93-102234 ., 9&.)aaa31
3cgi8g�►a�f i Wa�7EWW 96008 ilei n i tl �est�661�� d�■ PERMIT-NO:I6� : 4 /1 7/g77O
661-4000 EXPIRES: 03/16/94
ADDRESS: 1O1O S 336TH ST Unit: #324
NO. : 926501-0020 ';et,7/f jf J)
PROJECT DESCRIPTION:TI - CONVERT COMMERCIAL SPACE TO NEN TENANT SPACE.
REVISION REC'D 9-17-93 TO INCLUDE MECH MORK.
OWNER — CONTRACTOR — LENDER
UNIVERSITY ESCROW SUPERIOR BUILDERS INC
1010 S 336TH ST STE #324 1112 S. 344TH STREET UNIT #307
FEDERAL MAY NA 98003 FEDERAL NAY MA 98003
1111111 874-3647
SUPERBI1
SUPERBI112D2
FUEL TYPES.:GAS ELE FANS - 0 BOILERS/COMPRESSORS FEES:
GAS PIPING.: 0 ft HOOD . 0 0-3 HP . 0 PLAN CHECK DEPOSIT.* $ 117.00
FURN<100K..: 0 DUCT MORK - 1 3-15 HP • 0 FINAL PLAN CHECK...* $ 0.00
GAS HMT - 0 MOOD STOVES...: 0 15-30 HP . 0 PLCK-FIR come only* $ 9.00
CONV BURNER: 0 FURN>100K . 0 30-50 HP . 0 BUILDING PERMIT....2 $ 180.00
BBQ - 0 MISC • 0 5+ HP • 0 SBCC SURCHARGE * $ 4.50
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS PLUMBING FIXT....93* $ 7.00
RANGE - 0 <=10,000 CFM: 0 ABOVE GROUND: 0 MEC PRMT ISSUANCE... $ 20.00
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
TOTAL FEES $ 344.00
•pection Record Mater Line OK Mechanical Inspection Notes:
GAS PIPING OK Date By
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INF ATION FURNISED BY ME
S TRUE /DCORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL MAY REQUIREMENTS MILL BE MET.
OWNER OR AGENT _ _____� __—:�___—_�__— DATE / J �_
FILE COPY
IP
CITY OF
33530 First Way South B U I L D I NC PERMIT PERMIT70
ISSUED: 09/02/93
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FLF
661-4000 EXPIRES: 03/01/94
ADDRESS: 1010 S 336TH ST Unit: #324
NO. : 926501-0020
PROJECT DESCRIPTION:TI - CONVERT COMMERCIAL SPACE TO NEN TENANT SPACE.
= OWNER - CONTRACTOR - LENDER
UNIVERSITY ESCROW SUPERIOR BUILDERS INC
1010 S 336TH ST STE 1324 1112 S. 344TH STREET UNIT 1307
FEDERAL NAY NA 98003 FEDERAL NAY NA 98003
III 874-3647
SUPERBI112D2
BLD?:X NEC?: PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •9 FEES:
TYPE OF NORK:TEN USE:COM 1ST.: 0: 0:sf STORIES • 3 REQUIRED PARKING..: 0 SPRINKLERS9 •1 PLAN CHECK DEPOSIT.* 1 117.00
CENSUS CATEGORY 137 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS •9 FINAL PLAN CHECK...* $ 0.00
OCCUPANCY GROUP 3RD.: 9500: 1269:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 pa PLCK-FIR conal only* $ 9.00
:82 :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft BUILDING PERMIT....* $ 180.00
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...S: 17000 SIDE • 0.00 ft WATER SERVICE..:? SBCC SURCHARGE * $ 4.50
:3-1HR:? :? :? DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:? PLUMBING FIXT....93* $ 7.00
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:08/31/93
13: 0: 0: 0: TOIL: 9500: 1269:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 317.50
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN< OK..: 0 DUCT WORK • 0 3-15 HP • 0 SHOVERS • 0 SUMPS • 0
GAS ...: 0 ROOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONY KNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 1 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP - 0 DISH MASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC NTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 "(=10,000 CFM: 0 ABOVE GROUND: 0 LAUN NSHR OUTLTS...: 0
GAS LOGS...: 0 >`10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 80 pm .FTER ,SUANc IF .0 NOAF .!TED ' IDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT T 'RFO' ION Fb D BY Iasi,r t'j AND CI- CT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CI .Y OF FERERAL NAY REQUIREMENTS HILL BE MET.
1111elelOW
OWNER OR AGENT _`=� �-�_mw ,....1....... DATE tija c
FILE COPY
, 1 , y
CIIX-OF_FEDEWAA WAX. .. I1f1E it�� P6Eli� II PERa111..�10: $/17/Q.
FedeOat i May,wWA 980®E3 d n des t T RRI IBM: fie/1 1 7/max
661-4000 EXPIRES: 03/16/94
ADDRESS: 1010 S 336TH ST Unit: #324
NO. : 926501-0020 * 4 W ,Dom` --
PROJECT DESCRIPTION:II - CONVERT COMMERCIAL SPACE TO NEN TENANT SPACE.
REVISION REC'D 9-17-93 TO INCLUDE RICH HORS.
OWNER ___,_tea--= LENDER _._--___—---- ._: _._... ,..-._
UNIVERSITY ESCROW SUPERIOR BUILDERS INC
1010 S 336TH ST STE 1324 1112 S. 344TH STREET UNIT 1301
FEDERAL MAY NA 98003 FEDERAL MAY NA 98003
III' 874-3647
SUPERBIII2D2
FUEL TYPES.:GAS ELF FANS...........: 0 R0I LEP`>f c. i °� *11' '— FEES:
GAS PIPING.: 0 ft HOOD • " s�3 iii._ _..: 0`. 'rs.i r, PLAN CHECK DEPOSIT.: 1 111.04
FURN<IOOS..: 0 DUCT 1ul}RX... :x: 1 1`� NP. .._: 0 FINAL PLAN CHECK...' $ 0.00
GAS Hill • 0 i=__,......—. ..
WOOD STOVE,`. 0 1�a•30 It 1 only$ $ 9.00
CONY BURNER: 0 FURN>1QM1w.,.;.
0 ,0-50 NT ... ;•1 . IT....i I 180.00
10' - 0 NISI *:Ar
<. y i $ 4.50
_ � 2V.4°.. 4
GAS DRYER..: 0 A , T L fU Ara.. --- PLUMB F 4.00
RANGE • 0 < , iC 0�� ,I60 . Gh nW 0 NEC PRMI ISSUANCE... $ 20.00
GAS LUGS...: 0 > 11./000- E ^,0
m � z�5� TOTAL FEES $ 344.00
4 ' ^„^
Gijon Record Water Line OX Mechanical Inspection Notes:
GAS PIPING OK Date By y_____
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO NORX IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE,
I CERTIFY THAT THE INF LION FURfNISED BY NE/S TRUEORRECTORRECT TO THE REST OF MY TIN}NLFOGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS NILL BE NET.
OWNER OR AGENT ` DATE
kr `
FIELD COPY '< .J. N'Ni
AdOO U13u
J
• r
t
------ _- 1 • 1v1 ____ ----- -_-:• ---'----77 1 11439V NO 831111C'1311 38 11111 51113113111110311 AVN 1111131131 JO A I3 318V3IiddV 3111 01111 39031110111 Ail 10 1538 3111 01 133111103 UNd_3f1U1-��''3ii��AB 0 IN 1 NDl
!N 1 111111 AJI1N33 1
'13NVI1551 30 31V0 11311V 11V3A 300 311IdX3 S1IWtl3d MINIS SIV 1V11113015311 031NViS Si XNOIi 1*Kin
3NVAS 1 11311 SAVO+08 3NIdX3 SI:INN3d
0 :'0NA0N91138NA 0 =1113 000'01 < , 0 :'''S901 5V9
0 "^SI1100 $NSN 1111V1 0 :0000119 300811 0 :1113 000'01-> 0 • 3911118
0 :"S311A1X11 831110 0 :""51131V311 NIA 3313 --- SINN' 1301 S11NA 9NI10NVN 11Iv 0 :"43AN0 SV9
0 :S1131XNINdS NNV1 0 • SURSON 9510 0 - "di +S 0 • )S111 0 • 1188
0 • SNIVNO I • SUIS 0 • di OS-O£ 0 • 1001<NVOI 0 =1130N118 AN03
0 :" 'S1131V3d8 3VA 0 • S3I11O1VAV1 0 • dii Of-SI 0 •"'S3AOIS 0000 0 • 1N1 SV9
0 • SdNAS 0 • Sl3N0NS 0 ;""'dIl ST-£ 0 • XNON 1300 0 :"111111140.1
0 :'101103 9NI NINO 0 • 5801 NIV8 0 • .—- "dii 1-00 • 0000 11 0 :•'rl$ SV9
OS'LI£ t 5333 111101 0 • S1V0I11A 0 • S13S013 8311111 SSOSS38dW03/S1131I'' 0 �,, 511119 .:'S3d11 1301
L-'45V311V 3AXIIS03S is 4 =334111105 ��° �
„,�• 1101 0 :0 :0 :VI
- -- - s•- ' , - '-��•' 119 _---_-------OVOI i NVdn330
00'L $ sf6"""1XI1 9NININIId c "33IAN35 113N3S ad 00'0 NV3 tea ' swr, 30 : i i i=11111 £
OS'6 $ * a ,.� _ir.5 .g.. 33IAN3S r,'i �> ---
te
44:
-4--..,.., 301 ,„ t I Ad �� � �tl --N011 3AN16NO3 JO 3d111
00'081 I .... � � i
s lY ' �'11�° ��; �,' -� * a� � �_`d 0 �g '15I7f3 15�� =0 � � 10 i� �� Z8�
O0 6 $ sAlda t � NI1- - 11 �� 11 - 3l3S 0381 ' . -NtI1�A js;AZT ="011f d009 A3IWd(330
00`0 $ 1'..13303 NVi,t 1, _ , r ,� ,, *311 ..'.* iN l is;. , =0 �'iNIZ ID. AN093iV3 S0SN33
00411 I s'IIS0d30 133113 *Old c• cS831XN1NdS 0 ;"9NIINVd�f u � , ; • II S ds=0 ',''0 •'151 1103=3SA N31:110 30.3.0.1
5333 c• NV14I 7 k A,) r 1 Mild0 --- ---15IX3--1111 X=.R1d •43311 X.i018
_ _ : --
/.111-P19
•
£0086 VN A1)111013033 £0086 VN AVN 1V113033
10£1 1190 1331115 HMV 'S MT Pitt 315 IS 1119ff S NOT
311I 58301I08 801N3d05 9011353 A11913AI$0
:�-. _..._.._ , .. _._ 1130931 .,_ . .,.__ ._ . -----_ ------ --- 110i vsiNO3= - 11311110
'33VdS 1116131 N39 01 33VdS 1V13113NN03 1N3AN03 - I1:NOI ld I2i OS3O I 03.I.'O Jd
0300-TOS9Z6 = 'ON
PZ2 1tuff IS H1922 S OIOT:SS3U0O4i
t'6/TO/20 :S3JIdX3 000I' T99
313 :A8 O'Tb-199 s1senbe;J uoTgoadsul 6uTpttn8 £0O86 VM `AeM tp.-iape3
26/30/60
SSI
OL6O-$60"18 :ONn1IWH3d ,LImad IN. 1 y1AHM 1VH3O33TAOOA1;XO
i
4
to - \ m
o
0
1
,J
h 4
C
1,
•
a
O a
1- ) 1')
CIz
5
L. •v rl
M ,rN Ki .V I -1cJ`•
Z l� 1�
V
T �- T T T ` T T > T T '.' T T m m m m m m m
m m m m m m m 03>
m m m 1141;
mC7ppZZa0' Z wt7p Q 0 wWZZMQpLL CL � yW QLLQ �'oc 0 ag0Zj.•.-.
NO C7 p0QC7 0o0O pW p LL MZ
YQZuJ. Z a Z z (7 r? N 0Z W Z Z i( QZmw OC m a _ _ g VWaZZuj0 w Lmilm � � � � A � � � � y � � U � U m a� �p/� a� m m a� N a� a� rr^^ a� W a� �_ a� = a� _ a�
• CO p CO .� co Z co _ CO � CO Q m co CO p� co CO CO CO D co � <v Z w co D co F- ca 1— co
U) 0 U. 0 a 0 D 0 N 0 n. 0 C'3'', 0 0 2 0 11 0 Z 0 0 0 (74 0 v) 0 b 0 w 0 r. 0 m 0 p' p 0 0
d_.1.,, RECEIVE City of Federal Way.
UG3 1198c,APPLICATION FOR BUILDING PERMIT
s
CITY OFBUILDING D PDEAL WAY - /54.0 73-p 970
PLEASE PRINT APPLICATION #:
SITE LOCATION Address / o /0 £ 3 l G "' .S t , i S ti TIC'.�--, `j
Tenant (if known) , Lot # Assessor's Tax #
U►V �k.le<-S1 .E.SC..roW / (t- 2— 6 ,cc,/- CCe.0-66
Build' g Owner Nale Address,
S /a 1 ‘"Tee e'-'Ilei / . O A (3a^ 31)O 1
City I-/p,uQ f i../4,t State /-{A4 v,�,,A i i Zip 9 b So Phone-Z04,- ;16/- 7 6,1? I
Nature of Work (A,4/I s, S p v. &t1E. rC IbC A 4,c),a .4,...,,,,-.., 4 ?I1.4.wt L i iUO\ j
APPLICANT
Name (F,M,L)
5LA,rtr;Qt- 13 CA-1.
A- /otets , 1NC-,
Address
/ 11 2 6 , Z L'/`/ 14% Z. t, lot f0 ; 4. •3°7
City re eke t.q-I (4)6y. State tti: A Zip 9 Sob 3
Contact Person Day Phone Other Phone Fax
•Zol,NI . ._1%..t.% c I+?„.e - 7L1-3(p L/ 1 -- 87Lt •.17788
BUILDING CONTRACTOR
Company Name
S‘•trpe � ioc- du i fcicc-,g 1 a tkiG. .
Address
1112 S , .?`/,/ }h S1 , I L 4- 3457
City pe r r iqW' I4y State ( I /; Zip C3S�]O3
Contact Person / Phone Fax
Svkt Sc,.-� WG i4rct 7
7,1 -Le. y7 c L/ -378$
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes 0 No
.- 14f' E ik aa- 11A I.)Z ` Ll - 9 `i
. ........ .. ................................ ....................
..............T............................................................
ARCHITEC ''
Name
C •
{,N NC_ 1 I 0 e t.t t\_
Address
1
City State Zip j
Contact Person Phone Fax
LEGAL D SCRIPTION
Lam, .. i Z Wesi.4- 6--A"^1tt. 0 -- (cc PRr-L I�iuis ,oN z 4-S rec.* t-
JecA
ObLto-P\e_ / c3 1pfA4- pA(\e_ 1 `f ier /S r-e- cota c4 Ki q 66.c.4.. ..\ ,1.).( Isla/4
(A.1‘, c e . Aet off. 4 rile # 71 o S 31 n 8 e t)
Please Complete Reverse Side
CD0492(Rev 4/93)
JCTURE Existing Use /'j r, C Proposed Use c f`
r'ermit includes:
ing U Plumbingchaical t ❑ Other �_
Type of Work: ❑ Residential ❑ CI limber of Units ❑ Deck
4 Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor 1Qfo0C sq ft 2nd Floor/9 OOC-' sq ft 3rd Floor 4- - - sq ft Existing Floor Area 9i S000 sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area JAG" sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation S t 1,r - '
Zoning Lot Size Existing Bldg Valuation $ ...1.041.6.44p.0 t'
LENDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
e' e r A-i-e..... Pe_t—t-k.t 4-
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 `
Fuel Type (electric/other) Gas Dryer a..3 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 • rjuryithat 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 wo for ich permit application is made.I further agree to save harmless the City of Federal Way as to any claim(including costs,expenses,
and attorneys'fe.. incurred in investigati.n an• 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 su.h cla m arise (out • . �att,.ce of the City, including its officers and employees, upon the accuracy of the information supplied to the City as a part of this
application. afli`-
C?Owner/Agent: —jam �\_
.i1 \`� . eh Date7
��
• City of Federal Way a
N)`,) Frv' APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION It:
SITE LOCATION Address
Tenant (if npwn) Lot # + � Assessor's Tax #
lJ (A t L,—v5 : Sc (Z1—W /
Building Owner a Address
cat? --c —L-� pO
City 11,` statee� Zip
'W:?}Z.., Phone
Nature of Work ULA 4--/
C�
7
APPLICANT
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUILDING CONTRACTOR
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified E Yes ❑ No
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
•
Please Complete Reverse Side
CD0492 IRev 4(931
STRUCTURE ming Use 'loosed Use
Permit includes: Illiruilding ❑ Plumbing y--Mlechani,calr ❑ Other
Type of Work: ❑ Residential ❑ New ❑ 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 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
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 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 clai 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.
Owner/Agent: 7 1
' f
/74'
c
,/- ���t'"c�C �� '�� ,`f�-i'- � Date: � /'�
JR
�„� • City of Federal Way REVD' 1�IV DATE
MES/ItoN D LICATION FOR BUILDING PERMIT SEP 2 71993
SEP 2 7 1993 /� /L-l�J G C�
PLEASE PRINT APPLICATION #: L l �O 7O
SITE LOCATION Address /L%/& S. J231 tlt, SI-. , SC(/ fes,.29)/1_
J9)G1_
Tenant (if known)- Lot # I �"
As fo�GTl #C
O C- D�Lkk) e-7-c. +-7- c_��J
Buildin Ower Name L: ! Address //
p
City //ILL( ILCIcc. State 1-I1L .'(2.,/ /• zip i1/', ) )9) Phone ,3Jli&4i7/-.A76t
Nature of Work Re_V e."-- 6.-t,00,— /9 cJ C1J,..Re,-1,(,..„%k 1
(
APPLICANT
Name (F,M,L) j
l I-t
SLcaCr i I)I/ 1JLLI /C�C�.i�'� 6. .
Address
/ / /2) . )714tk- (l Ll/t, %)i7
City -r 2.0 Vit/ /, 'iLL . State l-'%f') Zip ii,�l•�i'>>
Contact Person L 0 Day Phone Other Phone Fax
' tit_�b �tiii 'EifzL✓ 74-- 47 �'7,1-X75=i.C, I
BU LDING CONTRACTOR.
Company Name LL .... I / GIi //lc.l/�•l l/; .L i t���.
Address / / /9) ..AI tide, U±./ Li 1,LL. &L'7
City T' r'.1i1/0—I IL-a-L,1, State if %79 Zip CI i1G0,
Contact Pjso j 0. Phone Fax ) r.
()it it-- , OP ti.) ../ 7-L Li" Y74 . lc:l7 Vll�—.!77.(v
Contractor's # (card must be presented) Expiration Date, Verified 0 Yes 0 No
,S Li P A/3i i 1 1)3 -4-11 V
ARCHITECT
Name 1
L. 1L1LL/ 1 a3; 01-i(.__
Address 0
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION /�;;
Lc-l-5 I-1-,, tULS� LCL.il 2Ci V�'1
�')i(�.e lLVLT►Vi /C�/!., �� as J1 ), ))/ 4
/
V U I L.0 I2l�', 1 D� pio---f- i ?G. la- 4- 16- Yc-L'GVGI L`t M(_61Cv. 0,61,1_81-u ;
',L / '
Yll,�r_v '/)U Lf fi..J, il
vl77Gi�I Gc''0 a
Please Complete Reverse Side
CD0492(Rev 4/93:x.,
Existing Use n'7 Proposed Use ,,��))
STRUCTURE . .. g 0�l C� � V/M/P��
Permit includes: Building ' Plumbing '1 Mechanical 0 Other
Type of Work: 0 Residential ,� New 0 Remodel J Number of Units_ 0 peck
gCommercial ❑ Addition 0 Garage 0 Shed 0 Other
Enter 1st Floor /k l;f Gsq ft 2nd Floor Ili GGGsq ft 3rd Floor i%G7 sq ft Existing Floor Area 1./,2 sq ft
Area Basement sq ft Decks sq ft Garage • sq ft Proposed Total Area /,/,/,(1 eq ft
Water Availability U'' Sewer Availability c4 On-Site Septic System Availability 0 .: Project Valuation $ _i)j` 666_
Zoning Lot Size Existing'Bldg Valuation $ L.Lz)
LENDER
Name Address
I' 1tii(_
City State Zip
MECHANICAL CONTRACTOR
Contractor Name (, Address
�
- 1.�L:.1 1.5-.1 (� //LI 1 �il: .I f
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUMMBING`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 {li
MECHANICAL UNIT COUNT
r 1 /i"
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 and further that I am authorized by the owne
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,expense:
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 Wad
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 thi
application.
Owner/Agent: Date: