94-100743 •
Cr City of Federal Way
EE
RECEAPPLICATION FOR BUILDING PERMIT
9 y- boa 7 V3
APR 15 1894 �1i
EASE PRINT 1000 a�c� S f_ APPLICATION #: BL 1 LI - 051-
may
___ t3E)^DfNGEgs 11th Place South to 1st P1 a South
Tenant (if known) Not applicable Lot # Sec. 17, T21N, R4E Assessor's Tax #
Building Owner Name Not applicable Address
City Federal Way state WA Zip Phone
Nature of Work Trail Project
APPLICANT
Name (F,M,L) Federal Way Parks Department
Address 33530 1st Way South
City Federal Way State WA Zip 98003
Contact PersonJennifer Schroder Day
Phone Other Phone Fax
661-4042 - -
BUILDING CONTRACTOR ::
. . .. ..... .. .... ... . ... .... ............. ...........................
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date — Verified Li Yes ❑ No
ARCHITECT
Name
OTAK, INC.
Address 620 Kirkland Way, Suite 100
City Kirkland State WA Zip 98033
Contact Person Phone (206) Fax
Mandi Roberts 822-4446
(206) 827-9577
LEGAL.DESCRIPTION
S/tFer C-/ OF Pz.At s&r-
FiECE VF D
Pit 1 5 19Y4
•
CITY Cr FEDERAL vlfAY
BUILDING DEPT.
Please Complete Reverse Side
C00492!Rev 4/931
1 STRUCTURE Elpg Use Lir Use
P. mit includes: G Building El Plumbing ❑ Mechanical ill Other
T' )e of Work: ❑ Residential fl
CI
❑ Remodel ❑ Number of Units ❑ Deck
L1 Commercial CI 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 S
Zoning Lot Size :Existing:BlOg Valuation; $
LENDER
Name Address
City State Zip
111ECIIANICAL CONTRACTOR` >»<<
Contractor Name Address
City State Zip
Contact Phone . Fax
_
License # Expiration Date Verified 171Yes LiNo I
ii
PLUMBING CONTRACTOR :>::<::>:>:::'�>�>
Contractor Name Address
Not Known
City State Zip
—
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBINGFIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains 1 Other Irrigation 1
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains 7vtaf,04:0. .O.Oti 2
I
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 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 pert of this
application. Li
Owner/Agent: Oiii,AAAAO.; (...icii Date: 1 _15- -9 c-
Rroy., 1 n4. Mr e_41,cas, Lud A 1 paw \ r*.