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rSETBACKS & FOOTINGS •*ler) 4"J i?
Date Ss-1;2.Z By)ili
FOUNDATION WALLS
Date - C V By /14/
PLUMBING GROUNDWORK
Date am) By
.................... . . .... .. ..............
UNDERFLOOR FRAMING
Dateg-)% —9y By 14,1
SHEAR WALLS
Date ;z''_ / By /1"
PLUMBING ROUGH-IN J�J(,J )L N; p
Date r�c74% By/ L)
GAS PIPING
Date By
MECHANICAL ROUGH-IN / L wog_/� C x���$, )lV tD„J L c�,
Date Q-- -6;e/ By /-.1.-7/1/
MECHANICAL (OTHER)
Date By
FRAMING _ er cxc vr--
Date q-Z7,tri Byj
INSULATION
Date/0- By inoLlA
GWB - 1ST LAYER %/,9-A,i/v 4 ,4J % )K /1'I
Date
GWB - 2ND LAYER
/�._
Date By ` % '4167 ,���i T %I�..vG; �/C f�GT�� L)./c;vycGdZ/�;r�r
SUSPENDED CEILING /37 (')e-r_JAL--2 S #1.4-4/1- /r" -4'a 6,2(0/xc -z r 1A-),6/
Date By ,J SPCGi_ � �2
...................
..................
...................
...................
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL
Date / 'Z3_c L( By//ti
OTHER
Date By
OTHER
Date By
CD01 93
.11 , . ,
• • (,(4of - 2-ri / s-
�..� City of Federal Way RE9PD
--It= FIZioicir<1=FL-
`� APPLICATION FOR BUILDING PERMI j *.eO _ veohif
CITY OF FEDERAL WAY
BUILDING DEPT.
PLEASE PRINT APPLICATION It: .1131.—D1 Z./ — e)55-3/
(SITE LOCATION Address ' I to
Tenant (if known) Lot# Assessor's Tax #
)0�' S�'73icig - aotno —c3
Building Owner Nan?e Address
! : C-Q- Dare `—tom-erd 7 �7 �"e , ,,: c.
City 7,._c 0 state �r
�' �'��f"'Gt.�" Li) � � Zip ���� Phone �i;�)6 7- �[D`-/�
Nature of Work c e 1 0(.)
[kv \ O V' C((kE kir ;C L
Name(F,M,L) 1 ' 1 -
CI Ill Ortn-er0C ,
Address
,5i'-7�'r] u :,.W
City F`e eicero l.�J
( y _ State Zip
Contact Person (/ Day Phone `Other Phone Fax
L carr , iriL(' L(-04 1
BUILDING CONTRACTOR
Company Name
CI./11 .-.) //Cole S -7i"C
Add
City ti 1//4 eiritlY. State La A Zip ' 7-'? 7 (
Contact Person
Phone Fax
Contractor's #(card must be presented) Expiration Date Verified O Yes O No
ARCIIITRCT l
Name O Y 1 e'
Address
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
o aoCA 1 _ _ $ ` .14 No. . i. . .
'yid . IirtQd' J �...P Uc I ory-2, F� ( �l a.- as 9I - 67 --
) �
i
1 i=,. ' -1k dI i. _I. l
Please Complete Reverse Side
CD0492(Rev 4/s/31
ExistingSTRUCTURE , I Proposeee
Jif
Permit includes: til Building ❑ Plumbing ❑ Mechanical ❑ Other,
Type of Work: JE' Residential ❑ New El Remodel ❑ Number of Units_ ❑ Deck
❑ Commercial ca Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor ----(._)L.,) sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area I'7 LP O sq ft
Area Basement 5(03 sq ft __ Decks sq ft Garage sq ft Proposed Total Area al cn 0 sq ft
Water Availability d -war Availability C" On-Site Septic System Availability ❑ Project Valuatio $ ::
Zoning /' Lot Size Existin BldgValuation
.syz) ---1-:=-> is$ rgat:, AsSCssc.7> vitt(1 t
LENDER :::::::::>< «< >...:..::::::: ;:::::<:::>
........ ............................:mii:............... ....:x:i:i . .............
Name • Address
City State Zip
............................................................................................
...........................................................................................
............................................................................................
...........................................................................................
1ViE(L OAUC.ONTRACTO12:ami:i ::
Contractor Name Address
_LI
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 FIXTURE COUNT
...............................................................................................
Water Closets , SinksUrinalsIICLawn Sp'nklers�
Bathtubs '' Dish Washer u'Drinking Fontai s Other
cl r
s
Shower • Electric Water'He t s Sumps
Lavatories , Washing Machine i Drains Total Fixture C.atmt ;`:, ;:;
...........................................................................................
MECHANICAL'UNIT'COUNT
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range \\'/:\
J \` i Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log j y 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 TonsTotal.;Untt 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. ;y��,/�,-,�J s��///J /j
�'''��' V �t�' f ✓ _ Date: 7/2'0/ 1/
Owner/Agent: r L
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