96-101019 94-/o) ` 19
CITY .OF FEDERAL. WAYuµ , ,,r PERMIT NU: BLD96 -0120
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SETBACKS & FOOTINGS
...............
Date By
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WAILS
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 c<-'
OTHER
Date By
OTHER
Date By
CD0193
•
• City of Federal Way ','FIR/1= ►
a,
APPLICATION FOR BUILDING PEARIVIIIT2 1996
.
CIiYL,- I , ,, :;„Lv r'
BUILDING DEPT.
PLEASE PRINT APPLICATION #:f LD PE— 642-0___
SITE LOCATION Address O S .3 GJ 2-j37
Tenant (if known) Lot # Assessor's Tax #
h/t )4 L-Yti&' VI c DO/1,.//;-Ce
roz//5-0 0 3 3 0
Building Owner Name iAddress
D re (�Sci+44 38is S- (-b 33?)61i -C(-
City F e LU . State (,(J s Zip 0 33 Phone '3eO �� ( f
�_ r� /� _ u_ (”- fes
Nature of Work a,,,,�t p . Il (9G F-• t c_E(clf -6 our ,?-f(;I oki-(-
APPLICANT
Name (F&L)
Address
D-7(1/ ki • -. o d_ e-
City L--iy-VviA_S State Wt , Zip 5 eC)'7
Contest Person Day Phone Other Phppn'.e Fax
bLeEy✓ -3�u~ 3`{ - -Dc-1I •5r�- e,3Ct-Or y
BUILDING CONTRACTOR
Company Name
Address C
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/93)
STRUCTURE Existing Useiers_it • Proposed Use i
Permit includes: Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ;l ther
Enter 1st Floor- 'sq ft 2nd Floor TJX '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 $
Zoning Lot Size Existing Bldg Valuation $
LENDER
Name 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
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL UNIT COUNT MECHANICAL VALUATION ONLY $
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 1 5-30 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 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'tees 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 c r • rises out of the re'a e oaf the City, including its officers and employees,upon the accuracy of the informatio supplied to the City as a part of this
application. /
Owner/Agent: / � �L �._ Date: l ��