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Date By
2 NI..ATIpN Nt ,I.S
Date By
3 PLUMBIMG GROUISIDWG RK
Date By
...........................................
4 SLAB`INSULATION
Date By
5 FfJOTI�tli'..:QIAfCSI; [T[DEi1 ........:.:::::::::::::: ::::.
Date By
6 UNDERFLOOR FRAMING
............... .....................................
Date By
7 SHEAR WALLS .
Date By
8 PLUMBIN .OUCH IN
Date By
SP
9 USI
6A
Date By
10
Date By
11
Date By
12 INSULA` QM
Date By
... ...............:.
13
Date By
14 <::.::;:::::,
Date By
115 SUSPENDED CEILING
Date By
.................................................................................................
16 PLANNINGL t~1NAL
Date By
17 PUBLIC WORKS FINAL
Date By
18 FIRE FINAL
Date By
19 BUILDING FINAL
Date <i h/ l By 0/1.
20 4'Ati.t. > >'::;:' > : :: •
Date By
CD0193(Rev 4/97)
Bul DING DIVISION
qif of • ` 33530 First Way South
•
E 1 f FIL Federal Way,WA 98003
uV FAY (253)661-4000
REC F-1`1 F lrl
Fax(253)661-4129
JUL 1 4 1999
APPLICATION FOR. BUILDING PERMIT
BuiLLiN ,,;-'
PLEASE PRINT ........................................................ APPLICATION # ,� "l l - O1f/I
11
....
Site address
e s
Tenant name 2.42.1,e11#4
d ���7,.rc - Lot# Assessor's Tax#
F. • �,I,�,f /57/(�1x 70
Building Owner's Name �u � �� // Address / 29c7 / I
�� ( Cllr Zi '�—9/ec-� I Phone
City./���. State p
- Description of Work ,SC,Yt( Iz
...........................................................................................
..........................................................................................
..�*.�.y...�......�.+.r.....�..*.ry.�.............................................................
ec
Name (F,M,L) p -_n 4 al y77 /�1/J rl/+
'`
Address 23I
City P i M/04e-, State(. Zip 'spy'e ,
Contact Person klema) Day Phone 206 ,yS Othef� on Fax
Fax
...........................................................................................
... ....................................................................................
...........................................................................................
tjUi UINU C IT( TE3 3[> >>>: :aimi:<• Federal Way Business License #
Company Name
`�,e ,r a- - le-Pg-7-�,nc-
Address :
J �( � .
City ¢( State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified )(Yes 0 No
............................................................................................
.........................................................................................
..........................................................................................
.........................................................................................
..........................................................................................
Name o,e_fe
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION f 7 /i f J'y j 2
Please Complete Reverse Side
•�ri�
'w�....iitii:.:;.;;. : :;:;: ;;;:-::>;;; ;;;;;;:;::; Existing Use Proposed Use
Permit includes: b Building 0 Plumbing 0 Mechanical ❑ Other
Type of Work: ri Residential 0 New ❑ Remodel ❑ # of bedrooms ❑ Deck
0 Commercial ❑ Addition 0 Repair 0 Garage 0 Shed
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 0 On-Site Septic System Availability ❑ Project Valuation $ $ C z-t
Zoning I Lot Size Existing Bldg Valuation $
ENQI >: > > 4fiail > >iii0i<> >> y < : >
.:;:.;:;: ::::::::. :..: ::.::.: :.:::._:.::::.:.;:<.;:.: For new residential only - Proposed selling cost: $
Name ,L r (CLi1
Address
City State Zip
MECHANICALCONTRACT.OREMM
Contractor Name x:k,id: Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
[NC..COI11Mi4CTOR...
Contractor Name i Address
City State Zip
C-ontact Phone Fax
Li:;ense # Expiration Date Verified 0 Yes ❑ No
ii : aJ S::>:ai:?i%'":z:ii:: 2???: ?i:»::>::m,:: i:i:i E>[[[[»E<>[::i
M IIS OTIXTUR ::C..OUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains TotaLFixtttfeCOunt
:MEC >:::>: >__.:t:<;:::>:<»i i,izi;>?iiim > aimi <`
HANICEtL:.UNIT'GOUN ::::::::::: :. .:: MECHANICAL EVALUATION ONLY $
Fuel Type (gas/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 <1OOK 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
T(ttel Unri Oount
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 inv- igation 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 o Pj e r lance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application.
"r' _<<-i.- 7
Owner/Agent: C Date:
[lunars.Aw
REYSFD 5/1E1/99