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E. �th PLACE City BELLi VUE� State [n]� Z�P 9 8 v 0 7 Phone -� Nature of Work TENANT IMPROVEMLIIT / RENOVATION � APPLICANT " __ _.. Name (F,M,L) ROBEP,'I' ti�LLLS & ASSO�IATES Address I1416 SLATER A�E, r,. E. SUITE 104 _ City uIRKLAT;D State T .� ZiP q Conta p@ Other Phone �Citi��T WLLLS Day Phone 8 2 G_0?6 O Fax 022-21�8 BUII,DING CONTRACTOR '' ' N�T YET SELE�TED Company Name i ' - _ � �_..�,�� A " � ��Y1�� �QI�,'� �f-�` Cr'� �1, Address �) .• �y ✓� C���`l •) •�Y�.<I ; }�. �4f� City ? , kj State L�,�f ziP '"I� � Contact Person Phone Fax Contractor's #(card must be presented) . Ex iration ate ,, ; q � ��y �'M �����' � �g '(j P +' _ Verified Yes ❑ No it; if�l r� ��`f , . ARCHITECT _ Name RO�ERT WELLS u� ASSOCIATES Address 11415 SLTTE� AVE. N.E. SUITE 104 c�cy LA^�D scete W� 1 zip 98^33 Contact Person Phone nOBERT V�ELLS 8G2-v76� Fax 822-211Q LEGAL DESCRIPTION THE EAST 145 FE�T O� THE NORTH;AST U�RTER O�' THL NOnTHLAST QU�RTER Or THr� NOnTHvvEST QUARTER O� SECTICN l� , TOWNSHIF 21 Lv'ORTH, P.ANGE 4 EAST, 4�.M. , IN KING COUNTY, WASHINGTON; EXCEPT THAT PORTION THEREOF ,T_,YIiJG WITHIN STATE HIGHW�'�Y N�, rj. P/ease Coma/ete Reverse Side CD0492 IRev 4/831 STRUCTURE ' Existing Use RETAIL STORE P osed Use RE�TA�RATv'T _ Permit includes: ; ilding (T•�� � Plumbing lechanical ❑ Other Type of Work: ❑ Residential ❑ New O Remodel ❑ Number of Units ❑ Deck J� Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other Enter 1 st Floor-';��'�� sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq h 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 :; �? �G�, Zoning Lot Size Existing B1dg�Valuation $ __ _ . ___._ _ _ _._ _ _ __........._..... _ . _. _...__. _ _ _ _ _ _.......__.. .... __........ __ ____ _ __. ............. ._..._......_........ ..._ .....__ __ __._ LENDER NOT APnLICABLE Name Address City State Zip __ __ _ __ __ _ _ ... _. ....._ _ _ _ _ __. _ .......... .................. __ __ _... ......_.............___ __ _ MECI�AIVTCAI.::CQNTRACT(.1R NOT APPLICA;LE Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUMBING CONTRACTOR Contractor Name Address City �'tzte Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUMBING FIXTURE COUNT Water Closets 2 Sinks 4 Urinals i Lawn Sprinklers Bathtubs Dish Washers 1 Orinki�g Fountains Other Showers Electric Water Heaters Sumps Lavatories 2 Washing Machine Drains Total Fx�ure Count c�, _ _ __ ___ MECHA1vICAL i.J�IT.COUNT P30T APPI,ICABLE 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 Boilere Above Ground Conv Burner Duct Work 0-3 Tons Underground BBQ's Wood Stoves 3-15 Tons Total UniL Count DISCLAIMER: I certify under penelty of perjury thet the infarmation furnished by me is true end correct to the best of my knowledge and further that I am authorized by the owner of the above premises to pe he work for which permit application is made.I further agree to save harmless the City of Federal Wey as to any claim(including costs,expenses, and attorneys'fees incur d in' esti tion a�d defense of such claim►,which may be made by any person,including the undersignad,and filed against the City of Federal Way, but only where such cl m s s out the re ance of the City, including its oNicers end employeec,upon the accurecy of the information supplied to the City es a part of this application. }'- Ow�erlAgent: DD� Date: j1�0/�� ��f f 1,� ��t�r►o ���♦�►► a,o�r�► ���tr�► ��ee�►► ��tor�� 1�os�/� ♦ \�,�,/�►y��,11�11/�i�,�o��1111/�i�,����1111/�i�.�.���eoo,,,e,����1111/�i,,,����11�1 il/D,��,�����0/ , �V�������� �.�1V\��11��///�!.VAV\�����0/////-��A�\������/////'�:�AV\��1�1�////�'a:V�V\��1�1��////���V\��1���///i.������������� �`��\�`I��j��/�/�:�:�������i� �i�.��.\\ ���i� �� i• �� ��i // \\ �// \\ // \�\ // ��11����� �S` ������ 11 �� ���- �A�i�ii / � � /� ��V� I/// �• ��\�����i// �� \\�������//� \\�III //. �� � � � �_�� \ �/ /� �, \ /� � �. � \\��ui / � � \1 I/�/ � 1 //� i.1�\ _ ` \� �/ ./���� � /� 0 \\u�u / � ��,,,.,,,i,/ � ���,,,�,,;i,/ � � \��„���,.i�/ �� \���„„�,i�/ � \�����,r�!i� �� ���„��,,,i�/ �� j/�' �� ����; � ����� . �=� 3�V-Id Sf101'I�IdSNO� V NI 15�d ==� . ��i�j ��._.� ����/ •sastcua.�d ar{T jo lundn��o.�o�puD.raunao a�/� \��=� -��� jo�tltlgqtsuodsa.r ay� st a�untldzuo� ��ns •palnnzts st �t ��tr�n1 uodn punl ar�1.ro a.rnl�ruzs ptns fo asn.�o uot��ru;suo�ar�1�ut��ajfn uoJ�ut�sn� ���� �;�p �'o a;n1s ar�T.�o �ijt,� az�l fo uotlnjn8a.r.�o a�unutp.�o tirana pun ��na r�jtnt a�unttdu{o� l�t.��s sa�uapina a1n��►l.�a� sty; lnr�; uos.�ad.raylo �fun ol ��►i�� �a���� .�o;undn��o�.raunto ar�� ol sluti.�.rnM.�ou saa�uti.�nn8.ra�;tau�t� ayz `(suorinliu�tl lauuos.�ad pun awt��Gn�aBpnq uir�lr�x) alqrssod�flqnuosna.� st ���r�� =�\��\\� sn uot��adsut pun ntatna.r d alaldu�o�sn apncu snz��t�a�l q8nor��1� •�rlqndln.�aua8ay�fo�tjajns pun�1jnar�ay���aj�'n�fla.ranas 2sou�untoys snr� ��%////�� ����_`_�.y a�uai.radxa �r rx s.[al;nu[ aso � uo snna aln�r t�.�a sr 1 o a�unnssr o ,�ot.�d�jt a } �f a nur uot1�adsut un rKacna.� a 1 ur sn�o �uoud a -����-�O � — - �f �1 �! .� .� �f 1 z � �! 4 P P �! 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