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• 0 BUILDING DIVISION
C7TYOF '- 33530 First Way South
ECIEJZF ._ Federal Way, WA 98003
\)\> E �, (206) 661-4000
FEB 21 199°a Fax (206) 661-4129
CITY UI�DIN�DEPT Wk 57-/00
FOR BUILDING PERMIT 97,/�� ���
PLEASE PR/NT • APPLICATION#: Bun--011C1
SITE LOCA•T[6N l ` Address 3,5d Olt•- + 'IJC/1`I.(,t.L 3 bit, redeye-4e * ''tb [ 8Gn�?
Tenant (if known) Lot # Ass>ess is Tax #
Z31— ")SIO
Building Owner's Name ckity 1,,
�p4 / 0,.sri((,(.cTro Address (`J See let e� �/le�lJ
City State Zip 'Phone
NV
Nature of Work W 5 iii ye p(- 1-11-ILi 0,3 dert-HC r-tru 70 it,
Name (F,M,L) 9 ee�}-v..; 6t tit'l.. 0, o C'tt-*/t-/
Address
City State Zip
Contact Person Day Phone Other Phone Fax
Company Name
Address
3i/P1.6 Pet-
City ��/t ei rat b4{ a �{ State GA.)A Zip q S'Zi
Contact Person .� Phon 9„6�/�/4� .F x I t
LLL --9 (!1 $4s ( 0 4,61 (f
Contractor's # (card must be prese ted) Expiration Date Verified 0 Yes 0 No
£ frIZVLCT !O/ ' e -,2-e-to
...........................................................................................
Name 6' S Nes/ n ( 4v (s.1.4^ L `)
Address,3 0 v ,^
City red,e area 6uC State 14)f1 Zip E 3
Contact Person / � �(7 P�onzi/....6i(1.7 F".6(.... 20 /6
(�r,j/ (;J L
LEGAL DESCRIPTION 66(1/6/ cm/24p° iAi fes_ V� tot_ 4, 2/
Diu IS(OY'- VV
Please Complete Reverse Side
e Use
S
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Us
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...................................................................................
�' tri.:.u...:::..::.:. :..:.......... :.... ........... ...
Permit includes: l5l Building $ Plumbing Al Mechanical 0 Other
Type of Work: Residential )0 New 0 Remodel 0 Number of Units_ 0 Deck
0 Commercial 0 Addition 0 Garage 0 Shed 0 Other
Enter 1st Floor IS'-4- sq ft 2nd Floor We( sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage / • sq ft Proposed Total Area .3tilQ7 sq ft
Water Availability )1 Sewer�/ Availability EI On-Site Septic System Availability 0 Project Valuation $
Zoning I Id,e4I 1 CLot Size `/"--' ' Existing Bldg Valuation $
5 -.I, 6
Name Address
City State Zip
MECHANICAUCONTRAMORMEN
Contractor Name 4II IN A- r /'yam„I 6...6 Address- /5`J JL ( �G p Sty-see(
City iii-.A a.Pl c���� (J l State Zip q wog
Contact �i vr //11 phone ? .../7-71i3 Fax 3f3, 773rc
License # P I_-t.- fJ ' A C-0"/41C 3 Expiration Date•'Z'1 4b Verified ❑ Yes 0 No
a
>FLUMBINQCONTRA TOR: '..:.:.::::>:>> J
Contractor Name iIe/' M^ / Address.,z`/ Li
k ,S"
Q-' I
1 1
City //tee State 1 Zip C 'ci.o /
Contact `.4etie. Phone-3 - 3:Q Fax 3e—<
License # TT )2/...44 ** l<16, (�/ Expiration Date.>2"e?j( Verified 0 Yes 0 No
EPLIAMINGFIXTUMCOMMME
Water Closets Sinks 1 Urinals Lawn Sprinklers .1
!�
Bathtubs Dish Washers / Drinking Fountains Other Li
Showers O\ Electric Water Heaters 0 Sumps '
Lavatories 5— Washing Machine ( Drains .. Total Fixture Count
MECHANICALUNiY
MECHANICAL ANICA
L EVALU
ATION ONLY
$
:`:GIFT >> ' >'''''
C
Fuel Type (electric/other) Gas Dryer Ci' Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping t' ' Lr'fll Range 0 Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs I Gas Log i Unit Heater N/A 50+ Tons n
Furn >100 BTUs 0 Fans 5Miscellaneous — Fuel Tanks N/A
Gas Hwt i Hood I Boilersi/ Above Ground
Cony Burner 0 Duct Work 1-15bi I(n}eCi 0-3 Tons Underground
BBQ's 0 Wood Stoves D 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 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.
Owner/Agent: -011. 46/ r�`�z' l/(G/ Date: 0/-ct/./3
WV.°8/21/96
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