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SETBACKS & FOOTINGS
Date By
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
...........................................
............................................
Date By
SHEAR WALLS
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
711
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(4( By,(//4
OTHER
Date By
OTHER
Date By
CD01 93
i •
«rye City of Federal Way
v Frv- APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #: •&-i0
SITE LOCATION Address 7� (,1 L
Tena s (if
know1) Lot # Assessor's Tax #
Building O `ner Nam Address
r
121IL l r( iya 1
Cit
y A.; / £ 4 State +� _ Zip 5 ,' 7 ` ' Phone
Nature of Work
•
APPLICANT
Name (F ,L)
Address 7-4
City c lr' ,4 t �1! •
G � !''�� State (�/� Zip ?r'L'f � f
Cct Perso7) / Day Phone Other Phone Fax
BUII.DiNG CO1�ITRACTOR
Company Name
Address
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
C00492(Rev 4/93)
STRUCTURE existing Use OlProposed Use
Permit includes: El Building El Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New El Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ 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 ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuatfan: $
Zoning Lot Size Existing Bldg /afuaton $
Y'ENDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
•
License # Expiration Date Verified ❑ Yes ❑ No
nywns 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 TotalTixttrre<Caunt
MECHANICAL UNIT COUNT .....'
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 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 end further that lam 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. / - r7.
`
Owner/Agent: / ✓L'� AVIV / r Date: �/ / S /