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BY $'S 14 (3W6 -2ND �AYEF3 Date By __ _ _ ___ __ _ _ _ _ _. _ _ __ _ . _ _ __ _ _ _ _ _ _ _ .. _ __ .. _ _ __ _ _. .... ___ .. 15 SUSPENDED CEILING Date By 16 PLANNIN(3'�INAL : Date By 17 PUSL.iC WORICS FtNAI. i'. Date By 18 FlR� �IN/�� Date By 19 BUILDING 'FINAL , Date By "s'S _ __ . _ _ _ _ 20 Q'THER Date By CD0193(Rev 4/9� Q"'of — BUILDINO DIVISIpN � �D�L 33530 First Way Sotrth� Vv �y �������'�'� Federal Way, WA 98003 i206) 661-4000 R���� ,� � ,���,�� Fax (206) 661-4129 ,�f� � APPLICATION FUR BUILDING PERMIT PL EA SE PR/NT � � � `` � � n �, D�/�� � ` ` APPUCA TION�; (�f/ `� SIT�T�Q.�T�O�Y < Address 2 L}5 2. � 2 /�!� PL.�,GC � Tenant (if known) Lot �' 4� Assessor's Tax 3 2 - 0470 Building Owner's Name Addrass Sci,�N,r-�i ,c2 M,�� ��c/c. (o5lO Sc�uTi�c��+lTb/'Z. �jLV r�. CitV �� 5tate Zp Phone '�� Z g^ Nature ot wo�k CoNs-r�y�T c S G t —Ann/L( �����- C — ��:�Lzc� Name (F,M,U GH � �I � ' oM � ING . Address � � IO ��Ll i G�N►�.. �. � l_ �D. ���„ ��► � A ` S�eta f� . z � 1 B Contact Person Da Phone Other Phone (�G A f�I�- GA u 1 r�l I� �2.oG 2 48 -- ''-�-� I �� FaX 2�}Z- �}-Zo� !r��i�n�iG eo�r�a,�oR ; <, < . _ . _ ,_ ._. .:.:;< ,r Company Name �ME- Addross �� Ciry I� I State � Z �� Contact Person �� Phona �� Fax �� Contractor's # (card must be prasented) �G H� �I � G Exp�reb°n Date Verified ❑ Yes ❑ No -� b3-a� -o� . ; :�RGHITE�T _ _ ;;: Name �b�� Address �� Citv �� State I zo �I Contact Person �� Phone II Fax �I �GAL DESCRIPTION ER-1?i4-Ca E DD I7 S D T / � � V � P_Ieas�Com�/ete�esrers ide , _ __. .S`-T'RUf:TUR� .:; ; '> istine Use �f� roposed Use S�N Ca L—E �"'/�j✓I�1..7' � Permit includes. B u i l d i n P l u m b i n Mec hanica l ❑ Other Type of Work: � Residential �Naw O Remodel ❑ Number of Units ❑ Deck ❑ Commerciel O Addition O Gera e ❑ Shed ❑ Other Enter l st Floor �_ 0 93 sq h 2nd Raor 1022-sq ft ard-Fi�aur 320 yq ft Existing F1oor Aree sq ft Area Basement s h Decks s h Gare e s h Pro osed Total Area 2 g ft Water Availabili Sewer Aveilabili Ort-Site Se tic S tem Availebili ❑ Pro'ect Valuation 5 2 � ��Q Zonin � LotSize ��� S • F. Existin Bld Valuation S , , � /� ) ,: r �♦ . . .. ... _ �.T` :'.. :. ...� ���;�� �� . . . ��� Name Address � AN c�c State Z �'��.'�l���i�f,'"��.'�.f�.��� Contractar Name Address Ci � State Z Contact � Phone Fax license # iration Date Verifiad ❑ Yes O Na ?:>�<z�:;�'i <>;:;•z:::>:<:�za�;;>�::::.;:.;:.: i�s�,��t� S.:Y.'... a\x.a.,�};.ti>:titiv.,vv � �t��tM��'E*�' a.��t•.,�..�..���c. '..�.,.. • .'s� .. . .. ��`3::\`�33w�"�?�:.�' .�..c....a'i..:......... Contractor Name Address C:i Stata Z � Contact Phone Fax ". Cicense ,� ^ Ex iraoon Date Verified ❑ Yes O No -o;tf;.?<;:<:�::�:;:.:..:x�� .:x�:�:::•:::::.�::::::•.:�:.::.�::.:,:::. Il.i�:iii;:i:::;::>;;+:;:: ;:`:\�::;a>;:�:y}>::::;..}:::�:::::a�:::;iYv�:�;:i � FLY71�+iB���3't3�2E'���T:;.:.::;:;.:.:�::,<::.>:<: . Watar Closets Sinks 2- Urinals Lawn S rinklers Bathtubs � Dish Washars � Drinkin Fountains __ Other Showers � Electric Water Heaters Sum s Levatories � Washin Machine Drains '' Totel Fnctu�e Count �" 4�««;;.;>:::;.:.; ,<.;;::;<.:;,:>.::, hTE��ANI�l�``rE4�II�.T��,$�� •; • MECSANICAL EYALUATION ONLY S 2 O �' Fuel T e (electric ther) �.(a A-S �.` Ges D er Air Handlin < � 10,000 CFM 15-30 Tons Len th of Gas Pi in 5 L• (-'. Ran e Air Handlin > = 10,000 CFM 30-50 Tons Fum <100K BTUs ,�jaC� GeS�o f Unif Heater 50+ Tons Furn �1pp gTUs Fans Miscellaneous Fuel Tanka Gas Hwt �" Hood Boilero Above Ground Conv Burner Duct Work 0-3 Tons Under round BBa S Wood Stoves 3-15 Tons ' - . . . Total tlnic Count �ISCLAIMER: I certify under penalty of perjury that the informetion furnished by ma is truo and correct to the best of my knawledge, end further, that I �m authorized by the ownar of the ebove premises to perfortn the work for which permit application is made.1 furthar egree to savo harmless the�Ciry o( =ederal Wey as to eny claim (including casts, expenses, end ettorneys' fees incurrad in investiQation and defense of such claim), which mey be made by �ny parson, including the undersigned, and filed egainst the City of Fedaral Way, but only where such claim erises out of the reliance of the Ciry, ' ncluding its officers and employees, upon the accuracy ot the information supplied to tho City es e part of this epplication. Jwner/Agent; � � Date: ��o.,.:n.. �...�on�)119�1 -� v���� - 'U�j�l� �� ; ` ,+.� '��o +2 . � 8 ,�/5G �..3/ '�59��E r �/59°�{-r'r �3�"ES�, /9 ' S � � , � ;, t3•5 5'� , , .. � � '` ; �p - �. ; a` �o � ' � `� � � � O ;..�1 : +Ysi� ��. � J . : ' \ -�_ �C � � ;� ���F ! � � . �� � ; o �: � 3 � �' '�� � � � , .� ` �I �bc�F o 8"F''; m i N 47 I .L��NE ; � � o� / _ �_ � � � q� � '� � o ° F �a"F0 22 � B � c�'v �v�- � I yo m � g'-o�� FF�t6•�3 � � � �� �r��.�, Q�- A��'. �G-ra�� - Gi22 � -7���� � �>C/S TI'N� �ieoPos,�O � _ ,_ -@_..t_�,_oo ��' GR�t,o� ..��e.�/J� ; ,� 1 � � t; ;� �-T�',�� 'r rP� � - - -�! � � � ; _ - � '�� . ; ., 2Q\,�S g� � ,. � \ -' . � _ \', � �, � `� - � ,� �; (� t''�s:,.,� sxk�,��.�U���:�,;;..� . - � 6 ���` �G� ��C 8l0, 8 � 1 � .� � �� ��'e"` �"'�,`F'�� 3�lt�k,:r� �'�(�!- 8 t � �� �,-F 2. � 6��C t J ��.o�., '�,.'�CW.y �t....� ��Y�'- � �S, 2� � `'e� �j --�!� �--t.:,�.;�c,,,,VE �f ��,...� r- �, . .�r;F�j � C.r � �.s�. ��c�,�►� tl..v t.t�.. '' � T .q,eE.� = 72 0 � s, F � - O�JSE �`G.�t�� CT.� = I G �5 S , �=. T�EL�S �.�1 � � -T�7 BE' R�rio v�� �i</C. f o�eCN = 57 S.F- F= F/�2. 1.SP/�'.� L T s/OE�/� L/� = 5 ��- S. F - -`0�2/V�' !-�1� ?' ^7�E,�' V�v�-/S SU�2Fs�l C,�S = 2 2 lo(o S. F �T.�L �oT C'oYE,,�9 �,E = 3 � � �3G scNNE�oE �e �/oN1Es �Nc jVG. �u/�D/NG �� �1/. = t� , �S '(�/LD/NG' H.�'/�'HT�= Z�f�-3'/�'� LO % �} �� HER/T.9 G� GJ�I.�D,s-� �f Z� , C�21� �SC�LE � / - 20 O G,�-rE �� � � - 9— 9 �