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00-102796 . a G 33530 First Way South • Federal Way,WA 98003 uv F - �"( !VEb (253)661-4000 Fax(253)661-4129 MAY 12 MOO APPLICATi' �& BUILDING PERMIT PLEASE PRINT APPLICATION # 00 - / w 7 r (, -& -m- S »< Siea address s ‘s - _ Site .� �. �.:..:.............................. Assessor's Tax # Q Tenant name Lot# Q��`� _Q ' �j b cam' Y�1.c7 ,v 1-/\c::.--,6.4)(-)1,.1S '�`�- L Building Owner's Name Address .‘476%(--- z A — �_-c-A-rr� 1 r-c\rr-_s-j-Nei.a , 2-1. z5' ►-I1C--_s 2 - ,A JG-. <L,1.11."--1 City T - _ State ler..),Aiv Zip CL C Z 1 II Phone .440, Description of W0 7E4C 14()AUL "Ta 012C6LNAtt- 64/JF1 bQ e*77ONWV 0/Lit iS /0/ X4051 8(4)6 A3 -V/ 4-rite,t1 (1 S ON/75) Name (F,M,L) V A 1."-_G t 'F;L\.c2`�1--cx_c•n r: Address [r, ( '(:)�eq-...4qAxiG.' . C7 l) 11.--E.---. t City .14TTL—`-• State Zip q 8 LC,q Contact Person 'Day Phone Other Phone Fax ?i©' C • c --0.5.--, 4-- c_.) _----- afs , 4 3-7 I i3[j[ C�tiNTRiiCTiil Federal a I Wa Y Business ss Licenseense # Company Name • Address l t l S N °' CI Tom' City ��t-- State (-- ,, Zip q 0 (© Phone .`C7(' Fax Contact Person ( �, P. Pt7.,,4N� - zo6. S 3. 57 5",244}-, 3749 Contractor's # (card must be presented) Expiration Date 7 Verified 0 Yes 0 No — prn L -CC I Opt ?lam[ N 5 1 - Z cz,f AARPiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiil Name () L�•( 'P 1 As.Sc c-t/A.-T�� �..,,o NLP -- Address 7(2 <. C - 1 -I _ ,\j \-& . t.) t t - --:?---. 7 ( 1 City 61 �'\--L'^ State 1,..4.1./4 Zip q:') 1 0 9 Contact Person Phonenee..--C• �� Fax ` v Are. --�-2k -- ` $ c7 '."'-1- � z.-/�1 1 LEGAL DESCRIPTION E- ,44,-T—Ti4 C.--‘2:----7 Please Complete Reverse Side 4 . .'iStrtit)OlftliftEMiNEMENEMINgSiii!:;;)txisting Use \Z. 1 a e_VN.*A-\c-1,\ 0 • 1 ' • . 1 roposed Use 1.4_07 c_k_LA,tAc:„E Permit includes: Building 0 Plumbing 0 Mechanical 0 Other Type of Work: 0 Residential 0 New 0 Remodel 0 #of bedrooms Xpeck 0 Commercial 0 Addition epair El 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 0 Sewer Av bility 0 On-Site Septic System Availability 0 Project Valuation $ 7 S 6 6 Zoning I Lot Size Existing Bldg Valuation $ SaS_ A.-r-rP.,c_A-17.--,--7 For new residential only - Proposed selling cost: $ - Name ' Address N ,4 City State Zip MEMANICALCONTRACTORMNEEN Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No Ati.MiltaderiNTRACITIO.RMNOMM Contractor Name Address City — City State Zip Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No PLOMaKMAXitgieteU.NTMEMEM Water Closets Sinks Urinals Lawn Sprinklers Bathtubs 'N IDA Washers Drinking Fountains Other Showers , lectric Water Heaters Sumps -.- .... ....................................................... Lavatories Washing Machine Drains i.:,:,::i,:ii::::iiii;ini,iiii: :,:i:::iiii:iiiiiiii::::ii]i::: :i:iii::iimi:i:]:i:i:.:i:i:iiiii]•aiiiiii.:.:ii:iiiiiii]:i i‘iftd4At.iiitALUNittOdiMMEMEM 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 <100K BTUs Gas Log Unit Heater 50+ Tons Furn >100 BTUs iLfeas Miscellaneous Fuel Tanks Gas Hwt Hood _Boilers Above Ground Cony Burner Duct Work 0-3 Tons Underground ] .':•:. .,:iL:,:i*...,.i,,,,:.ii::, iiin:].:.:-:;:,--..-:,.::.::.i:.:: BBQ's Wood Stoves 3-15 Tons 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: _.44k_ Date: , ' . . Clilak et1.1.0.APP REV6E0 5/19/99