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Y•tzI --I Q c Y- 7 [Q RE 0-nOW d O O \0 0\ 0\ !n \ \ I Ln O\ }4 W 7R� eo, (D w wi ^ 2 I r 0.- 3> No c= -14 4^ IW q r r— =� ac." :.. 1= r V, err Iz; en, is nn ON as ---I S. w- FD T 3c 4w F :gc =, = - = CD r-> 49 'k-- C? k r N AP� t-n 'C 41 d pf txv to 31. 1, k o cA it en tt Lm f"t =tw rft Lft . . . . . jj. ?o lk ti spa rm r^ AD M pq :'' _ �x tee'! ii n � r r :4 rn 1: Ln If f " "o rf Inv tt S- cf) zo cn qp C6 em be RV'It:;p zt, w cm ox 0 "9 e, � cc ki —4 ITC 121�- rr, rr S low *lb- eft 401� 4oll 4o� CD CDO193 q„CF City of Federal Way APPLICATION FOR BUILDING., PERMIT WAY PLEASE PRINT G►� / Oyi fl1NQ �E'�� (tJ 3 p"C r APPL/CAT/ON #: SITE LDCAT. XON :: :Address r- Tenant (if known) Lot # Assessor's Tax # Build w=�(� k,C. Add� s� /- 'v lSL City State RK Zip b Phone p? 011 Nature of Work Ntw DJ `C1 C. APPLICANT Name (F,M,L Mn Address City State Zip Con act P vn Day Phone v- 0�1�,5 �� — 6� l Other Phan G _ 01 Fax vq-3 BT3II;PING':C ONTRACT OR Company N -L." Address i q 3 v- 's E City l s- ContactPer Contractor's # (card must be presented) /M: / f A —r~r r , ,?A --r ARCIUECT ilea -re- Iv `(s- chcyl ` (R 't-Q f {w t 3 d OV eve ro es ❑ No Name" o v Address..! IV, V), / f f� � �T( i c20 ��LL/ 7 City State Zip �� Q Contact Person Phone 50 - 7 VS Fax LEGAL DESCRI TED 71 7 Please Complete Reverse Side CD0492 (Rev 4/93) C t�r- �-• xistin ''! 9 Use ro osed Use ' P ti Permit includes: Building Plumbing C/Machanical ❑ Other Type of Work: Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck ❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other Enter 1st Floor 1 C6 -3sq ft 2nd Floor] sq ft .� 31-d Floor sq ft Existing Floor Area C!-22 sq ft Area Basement sq ft Decks sq ft Garage= sq ft Proposed Total Area 3 { —.;Z. sq ft Water Availability Sewer Availability On -Site Septic System Availability ❑ Project Valuation .S= Zoning Lot Size � i1 ~f t Existing Bldg,:Wnluatigri;: rJ LENDER Name Address City I• State (,()A- IZip Contra to Name s I Address r 0-0'77ee t�7-" (f - City ( _ / / State 6L) zip c7T73 Contact � � (� � Phcto _ C Fax License # JUG Ig- 1 DC C-,2>r SC Expiration Date cP Verified ®-Yes ❑ No — PLUM BING CONTRACTOR.. Coat 01-r Name - _ /.Address Qe ifst t an City I State zip mac/ Contact J Phone Fax License # �i I Guo 7 le_ Expiration Date q.�;- Verified ID/Yes ❑ No PLUMING FMURE COUNT Water Closets Sinks c. Urinals Lawn Sprinklers Bathtubs Dish Washers { Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains Total Fiittiire Count F M CHANICAL 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 Conv Burner Duct Work 0-3 Tons Underground BBO's Wood Stoves /v 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 claimlarises 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: _ L� S Date: W - r t +Z cD W r ui - 1 t t t+ Irl 3�+ + a\1' T� [ zr to Cl o 9�1. �I r�/ r .r �� — � f.� ra � r� �r ._r �.... w � .w r w f • a i F f y►+ pZA S W- ► i r It 5IL Ic k L1t, V �wzx