i SIINRl 9NIIQNVH HIV 0 :"H3AHQ Sas i •
0 :SS31XNIHdS NMV1 0 • SH3HSVM HSIQ 0 • NO1 +0S 0 • 3SIW 0 • 088
0 • SNIVHQ 0 • SXNIS 0 :"'NO1 05-08 0 • X00T<NHfli 0 :H3NH08 ANO)
0 :"'SH3NV3H5 )VA 0 • S3iHO1VAV1 f 0 :"'NO1 0E-ST 0 :"'S3AOlS 000M 0 • 1MH SV9
0 • SdWfS 0 • SH3M0HS 0 • NO1 ST-8 0 • XH0M 1)fC 0 :"X00T>NH0i
0 :'INf101 sNIXNIHQ 0 • Sall Hing 0 • NO1 E-0 C • QOOH 11 0 :'sNIdId 95
9I'ITZ $ S331 1V101 0 • SIVNIHfl 0 • SI3S01) H310M SH0SS3HdW0)/SH31I08 0 - SNVJ Z Z:'S3dAI 13li
Z:'ZSV3HV 3AIIISN3S Is 0 :3)ViHfS AH3?WI ' Is'o :0 -1101 :0 :0 :0 :0 •
66/0I/ZT:'03A13338 is:2 :0 :'Has QV01 1NVd0))0
3S H3M=7 :) :0 1)34 : Z: Z: Z: Z:
-I':..it4A.: _ ,... 3�rq 0009 .l t
,, .4k
z, �WSB NOI1)flH1SN0) i0 3dAl
. _ 7..,.., .=1, Ob a` :$":7-1 ,�: • Z: Z: Z: Z:
OS'i $ 30HVH)H0S 338S _ ,..., ?,,,. sc, - -- .. .:.1 01111003H NO'-:'' P, - 1 :'Q�HE dl0Hs A)NVdf)D0
SZ'SZT $ IIWH3d selling ic• SSV1) (IHaiVH a 7s:0 :) :'8NZ S9S. AH093IV) SfSN3)
T7'18 $ 331 X)3H) NV1d c• 61331XNIHdS 0 :"UNINHVd 03HIA03e '. .. =u;_? <s:0 :0 :'1ST WO):35f1 I1V:AH0M 30 3dAl
:S333 c• NVld dWOD ' n '' °'''-'3 ' ---dQ8d--ISI S--HWJ :aid :03W X:018
sss %911 = 3IVH XVI "ON 1d83Q3i JO AlI) 3H1 NIHIIN SI)3fO0d 8Oi XVI S31VS 9NIiH0d3H 113t1$ ?. LT 3403 NOIIU)O1 3SA 3SV31d 'S8OI)dal1NO) us
9XZZZ*I**NdQ
8008-199-852
28086 VM IND i 80086 VM AVM 1VH3Q33
iS H190Z S 6281 ( S AVMNHVd 03INVH0N3 TOZ98 i
)NI X d Q )NI S�IHVd Q31NVH)N3
E H3QN31 ; = ---- -------- ---- ---- HO1)VHINO _1- --- ----- -. .- H3NM0 _:I
Alaadoad Io uoIpod ris 6uote (II oos 'xoJdde) aqua} Hell ,OT IpnJlsuoo - 11V WO):NOI.LdIZ:DS3Q 1J31:O2id
9Z06-9012K, : ' ON
S AM>id Q3.LNl)'HDN3 TO495 :SS3bu.tic)
OO/L0/90 :S3fIdX3 00047—T99-552
203 :AS 091:47•-T99_ ESZ s:Isanbe j uoi;aaasui 5u1p[.?na 50086 VM 'keM I ..aapa3
66/O1/ZT :Q311SSi f' f' 1 N.•.p iG;.., I •"�" Ir u'TnoS AF'M '1s-IIJ 05555
ZOLO-66cna :ON lIWb3d �,.. ., !I�+I! r'1t.° d.,,p ,;;,W �! ,.�•.�.,,,� ,.��. �~Ao »1,. AUM 1F) 3Q33 JO AIL)
/61 A Qt- 66
Ad03 crow
Q•co 's 5 A e_e
,-,
,
, ,//,
31M
\ .
111 14 1111 SIN3113110011 ANN 111313J JO Al!,) 3111)I1ddV MI INV 130311(* AN JO IS11 111 01 1)11/0) INV 34III SI 3N Al 13161110 6111110111 311 1111 AI1113) 1
13114SS1 JO 3100 13111 111A 110 11103 SHUN WINO 41W 11111141S3 DIOM SI ANON ON 11 33NOOSSI MN SIGN OBI 1111dX1 SIINOU
I 0 :V0015810110 0 41j) 000*0T /. 0 :-5501 95
0 :-511100 81611 1001 0 :0000 3A00 0 :NI) 000'01=> 0 • 35N44
0 :°S3801111 V3010 0 :—S431031 VIN )313 ---------SINVI 13113
:I 0 :$831IN
13S 10W1 0 :''''"SIONSVM HSI4 0 • NO! +OS 0 .
SHI0 • SUIS 0 • '101 OS-OE SIM 31110111 SIV
0 . M )S1N
0 • 1001(1010.1 0 :"83AS0 CV5
0 :21311300 ARO)
j 0 :—S833U310 MA 0 • S314010AV1 0 '001 0E-SI 0 • *S3AOIS 0001 0 • 111 95
o • SdNOS 0 • MOONS 0 • 101 SI-E 0 :—'1101 1)06 0 :"100I>NUI
0 :11001 51131110 0 . SO01 1100 0 • 101 co o • 000H 11 0 :111Id1d SVO
9TITZ. t
S333 1V101 0 . SWUM 0 • S13501) 81101 SN0SS31,110)/S431I00 0 • SIM S3dAl 1301
3AIIIS1135 Is 0 :1)111805 Mall 45:0 :0 :1101 :0 :0 :0 :0
6q0TIZT:111113)113 Is:0 :0 :"Mn --- ----0001 INVd0))0
3)1A13S 1313S 11:00'0 . edrd Is:0 :0 :3)34 : Z: i.: Z:
S 831o1140,1,1000 , --1015, 0009 :$-4004 i5:0 ;0. .064 1011)0OISNO) JO IdA!
k44 40j0 .... --NM 0 4-1:131 4s.° :Ti :stito : L: L: i.:
AC -C‘' , \%-\"),"
Oct $ 3910010S ))16 100 4 °,---, ,,4,441.4,- -------=UOIR 033.1003S --101INIVA 4s:0 :0 :11OE d10d9 A)1061))0
SVSZI $ mod maima f!..'..ii414y60111 ....
H otro . "0110 is:0 :0 :'01t! S9c. A409310) SOSN1)
IrIO $ ......
331 1)30) NOld 4. 4Sd313NINdS 0 :-51140d 03/1100111 0 : "131108 4',:0 :0 :1ST 110):3S0 110:1101 JO 3dAl
:533I 4. 111d (410,' -'5%,11 :SIM 31111310 --dOgd--ISIX3--41.1 :411d :433W X:410
us WO = 110 XVI 111 111103J JO Ali) 311 111111111 S1)3t0Vd SW XVI U1V, ultaoilla 4144 4L4I 440) 4011001 1S0 154310 'S401)441110) us
4.4
9 8008-1997
1k
IS 4,0
44./AsPvek!A;e0 * Z11E086,1 6 Oi 1!33 E0O86 01 AVM 10/3031
1 7 S AtINIed 0311V11)13 TOM ,
OI
1 )111 3 d (1 ')N1 S380d (131M13
:quad ns 6uoie 01 Ns •xoidde) anal 11E1 ,OT lmilsuo - 110 110):N01.1c1flOS.710 i D3rod
istA
9Z,06-901.48Z : '011
S AM)Id 03.0191IDN3 TOZ9E:SS3110110
00/L0/90 :5RI1dX1 00047 t99-Ece.' p
ZD.A. :AEI 0' .I1,/ -i99-ESZ sr3enbau uoIlDedsui BuTPITI)14 60006 UM 'AvM TeJapai
66/01/ZT :0311SSI IIWI:13d ON Ial ma glnoS AeM 1$J1A OCc4EC
ZEL0-66(118 =ON iIWV3d AVM 1t12130:1.1 30 AI 0 0
1
................................................
Date::.f2--z�gf By ....... PO-5-7iA/5 k pidA
Date By
Date By
4
Date By •
5 Filet 1t 100WNSPOU'T;DRAiN,S
Date By
......... .
6UN E.:R' A1�IING: •
Date By
Date By
8
Date By
Date By
10 MECHANICAL.,ROUoH IN......
Date By
11
Date By
12
Date By
13
011111;E.;:.:1:..;::;:. . ::.::::::.::::::::::::::::::::::::::::::::::::::.:::.;::.`
Date By
14
Date By
15
Date By
16 'PL►C 11NG::,F1NAL:::.:::::::::
Date By
17 PUBL.IG VO KS FINAL:':;€ ...
Date By
18
Date By
19 BUILDING'FLP1AL
Date By
20 QE .....:..::....
Date By
CD0193(Rev 4/97)
BUIL
ES L_ RECEIVED 33530 Fust ay
Federal Way,WA 98003
N)N) FFY
q (253)661-4000
DECq
I 0 1999 Fax(253)661-4129
.lTY OF FEDERAL WAY
BUILDING DEPT.
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #
Site address
ti-
$01400.%4111111111111111111111 3 k� �c., �., � <_4..)A ,a > 'vim
Tenant name Lot# Assessor's Tax#
(t� p �n ZztOS�- 9�2(c
Building Owner's Name Address
City ' �:1C--b State v-' :> • Zip I `6C::0'-? Phone'2
Description of Work
Name (F,M,U
Address
City State Zip
Contact Person Day Phone Other Phone Fax
Federal Way Business License # (o OC 3-3 8 "7
Company Name
Address
Satin
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified CIYes ElNo
1 1
1�1 1 Z I(pCiI S
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
4 5 yc i6-1"
Please Complete Reverse Side
1
::+�
Vis: .: `,.'..
, .._.:..51...TU... .. _.._..::;. ;._::-;;;;::::> ::.:,a Existing Use l Proposed Use
Permit includes: Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ #of bedrooms ❑ Deck
"ft, Commercial ❑ Addition ❑ Repair ❑ Garage ❑ Shed
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 $ C'c O
Zoning J Lot Size Existing Bldg Valuation $
NDER:: _.:::.::.;;.;;:.;:.:.:.;:.;::.:;.:.:.>;:;:;.;:,:.;:.:.:;.;:.;;::::;::.:.;:.;:.;:;::>.:;;.: For new residential only - Proposed selling cost: $
Name
Address
City State Zip
NIECTIANiCAVCONTRACTOREMEN
...........
Contractor Name Address
City State Zip
Contact Phone Fax
7 License # Expiration Date Verified 0 Yes 0 No
PLO111113[`>:>:::: :_?*:*i::>:::'s::::..: >,, >;:<>`:€::>::>':» '>><
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified Cl Yes 0 No
BINGTWTORECOUN.V.M.1.:.:EiM
. .
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine % Drains Total:Fixture:Count
11IEC] <:i><"..]:i:i:< :<:::>`< <»s:":::>:>:::>» > < .>': [> >
HANIC�EL.3Tt1tiT..CO>;3N;ii MECHANICAL EVALUATION ONLY $
Fuel Type (gas/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
BBO's Wood Stoves 3-15 Tons Totat ill Coati .
/
DISCLAIMER: I certify under penalty of perjury that the infomiation famished 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 ci ,incl .'ng its officers and employees,upon the accuracy of the information supplied to the city as a part of this application.
/j �J 7
Owner/Agent: �' { f✓ Date: /12-lie �`
uom.c.nw
41111V
nerwo sn nroo