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RESIttEI�Ti�I AIN) f�i}IM6 PE�tIiS EX�IRE ONf Y�AR RfTfR DpTE l�f' i3S!lAi�CE. , � E�TIF1' TNAT TNE�MFORMATIOM FURMISED 8� ItE' IS TRIl� AND CORRECf T� T�E BESt UF MY XMp#I�.E66E AK� TNf APPtt BLE CITY 9f FERERAl. 4Rq'� REQUiR�lIENT� M(lt SE NET. � '' • � ..� �.., � , � - ..�,/9 � ,i, �j �,�%�' ��,; , r �� �3ATc � < . .._ ___ �— - ___. .. ,. . ._ ,. . _ ; �, .' . FIELD COPY SETBACKS & FOOTINGS Date By FOUNDATiON WALL$ Date By PLUMBING GROUNDWORK Date By UNDERFl.00R FRAMING Date By SHEAR WALLS Date By PLUMBING ROUGH-IN� Date By GAS PIPING Date By MECHANICAL ROUGH-II�i Date By MECHANICAL (OTHER) Date By FRAMING Date By INSULATION ' Date By GWB - 1 ST LAYER Date By GW6 - 2ND LAYER Date By SUSPEND�D CEILIPIG Date By PLANNING FINAL Date By ENGINEERING FINAL Date By FIRE FINAL Date By BUILDING FINAL ,,�� C� I�.�V Date `� ZZ By� � ATHER Date By OTHER Date By CD0193 t . ' . � �.� � City of Federal Way -�-- �-,�r=� �`� APPLICATION FOR BUILDING PERMIT PLEASE PR/NT APPUCAT/ON#: ' � � � SITI:I.00ATION Address �L J ���_3 `3 � �� �, L�j Te nt (/if��nown) Lot# Assessor's Tax# G�i � G �` �� ��� � /) B Owner Na / r' � Add� ''�� ,� , J� C-- > .J�i/_ � � ?r � � �'' - / „ /��. r � �=_ j ity — . - .�/-f�� State /��C`/� Zip � /�i'�� �' Phone �`" - - ;r_ � Nature of Work ,� 4� � _ � / � � -- � APPLICANT ` Name (F,M,L) � � - �� Address . / City '� State Zip Contact Person Day Phone Other Phone Fax EUII,DING CONTRAGTOR _ Company m8,, > f-- — � ��i �-%,/-;j l; � ��� ,? , Address • :� City Contact Person �> r. `� � State � /�%� Z�P � �� � _ � ����.- ..� Phon����� Fax u i �� ,� Contrector's ( rd•must b pre,sent Expira ' D t ` Verified ❑ Yes ❑ No ��l-' ;� -�_� 2� �t`f , �RCH�TECT Nama �� � � / Addr ss City State ZiP Contact Person Phone Fax LEGAL DESCRIPTION P/ease Coma/ete Reverse Side CD0492(Rev 4/931 STR�CTUR�' > Existin � � � p y t ; •r • .... � Pf0 � �S8 ; / �'Y�� ��� �?�7 � ....�i/_7° /..� , Permit includes: L� uilding ❑ Plumbing ❑ Mechanical O Other Type of Work: ❑ Residential ❑ New emodel ❑ Number of Units L ❑ Deck C�6mmercial ❑ Addition ❑ Garage ❑ Shed O Other � Enter 1 st Floor� i(a sq ft 2nd Floor sq ft 3rd Floor sq ft Existi�g Floor Area �'�> sq ft Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ ProjectlValuation y,;,.�;� �;ia '"� " Zoning Lot Size Existing BldgjValuation S LENDER Name Address City State ;� Zip � _. ...._. _ _ ,, t 1N�CHAIVICAL'CONTRACTOR _ __ __ _ _ Contractor Name Address i� / c�cy stece zP Contact Phone j Fax . License # Expjfation Date Verified ❑ Yes ❑ No PLUMBING CONTRACTOR `� Contractor Name i Address i / City State Zip Contact Phone Fax License # � Expiration Date Verified ❑ Yes ❑ No � �/ PLUMBING FIXTURE��IfiI'I` � Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water H �ters Sumps Lavatories Washing Mac ine Drains Total`,Fixiure Count i / MECI�AN�Ct�:UN�' �I�UN'�` Fuel Type (electric/other) as 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 Boilers Above Ground Conv Burner % Duct Work 0-3 Tons Underground BBQ's Wood Stoves 3-15 Tons Total:llnit Counc DISCLAIMER: I certify under penalty of parjury thet the information fumishad by me is true and coRect to the best of my knowledge e�d further thet I am eutharized by the owner of the above premises to parform the work for which permit epplication is made.I further agree to save harmless the City of Federal Way as to any claim(including coste,ezpenses, end attomeyc'(ees incuRed in i�vestigation and defense of such claim►,which may be made by any person,i�cludi�g the undersipned,and filed egainst the City of Federal Way, but only where cuch claim arises out of th reliance af the City,includi�g its afficers and employees,upo�the accurecy of the infortn ion supplied to the City as a part ot this applicatian. � � C �( Owna�lAfl Date: /� � � /v`� r�'/�fZ� /G'GI/!3'