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CITY OF FEDERAL WAYFt PE MIT NO: BLD97-0370
97-03 0
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SETBACKS & FOOTINGS
• • • i
if
Date By III
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS
Date By
riiiimommimim
PLUMBING ROUGH-IN
Date By
A 1
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date g— 1 — Bya,d---
INSULATION
Date 41416 — 1 _Ig By --- r
GWB - 1 T YER
Date,//// ? 7 By —
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
rENGINEERING FINAL
.....
Date By
FIRE FINAL
Date By
BUILDING FINAL
Date By
OTHER
Date By
rr
OTHER
Date By
CD0193
ee BUILDING DIVISION
�__ nom_ cie° 33530 First Way South
�� AY 9 Federal Way,WA 98003
wH 2 ° 19 (206)661-4000
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C,��n�F�pWAY Fax(206)661-4129c
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION# (2O� — e57-75iiiiy�� I
. �r +., ,f„ .......:::;:;:.:::::::::.:.:;..;;t.:$r,Fffn^,s::,.+ ,i Address //�� -• o?,7cOX.
Tenant(if known) Lot# / /2"1.214-e' Assessor's Tax#
Eil eg7 ,-/,t1, / 6i5lffo_oYaS=o/
Building Owner's Name / / ////cK.e7- c� Address//p, ‘ /,
City;,f---%/4"-dee,/,17 4,/l�f�hO� ,///State !.�//� ✓ Ov �F/"
Zip PI Phone2'2 97.26
Nature of Work EX/rrlcf/A NCi/".eo .e 6;fri f /re:0 V eGO-t $ ' '' ,-i2 7 6/3AP t---
T get, /41 jcsie/1
:. ,...off.
w
Name (F,M,L)
X a -,s 7c)7 ggi9ccv/ 5
Address
City a•.«./ C&2 60751State 6Zip !/ �3
Contact Person r 61
�Ou B>' hna�e Other Phone Fax
--70a - ,g2..?-J7.-za .-Acri ,Ya&9,7 f17a-3,3o—
Company Name NAY- /46nA.1-61) 4/VW
Address
City
State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
<`s
Name N/51
Address
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
:.;::>::::::::...:•:::.;•::.;::::.;::Ma:: 'K<: . : : :: :<::>:::»>: Existing Use Proposed Use
Permit includes: 0 Building ❑ Plumbing 0 Mechanical 0 Other
Type of Work: Id Residential 0 New 0 Remodel ❑ Number of Units 0 Deck
0 Commercial 0 Addition ❑ Garage 0 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 Ig Sewer Availability f9 On-Site Septic System Availability ❑ 1 Project Valuation $ 0�
Zoning '_._ -) Lot Size ; i :, _t1,, Existing Bldg Valuation S 1,04-c a-
LENDEf ?'_[> << > ><><' »€< «> '< €> >
Name Address
City State Zip
MICA «..r'ONTRAIr'TOR _..
Contractor Name Address
City State Zip
Contact Phone Fax
7-
,
License # Expiration Date Verified ❑ Yes 0 No
PLUNIBINOZONTRACTORMEMEM
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
1 uMatNG.€::IXTU:::::::::::: :«:«u<::. RE »> <
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine DrainsTotal Fixture Count
tiaidiaiiii.axeiigiiiiidiiiiii1111111111111 MECHANICAL EVALUATION ONLY $
Fuel Type (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 Bur r Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Ttite1I11Uf Cntrrit ,;:
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 relia/fi;Ohlie city,including its officers and empl yees,upon the accuracy of the information supplied to the city as a part of this application.
I
1' ,_6 II !. L -- ` o( Qi f
Owner/Agent: Date:
BUILDING.APP
REV..12/11/68