00-102798 ♦ EVE
S+ BUILDING D;VTSION
ari; G V • 33530 First Way South
Federal Way,WA 98003
VV AYEI�Z�t-- j ( 1 2 (253)6614000
r1n{ Fax(253)661-4129
V r I BUIL.DN DEPT.ERAL WAY
APPLICATION -FOR BUILDING PERMIT
APPLICATION # CO /0 L1?
IiiiitiddiocimigningPLEASE PRINT „r.
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' address .�
« � Site
Tenant nameLot# Assessor's Tax #
c tv-se .6Tb1--ae_ �_At)e�1,-15 lis SP •
C)F3 Z1 c)4-91 0 b
Building Owner's NameAddress
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City .1=�T`t..- TState \A Zip 612, L Z 1 I Phone z' •1 10,
Description of Oriel 2&Z -/9,491i !4,,, 4.e' , '/'4- L'i,v Gf'%L.o`!t0/N) '74 ((, i4,) 71, G/47-3
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Name (F.M,L)
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Address k_� I-t-G 'Zc:=> '
City .' _..l41`TC-F= State 4 A Zip q e 10 C .
Day
I Phone Other Phone Fax 206
Contact Person -� o s ,, 4 3 7 I
�.�1,C= �X' . �.�5. 430
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Way
Business fines
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License #
Company Name -C—,cV L - Gt?--vA `/ 1 t---LG'--, .
Address . l 1 t o c 1,.rte
City LE- L--- - State Zip q ' to
Phone Fax .a-
Contact CE-.
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Contact Person Zc6 r sca. 4y• j� s a61-, -5 7 49
� ^`G�N��_ Expiration Date Verified 0 Yes 0 No
Contractor's # (card must be presented) TP.`-'Le-cI I c 7 ?1 N 1 - i I
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Name
Address � � f
Tr7 I t G lG` '�� - 26.X.) \-4. . .C 9 l'�",.�"' Isc� d4 Zip �'C 1 0City ��/Q _Lam- State CI
Contact Person ,
Phone e ��� Fax
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LEGAL DESCRIPTION
�F 1477--1-14 C 1, _
Please Complete Reverse Side
• _."
Use \
1E,_ \a evv-vx a, Proposed Use
Permit includes: X.,),..Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New 0 Remodel 0 #of bedrooms_ Deck
0 Commercial 0 Addition X.,flepair 0 Garage 0 shed
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Flaor 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 .$ 1506
Zoning I Lot Size Existing Bldg Valuation $
,4-1,-r"..c_ 42
_ , .::,:,:::::::::i:,„„„„:„,.,,,„:,,,:„:,:,i, ii,:iii:::g
J4040t!tia;iigi]liii:1:idii!iiiiiiiiiiiiiiiiiiii:!ii:!]i:iiM:i !!:! :!iiiiiiigiii!iifili For new residential only - Proposed selling cost: $
Name , — Address
N
CityStateState Zip
MEtHANICACCONTRAttoilEMON
Contractor Name Address
N A
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
:PMVitt.tN&ZONITRAC7TORMEEMM
Contractor Name Address
City State State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUMBUStafiXTUREVOUNTagEM%
Water Closets Sinks Urinals Lawn Sprinklers
BathtubsDA11.Washers Drinking Fountains Other
Showers IN''' ' lectric Water Heaters Sumps
Lavatories Washing Machine Drains •:7F-giatAXittrecettntii;i ::: E,iiU]i:i,: ::
...:,:,::::::::,*i*::::::::: :: :::::]:: :::;:::::.::iiina0M]:i:i.iii::iii:i
tt).'trafAN1CALUNttTA:1UN3M:MM 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 .,N( •,ratas 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 Oitifteitiii]h:.:._-. .- '.-...•:-:-..
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: _ ..t Ail-% —tot - Date: , ' • . 67
BUILDIND.APP
REVISED 6/18199