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By 8 PLUM9ING ROUGH-tN ` Date 1 l' � �'" /`/ BY ,� / 9 (3A5 PI INQ Date f�' , �' ��i� :gy ���� ,,. 10 MECHANICAL:AOUGH-IN' Date __, �� � ; B� � �� 11 F�tAMING Date �� � _BY _ _ _ _ _ _ 12 INSU LATIO.Pt bS -. _.._. . Date �� BY ��t �'� 13 GWB - 13T LAYER _.. Datq�/—/8"— BY S� 14 C�WB -2Nf� LAYER Date By 15 SUSPENDED CEILING Date By 16 PLANNiN(3'FINAL'. Date By 17 PUBLIG tNORKS FENAE. Date By 18 FII�E FINAG Date By 19 BUILDING FINAL Date -- f�_ �i By ,j 20 pTHEC� Date By CD0183(Rev 4/8� �. , o ,� � �y�� BUIIDINa �:. `"'rF � 33530 First Way h-: �� �E1'ZRL_ �� . o,, � Federal Way, WA 9 3 ��. ' � .- � �y.'� (206) 661-40_0 ��=-�'�-�-'� Fax (206) 661-4129 APPLICATION FOR BUILDING P�RMIT PL EASE PR/NT • APPUCA TION!fi "CJ SITE�.O.C`ATIL}F� > Address 2 �Q S. 2 83 �v /�(�E Tenant (if known) Lot A� Assessor's Tax� 45 2 0 �- 0�{5 Buii ng Owner's Name Address �OU�, / � �Z �jL UD �c Nhl E�D�� /-IO��J F S �iC/G . 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F. Existin Bld Valuation S ��?�'?��:�: �>:�>>�����'�=�''�<><��:'?J>: Name �L�Y� �� Address �l. Cit State Z ::;�?;:;:: �.~C�. .t�z<�:��:'•.�.�.�''`.����=s::::?:::?;#`�>:>:':�: �;� Contractor Name Address C� State Zi Contact � Phone Fax License # Ex iratio�Date Verified O Yes O No �'�`�'ic�':' m���{����7(�[+ ^y� ;+r�. :3:{:<: .'>'L ii_,': :.:�:::::.>:::•:;.._.::::.�::::;:::: :o:v;::::::_:.:�::.x::::::.:;;. :.:;.::::..�:..::::.�::::._:::.:.�: :...:........�.::::::.:::.>::::.>.. _.. ... .............. ....... ....................... .. . ._:...L;�i4e�i#:��VE'i�ie!xi!...�.�°...`�..�.�.'�4�i��;i`%:::;;iiY�:::::[:�i%:`.,-:::';: Contractor Name Address C� State Zi Contact Phone Fax License # Ex ira6o� Date Verified O Yes ❑ No P�Ui�ZB�.NG�J�`:�{)���TT Water Closets � Sinks 2 Urinals Lawn S rinklers Bathtubs 2 Dish Washers I Orinkin Fountains Other Showers � Electric Water Heaters Sum s Lavatoties 4- Washin Machine Drains ToteL�xturc Counf ' ;<`��-.: �,�������T��€� MECHANICAL EVALUATION ONLY S Z,S�D °� Fuel T a (electric/ thei` �.I��/�S Gas D er Air Handlin < = 10,000 CFM 15-30 Tons Len th of Gas Pi in � 'Jr L.. F. Ran e Air Handlin > = 10,000 CFM 30-50 Tons Furn <100K BTUs 5�i'vG��TuS Gas Lo Unit Heater 50+ Tons Furn >100 BTUs Fans Miscellaneous Fuel Tanks Gas Hwt Hood Boilera Above Ground Conv Burner Duct Work 0-3 To�s Under round BBQ's Wood Stoves 3-15 Tons Total Unit Count �ISCLAIMER: I certify under penalty of perjury that the informatio�tur�ished by me is true and correct to the best of my knowledge, and further, that I �m authorized by the owner of the above premises to perform the work for which permit application is made. I further agrae to save harmless the Ciry of =ederal Way as to any claim (including costs, expenses, and ettorneys' fees incurred in investigation and defense of such claim), which may be made by �ny person, including the undersigned, and filed against the City of Federal Way, but only where such c�aim arises out of the reliance of the City, ncluding its officers and employees, upon the accuracy of the information supplied to the City as a part of this application. a__y.� t ` �wner/Agent: �t�G'L�C%� Date: i��iPwG.An �r�.�p 11171 Mll