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SETBACKS & FOOTINGS
Date By
7
FOUNDATION WALLS
Date By
7PLUMBING>
GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
7:S.HEAR
WALLS
Date By
7
PLUMBING ROUGH -IN
Date By
GASPIPING
Date By
7MECHANICAL
ROUGH -IN
Date By
7MECHANICAL
(OTHER)
Date By
FRAMING
Date By
71NSULATION
Date By
7GWB>
1 ST LAYER
Date By
GWB - 2ND LAYER
Date By
7.
SUSPENDED CEILING
Date By
7PLANNING
FINAL
Date By
ENGINEERING FINAL
Date By
7
FIRE FINAL
Date By
7
BUILDING FINAL
Date By
OTHER
Date By
7
OTHER
Date By
CDO193
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SETBACKS FO:OINGS:
Date 00 7 m t B
7FOUNDATION WALLS
Date � By
PLUMBINGGROUNDWORK
Date By
UNDERFLOOR FRAMING C % 60,
Date f By
SHEAR WALLS
Date By AL
7PLUMBING;.ROPGH-IN:
Date - j�- ? ,5- By
GA. S PIPING
Date By
7 7MEC
HAN A R GH-1N>I
Date By
, 77 MECHAN CAL OTHER)
Date By
FRAMING
Date y B (-
LA &52
71N SULATION
7Date 1GWTYEBy
/
Date G By
GWB - 2N911AYER
Date By
7SUSPENDE.q 6EILING
Date By
7PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
7 BUILDING FINAL
Date — By
7 OTHER
Date By
7.OTH.ER
Date By
CDO193
C"OF G City of Federal Way
G IVP?LICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #:
I.
SITE LOCATION1 O� p is Address '
Tenant (if known) Lot # Assess
_ o 1 & ilaeo U(�
Building Owner Name _ Address
City State (N4, Zip q M2 j Phone
Nature of Work A /I A -VI e,,I-1 A I /7,A,
Name(F,M,L)
Address V
7ILDING CONTRACTOR
Company Name
fl,ARVV T k UG
Address
A-V�,.
City State CL, Zip / J U
Contact Person Pone Fax /
Contractor's # (card must be pr ented) Expiration Date Verified ❑ Yes ❑ No
LEGAL DESCRIPTION s
N
Please Complete Reverse Side
CD0492 (Rev 4/93)
STRUCTILM
fisting Use
Permit includes:
f Building
❑ Plumbing
Type of Work: >0 Residential
❑ New
❑ Remodel
❑ Commercial
❑ Addition
❑ Garage
Enter 1st Floor_111e sq ft
2nd Floor �
sq ft 3rd Floor sq ft
Area Basement sq ft
Decks
sq ft Garage 6�� sq ft
Water AvailabilitySewer Availability
On -Site Septic System Availability El
�pa�`�
Zoning �S ' / l l.S���
I nt Sizei..
roposed Use
❑ Mechanical ❑ Other
❑ Number of Units _ ❑ Deck
❑ Shed ❑ Other
Existing Floor Area sq ft
Proposed Total Area sq ft
Project Valuation $
Existing Bldg Valuation $
Name Address
City
State Zip
VHANICAL CONTRACTOR
Contractor Name Address
City
State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
U1M1D11111T lL;:iJ1V 1KEll.l:V1C
Contractor Name Address
City
State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
UMBING FIXTURE. -COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers ( Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine % Drains Total Fixture Count
ME.CHANICAL'tM 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 <1OOK 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
BBQ's
Wood Stoves
3-15 Tons
Totab: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 part of this
application.
Owner/Agent:
-th 4 Date: � ,
3�41
L . 51.8:.0
1-
RECEIVED
. • APR 0 9 1996
370/ 0 f — -FERAL WAY
BUILDING DEPTo
a
Kc
Oe r
L = 110.�2�5'
1
. � o
- sr f, �•sC�. L.
TE 3
Permit Number, pL41V App
AfprQved 3( RIVAL ,� � � �• � _ ..J----
Date: By' LOT 51 Z-E ' 55�P�
COm111 11ts: —�- _�o 6Lx . 1121
kp COVE:
To
r�'� �.