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96-100145' R�-/oo� x� ` c��rY v� ��U���t� w�ti� . ,. .., .,... w� � � � � �, � : �;c:r,!� . -o_ ���� , },,,, , ;< < �� r� -� -„ � �; :�:���o �=i r�t w�� ��o�,t n �.�,��.:�. ��:,;;.�,�"�� ��'�.� G�1'1 ��..���,.. c:��u�.0: o:�/:�.�/�F Federal Way, WA 9�3C1�1;� I�uilc�ing Ir�spection f2equest�s 661--4140 BY: FC2 �iE��.-40C1Q EXf�IRE5: 0�/1..5/96 �DDRESS:1805 S ��.6�TH ST lJnit: A•-103 ;�f). : 0921Q4--9�C�4 �=�I'.r)JECT DESCRZPTI(�N;INSTALL (1) WAII SIGM WIiH INTERNAL LETTERS OMLY ILLUMINATION. ,- ONNER .������_�:W�__,����_�_��_�-_�=w�:,__w�-- CONTRACTOR ��,��K�:..-�_��._======_=_-= 6ENERAL INfORMATION ;����x���-=��-=:.:�r_���-�w�_�=-_---= r : NYUNDAI CHINESE HERB CLINIC TOTAL ART CORPORATIOH BUS LISC#: NEED r'- FEES =-_______==_-=_-=_---___-=. � � � � SIGN PLAN CHECK....� $ 35.10 � � 1805 S 316TH ST, A-103 31248 PACIFIC HWY S � PLANNING SURCHRRGE $ 25.00 � � FEDERAL WAY WA 98003 � FEDERAL WAY WA 98003-5402 � VAIUATION..: 3000 ZONIN6...: CC � SI6N PERMIT..WALL..# S 54.00 � � � PROP AREA..: 26.50 COMP PLAN: CCC ( PLANNIN6 SURCHARGE � 10.00 ( 6-6163 i 529-1212 � ALLOW AREA.: 30.00 CATEGORY : ? f � � TOTALAC062NB ST FRONT...: 335,79 COMP SITE: ? � � ! CODE CIT...: 22-1601(B) ( OTAL FEES:$ 124,10 � �� _.._______....___________________.._r_._.._....__W.._..J.______.._.._��._�....._.._______._....._..�.�.......__ .._________.....____________---------..-----_____ i ---____.._--------------------_1 -------____._____________�..__._..__.._____.____.____.._____.._---.__.... _._.__...___..._..._.....___._.._._____-•-.----.-.---------___---.____---__....____�����s�=--_..______...._---_-_--------.__------------ x*= CONTRACt�tS, PLEASE USE LOCATIOM CODE 1732 YNEM REPORTIk6 SALES TAX fOR PROJECTS IiITHIII TNE CITY OF FEDERAL YAY. TAX RATE = 8.2� Y=� = FREE STAND ---_=�;= SIGN 1 =_==_!=- SIGN 2 --==_�-=- SIGN 3 ---__-_= SI6N 4 =_==---- NALL SIGNS =-__==-_�== SIGN 1 =--==T== SIGN 2 =_===�_= SIGN 3 =====T== SI6N 4 =___=--=-� ; � I � � � ; � ( REGISTRATION ' I � � REGISTRATION ; ' ; I TYPE OF SIGN ! Other � ! SIGN TYPE � Wall ! � ! ` ( ILLUMINRTION i Internal Cab I i ILLUMINATION � Internal Let � I ' ( ! SI6N AREA I 1.90 f Q.00 0.00 Q.QO � E,�POSED FACE AREA � 0.00 ' 0.00 � 0.00 ( 0.00 ( NEIGHT � 8.OQ 1 0.00 � 0,00 Q.00 PROPOSED AREA O.OQ ! 0.00 � 0.00 � 0.00 � �� LANDSCRPE AREA i 20.00 � �� � 0.00� � 0.00 � � 0.00� � SIGN DIMINTIONS 1 2.916" X 10' i ! ! � AREA Of FACE c 0.00 t O.QO 0.00 � O.OQ ! 1 I ( � SIGN BASE I 0.00 0.00 ( 0.00 ; 0.00 � � i � � SETBACK � 0.00 � ` " 0.00 I 0.00 � 0.00 I I I ! ( GN DIMENSIONS � 8'x 6' � � I � � � ? � .._____________1-----____�._____L__..___________1_----_______---1-----------..--- -- ----- -..__.._....lr�====_=__=____1_�_���_:��_�_��1�_��W���,�_�-__J,____---=___-.----__- ,______________-.---------___....____..____.._________--..---_________..__..._.._____._.-----___.____.____.__._..__.,_____ ____ -- -- ---- ------ -# � footing/foundation inspection. _,___________..________________ Date __.._,_______,_ Electrical inspection _,..__ Date _,__,___,_____,_ ( _...._______..______________. Final inspection ............. _._.... .______._._.�..___---_._____�. Date ___.___�_._.... Electrical inspection _-.-----.._.___.________..,.,___.�_..... � . , ._ . Date ._.._....__..___ � � NOTE: All ELECTRICAL SIGNS REQUIRE R PERMIT AND APPROVAL BY THE CITY OF FEDERAL WAY � � --..___..______________..___.___..__ �____..____.._.._..__---_..�_.._,:�.�_..__.__M�_y����,�_�y__,.._____._====_�__:.�___-------=�-___�,---_ ------_.-___---_---___=_-�_�--���====�d x= ALL PERMITS EXPIRE 180 DAYS AFTER ISSUAMCE IF NO MORC IS STARTED. ** I CERiIfY tNAT THE IqfORMATI FURNISHED BY E IS NtUE AND COR � TO THE BEST OF MY KMOfILfD6E AMD THE APPLICABLE CIT OF F DERAL MAV REQUIREMERTS MIII BE MET. ONNER OR AGENT � ._. _., ._. , � �� � _......_._... ._�._._ _ _ DATE . _ _._ ___.__ __ _.__......_._ ______...--.--._.__...__.._ ..__�_�_ _ _.__ ._ t ' FtLE COPY �'] rY CJf` I��� I�t.Fr�'t(._ l�Ifa`r 4'�.;?�°Ii t hau �a� ,Pd-?� �,tii�,�, :�.����:� F � ►���� w:�v c�>��,�:f, �:�� ���'°,� '�'�:.;�'�� �` ��� c�.,��u�::�r: c� � �.i f-�;��¢, i��.=t��u•rE=z 1 4�.��x, Wf� `�f.tt:1+:1:-� �;�,i i l c;i.n--:? ! r�:>�ys:3c.t i �r► f?Fa;�i�t���l.�; �,r',:1 --,r��1.���3 .�ti'• F_r.�, �.�,:t --�oor� v , �>>���<:>: �u��%� ��<��, �-111�:C>f�FS�:1�C1`�� `..� '_31��� 11 �::1 ��r�it: : f�_."I ��_� � �D� �S �t�`�. : Q921t14��-r3'��(1�r � �,t���;�f �(���:St:"Rli�'I��t)P�l: [145�[All (1} MAII StbH tliti� 1NTERtdAt LETIERS QHIY ILLU�iINATIRIl. • ,ftR .x._._::.::,_:.:n-�t�,.,::,.�„«,..�,� .;,.; , .... ...�-,:-: r�MTRACTt�R _�.��s<r...:=.�a :, ._. :.:....:r_.:a:-:� fiEHERAI iHfORMAfIQM ....,7.:.,«.....�,._ �.:.�..:. .. ...... ..,,u. �.,�� ffE� .,. :r,., :�>_..�.�:.�..r�:�-.�.:G:.F:;.r-<:y � E��;U�DAI CNIt1ESE� HERB CLINIC � i�OlAl ART CO�PORA�fiOM � �l15 LIS[/: NEED � SI6N PIAN t�HECK....� � 35.14 � ' ' �gn� ^ ^1Fr�s �;T �-�na , 31�43 PAtIFTC HYY S � Plt�MNIMG �t►�?(tlAR�E S 2�.00 ( 'i:D�ftAl NRY MA 48003-5�»02 � vAlUAitf�}I..: 300C� ZOM,ItdG�...: CC � S�I6Y FERMIl..61All..x S 54.00 � � [ PROV riREA..• 1b.5U C�MF' PlAki: C�'f, � PIA�INING SU�iNAR�E $ 10.f10 � `�?Q-1212 ( AllO� AREA.: 30.�10 Cf1f60R1' : ? � � ?OTAIAC�)b?MR S1_fR�?NT...: 335.79 E;�JMP rITE: ':' ( ry� ; ��.���:���,�: ,., , .._ ,..._:�} ..,�;,.��.�,:�:�,�.,�,:>.: _..� �- _. . . .., ..�. _ . ..n��2-1�t11.. _ ,�.....�. , . , . ._ _ ., .. __ ., . . _ . _. . .b. � .��,�.�1,4��4�1 � CODE Cil f B) i(�ipl FEFc .. .. .w , , ,. __. _.._ . .. .. ... � . .... � _ .. . ��� d W.m � :xt CtNtittA6:�4�„ �IE�! ��CA�I�� C�� 1.'��t �'� fi�'�1�'�IIl� '�At.ES TAX FIIR �R07�Ci5 I�ITNIM i� ttTY (N� Ft11EftAl Y1tY. YAIi R�TE ' 8.2�i :tr FPEE Sir�ND �1f;;! + . _ �, GN 'L .-:.. ,� s�t��� � _.._�.._�.. :t����� -;.x.� aalL �l�;N� ..:�.„.: �;�, � -:, . t;I�;N :+ ��:�:-�_}-:- �;Ir,N 3 . ..,:<.���:. 5I6H 4 �a�,�.�:-,�a� ������ � �� ��,�, w ,�e � � 1 ( ( REGISTRAII���: � �Il.� -vUoG. � � � , �r ��� t'� � f�r�����,� (� � oc 7 _ �`� � � o � T�rPE t►f ul�;�; ;�� ,� ; , ' � � ����� a� ��� �� e �.�t� !:E'�� ., � ��3�� _ � I � � r r �` ��= � I �i �� �� � r�ik�t�i�' � �� ����� �. � � SI6�IpAREAt(!M Intira�� ����,�a� ���� w� . � ��� ,�go-� � �`t,�J�c�n �� f#t'��; � , .U� ' 0. �� �� ���:�1 � l?.00 ( � �* IANDSCA�+E: AREA 20.00� . �.�� ` ��0., y\� ^_ � �.�1 S�16N DthIMT14NS � 0.00 � p.OG 1 O.Q� � 0.00 � � � � �� �.41d' X l0' � � � I � AREA OF fAfE 0.00 URt�.� ��� �, �„� r�,{!D � I I � I SIGN BASE O.QO ; � '� y 4.00 � U.UO { I I ( I stii�acK n.o� ��;�� �;.;��� ����� o.�o � o.on � I I I ,�t,M bi�1ENSI0HS « e'� a' � �t I ij iI I '�:... .:.s;.�.:a. .._�:.,..anat2'.*.�'lm�s'nttxm�aTiLr�e�..,v��.�.:� Fxmnxx:.-zx�ev'L�sszxa�:xsr.q:xaata:Meew:e{-n@!ealx...^::..r:;,+anaacbfxraaR� �SnfArscYr,l�aMSTsa:a�:s1�m:;c'.savStieM�tn£Kam�nseexxe'n'xas.'.is�s»Tt':•��:�: �s...i"._.a.... a....._....14.:_..1.....,....�v.. ,a...:...•w'":ftaataa�:cttsuc�:i-�:c�".RMa;ar„� f�ating(foundatian inspectian. _ _ _ _ .. Date _ E1?ctrical inspection Date _ ____ � Final inspectior� ............. . ..._ Pate __ _.,.. Electrical inspection . . .. . _ .. Date � i HO1E: Atl EIECTRIC�II SIGbIS RE4UIRE A PfRMIi AND ANPRAVf+l. BY iNE �:I�Y t!f FEDfRAI �lAY � xe..:..xaaru�x..._....„:..�.:s..�,......raar.c.muver_. ...��a:,.�.::s:e:es:.�e:aan.r�:uai:...x.........::,1 .�.. ._,.:�r�...;_.at�.c.,. i�...:;..v;,,.a- ,..�.r�,...,..,. a,.-�.,.�a..i:.�.m .::_.:-�..:..ar,:r...-s.,�.z... ._. ,.....:x�c.�cr.:,, u.....x....n�: .� _.....va.a.�a .......,..._ ..se.�m.cxan.a,.a,�.....ex.n:s:..z.rta� ♦ Y� All PEKh115 EIIPI�E 1�tt bAYS I�TtR IS5Uft!!Cf IF MO IMNiK 15 S1Ak1E6, tt t IF�tIF�f fl�1f Tlif [Il�OR�IAtIQ�I fi�tNIS�LD �Y I5 AM� �i�t 'i f� (� �EST 8F !IY KMOtKt� AND r� AP�I.IfA�lf CITY iN F �.RAL MA� �Fd1GGIRf.iffMYS �llt. �E iIET. CNNER OR AGf a l �'��� . , � " � l _ -- _. DH1E � �� � - . � / � / , � C__--�' � � FIELD COP'Y ' r 1 =°F G 33530 Firat Way South � E� Federal Way,WA 98003 "" Phone(206)661�000 \/\► ; ..�:��:.�'�� �'� �. SIGN PERMIT # N� `�v� �1A� 12 19,�,� <>`��` __ t SIGN PERMIT APPLICATION ��,�,s- vva�, � _ ,.t,l;a 1?�c_PT. This application must be submitted to the Building Section and a sign permit must be issued prior to displaying any sign, except as expressly allowed in Federal Way City Code Sec. 22-1599(c) Permit Exceptions, whether or not the proposed sign requires construction or structural alteration. WARNING: DO NOT CONSTRUCT OR ORDER A SIGN UNTIL A PERMIT HAS BEEN ISSUED. THE INSTALLATION PERMIT WILL EXPIRE 1HO DAYS AFI'ER ISSUANCE. _.. __ Name of Business YU lJ��( G f(I N�� �Ff�R$ G�-I N1 C_ �Business Lic.# � Address of Sign �`a�� �• 3 If?-t-�.. S-{- . �}-(0 3 ��� �✓�1� b•JA' q8 oo 3 � Owner of Sign �,h . {}�_, Phone � �' 6�63 Owner Address ��o� S . 3(6'(� s�} , �} -(o Z F�� G,3-� I„�,¢� ��y0o� Owner of Property - M , Parcel Number ���� (� ��'X J'-I Single Tenant ❑ or Multi-Tenant � Contractor /L C o Phone S�"� ^'(�'"�L � ContractorAddress � 8 Pa� � � -f-lw S, �{v? GJ� ��' Registration# ����C.t�(�-�J(3 Contact '�P�'�q Phone S� ^ (�'��" -� All signs must meet the requirements of the zoning and building codes. �vo sets of plans (maximum plan size 24 x 36") showing the location and size of the sign(s), existing/proposed signs; elevations showing facade, sign location, sections,must be submitted with the Sign Permit Application. 1. Number of tenants, or available business spaces, on property g • �List type and size of all existing signs associated with the business (locate on plot plan). 3. List type and size of all other existing signs on the parcel. ����yH�l U NDA f F�P �� l��`�n �b� � ��i�j � C F-�A11Z I�{1Alk.� �� ��'+`�X I�-� � ���1'^'�f�{L��-� Pll dl�l�' U�D�1 l!5"7c(1 r� " �J.� <slu:�..-S�.i...M 2�s-i-�.�ns�1 a.��b� �tis�x �y-�t � 4. Is the Sign a Center ldentification Sign? � r.pJ��• 1�i7 �,'� 5. Does this sign qualify as a High Profile Sign as set forth in Section 22-1601 of the Federal Way City Code: A minimum of two hundred and fifty (250) feet of street frontage on one public right of way; A zoning designation of either City Center (CC) or Community Business (BC); A multi-use complex; AND A minimum site of fifteen (15) acres in size. (�r� ' I . Free $t�nding Sign Building Mounted Sibn . i Type of Sign: ❑ Mohument ❑ Pole Type of Sign: `�J Wall ❑ Projecting ❑ Ped�stal ❑Other ❑ Marquee ❑ Other Illumination: ❑ Internal (Cabinet) Illumination: �❑ temal (Cabinet) ❑ Intemal(L,etters Only) L�1 Internal (L,etters Only) ❑ External ❑ Extemal ❑ Non-Illuminated ❑ Non-Illuminated Q.1 Other (�escribe) � Other(Describe) , I ` Total Sign Area ( . �t.) (a)Exposed Building Face � �--o sq. ft. Total Sign Area per Face (a)Proposed Sign Area Z i., �� sq. ft. Sign Height Base Height (b)Exposed Building Face sq. ft. Sign Face Dimensions (b)Proposed Sign Area� sq. ft. Total Street Frontage (c)Exposed Building Face N sq. ft. Landscape Area (c)Proposed Sign Area '�, sq. ft. Set Back from Property Line `Note:Sign Dimensions,Section, Bldg.Facade;must be shown on elevation plans Total Estimated Project Cost � � b�� � I CERTIFY,:UNDER �ENt1�:�'X O� P�R7URY, THAT 'I H�J��RMA,�'XON':�'CJRNTSHED B�Y ME�.S TRUE > AND;CORRECT TO THE BE.fiT OF M'Y KNOWLEDGE AND FU12T�lt, THA'I'I AM;AUTHQRIZ�D BY T1i� OWNER OF THE ABO'� 1?RfiMISES<TO PERFORM`I'HE..WORK::�OR..'WHICH 'TT-TE APP�,TCATION IS< _ _ __ _.. ......__ .__ _... _ _ __ __ _.____ _........ __ _ _ __ _ _ _ . _ _ _ _ _ __ ._ _ _____ ___ ___ _ _ __ ___ _ ...._... _..... ...__ _ _ __ _ __ _. _ _ __ _ _ _._ _ _ __ _____ ___. ._ ......... _.... .. ._ __ _ _ _ __ _ _____ _ _ __ _ _ __ __.... _ ........_.._.. . ._ _ _ _ _ __ __ _ __ _ _ ._. _ _ _ ___ _ .. _ .____ . _ _. ___ _ _ _ __ _ __ _ _._ _ _. __. . .. .._.. ___ _ ___ __ _ _ _. MADE. Owner/Agent (s�gnar�,re� Date � • �Z� � (Print Nam � OFFICIAL USE ONLY (Please do not write below this line.) Registration !{ Registration # Registration N Registration /� Registration # Registration # Land Use Approval:` Date Zone - Building mounted - Sign Area Permitted(sq. ft.) -�`' � Sign Area Proposed �sq. ft.) �L -`' ✓� Largest Building Facade 3;%� ��= Number of Building Mounted Signs Allowed � ',yFree Standing - Sign Area Pemutted(sq. tt.�� .�'•:`�1 Sign Area Proposed (sq. tt.� � ' `` - N'� . Street Frontage r``1 Number of Free Standing Signs Allowed � / �� . �� Code Citation which allows this sign - ❑ H.P.S ❑ M.P.S. � L.P.S. � FWCC: Remarks �� Buildinb Section Approval: Date Valuation $ Total Fee $ • Permit Fee $ �� A`. Planning Surcharge $ -'-�"�. '�• `� ',;�,�� :.:� Plan Check Fee $ Remarks FANY DEPARTMENT INITIATING D[SAPPROVAL IS TO CONTACI'THE APPL[CANT AND BU[LDING SECT[ON WITH[N 24 HOURS ►NDICATING THE REASOPIS FO[Z DISAPPROVAL. , - - .., �,... i.��;P-1. ' , ` �F G 33530 Fust Way South , ED���� Federal Way, WA 98003 \\� � Phone(206) 661�3000 \/ SIGN PERMIT # � SIGN PERMIT APPLICATION This application must be submitted to the Building Section and a sign permit must be issued prior to displaying any sign, except as expressly allowed in Federal Way City Code Sec. 22-1599(c) Permit Exceptions, whether or not the proposed sign requires construction or structurat alteration. WARNING: DO NOT CONSTRUCT OR ORDER A SIGN UNTIL A PERMIT HAS BEEN ISSUED. T�IE INSTALLATION PERMTT WILL EXPIRE IHO DAYS AFTER ISSUANCE. Name of Business Business Lic.# Address of Sign Owner of Sign Phone Owner Address Owner of Property Parcel Number Single Tenant ❑ or Multi-Tenant ❑ Contractor Phone Contractor Address Registration# Contact Phone All signs must meet the requirements of the zoning and building codes. Z`wo sets of plans (maximum plan size 24 x 36") showing the location and size of the sign(s), existing/proposed signs; elevations showing facade, sign location, sections,must be submitted with the Sign Permit Application. 1. Number of tenants, or available business spaces, on property 2. List type and size of all existing signs associated with the business (locate on plot plan). 3. List type and size of all other existing signs on the parcel. 4. Is the Sign a Center ldentification Sign? 5. Does this sign qualify as a High Profile Sign as set forth in Section 22-1601 of the Federal Way City Code: � A minimum of two hundred and fifty (250) feet of street frontage on one public right of way; A zoning designation of either City Center (CC) or Community Business (BC); A multi-use complex; AND A minimum site of fifteen (15) acres in size. . r� _.__-__..f a. .. � � _ � I � �d--7 . 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C.�' FIELD COPY ••.r-••.!�'�' r�' K"E' BUIIDINGDIVISION „_..,� @ ��, �,,,F G . 33530 First Way South ' � E��-�_ , • , Federal Way,WA 98003 uV F�Y "� 4 '��9� ,. : �Zss��i-�000 '. Fax(253)661-4129 ^qS APPLICATION FOR �Ui�i�iNG P�RIViI�' g`� g�-. a3�3 PLEASE PR/NT APPLICATION # �9 �D �S:/�s`�-£d�:`.;j.`.�:;r:S:t2u'S.''w }''k v>•`':'"a't`>"`•Y:.;.`y'�" ..��°. � � ��✓ X����It'`,��'���?��:k ' Address ,. Tenant(if known) Lot�' Assessor's Tax# Bui�ng Owner's Name � � / Address : �� � ] L n " �ll.� /� �i(��7C � Ci - tate tJ Zi (� Phona - G` � Nature of Worlc c� 1 -� '/.;::n}•;::::r�•.;w:i•:.:•z....' �L'l^,'•\;i•��Y•,.{li^:•:ii�n�w:{.rin��f: M1:�}ii•Y.\YO`\'.k.r{}";'f.•,v, •f� %rv} .} Fr.;}y..�ei::Qr• ••\ . ,'����.. .. .. Name (F,M,L) Address C� State Z Contact Person Day Phone Other Phone Fax if.�S;:•,y;.;;:ii;v:r;:i;••,•.::;;.:�;;•`•�%SS:��:�ri3:::::�:.:y>;::;::i:2c;�?.>;;::::�;<�y`.`.�','.'-`f''p'y � . `��l�t::b��..�`�.:<.,t.��'.'.�4�T#'�A.,`�'.�r..`•.1n#��:�':�.'.�'.�..�...v,,�::.��.:.......• C,�ompany Name � � ��' t Address � / � f' L�-� fl C� State Lv �. Z �" Phone � �`'�' Fax Contact Perso� L � �� � , �'� -- —�' Contractor's A`(card must be sented) Expira'on Date Verified ❑ Yes ❑ No • <iz�•••�.%s•• 2•.�'•••n. "��,�••...•. ..{:.:; ..4,r.; ':4:4 .��'2'.. --y;•s.��"�?`f +�;+:/.v �ti..._, . ...a :•.:••r•: . ; . , ' � •.. . . .•.::. :#1�I�.�.�...�..:�` 'f`%�'...�.''.`x�.�r`�,�.�''`.^.:�5;'.t..�..t.. •.:.:...::::::�: Name Address C� State � Contact Person Phone Fax LEGAI DESCRIPTION , -- - �asP Cmm�lQtP Reverse Side '::�?R�w..` ......x.ir. . ��.:.`•.. . . .. ... ... F�aisti�g Use � r Proposed Use Pertnit includes: ❑ Buildin ❑ Plumbin ❑ Mechanical ❑ Other Type of Work: Residential ❑ New Remodel ❑ Number of Units ❑ Deck • Commerciel ❑ Addition �Gara e ❑ Shed ❑ Other Enter 1 st Floor sq ft 2nd Roor sq ft 3�d Floo� sq ft Existing Floor Area�_ q ft Area Basement s ft pe�� s s ft Gara e s h Pro osed Total Area s ft Water Aveilabili ❑ Sewer Availabili a OtrSite Se tic S stem Availabili ❑ Pro'ect Valuation $ ,� t Zonin Lot Size Existin Bid Valuation S :.:..:...::..:�>.. . . . . . Name Address Ci State � � .������'��k�������� Contracto�Name Address C� State Z Contact Phone Fax License# Ex iration Date Verified ❑ Yes ❑ No j��F;.}��2i?���G�?;-`r,.'�k",��t`:�%i#;�i.'�?2nk'•ti:y'�:(l�':ff,t,2,>,b?'::;k.�:;�:t:h'.?."•?�:c}%.;,W�:€..`.:ti: •a-- . :F7i��s�.lY.t�l�1•�F��.�.�tin'J.i�:;#�.��.VR7c":. � Contractor Name Address P Cit State � Contact Phone � + Fax Licanse# Ex iration Date Verified ❑ Yes ❑ No >�ctlY:'i',#J4;i%•�.v![;��i.;.,[.'x=• ,i. •>:>io c::;i�;,;.,F%,;,•t��•...;.f:,:.*r:••.�„• xy���.'•r .�:....;.�'o:r..�,f2;K,.�,e:(:.�'...:�.:'ti...�::�..•: Y" i4i.MM��":►+%l��:��'iSl.�i�I�lCdl�i�:+}> ..� Water Closets Sinks Urinals Lawn S rinklers Bathtubs Dish Washers Drinkin Fountains Other Showers Electric Weter Heaters Sum s Lavatories Washin Machine Drains ;T�:.�::.;::::. t.1�"-.iiEtim��ou�E:»:>�:;�<:;::::<;��::>;�: ��'kk}i)1#��-�'i.ri.��.'.�4.YA:i'��'�'i.Qf?4#���{•r.`.�, MECHANICAL EVALUAl70N ONLY S Fuel T e(electric/other) Gas D er Air Handlin < = 10,000 CFM 15-30 Tons . Len th of Gas Pi in Ran e Air Handlin > = 10,000 CFM 30-50 Tons Furn <100K BTUs Gas Lo • Unit Heater 50+ Tons Furn >100 BTUs Fans Miscellaneous Fuel Tanks • Gas Hwt Hood Boilers Above Ground Conv Burner Duct Work 0-3 Tons Undar round BBQ's Wood Stoves 3-15 TOns ...t;"'..<:;::';r:'':;::;'<:'�:.::::r;::;:;:�;:�"fsr�`%'�:�,:;:::<;:%'`••- '�GtB(���I�k��`rG�Ufi�.....wv,ff«..,,;r;:,:. DISCLAIM ER:I oatify u�dec penalty of pajury that the infonnation fuMished by me is tiue and oocrax W thrbe3c of my knowlalge,and furtha,that I am wUioeized by the owna of the tbove premises to petf'ocm Uu work for which putcut application is tnade.I futtha�agroe to save hatmless the City of Fedaxl Way as to ury c(sim(u�c(uding oostc,ex{�a�es,and attomeys'f«s incumod in investigation and defenu of wch claim�which may be made bY�Y P���.including the undecsigoed,and filed against the City of Fcda�al Way,but only wf�ae wch claim arises out of the rolianx of the city,induding its offioas and anployees,upon Uu aocuracy of the infamation mpplied to the city as a put of this applicatioa � � L Owner/Agent: �' Date• � ` r f EU�DMO.AR . REYOEO8/2E/07 ..