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71SF_TBAC.KS & FOOTINGS
Date By jh► /�
7
FOUNDATION WALLS
Date I - )P17.3 By * n/
7PLUMBING
GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date
.SHEAR WALLS
Date By
7
BING ROUGH -IN
Date By
GASPIPING
r
Date'3— fG-t By 6R't/v
7MECHANICAL
ROUGH -IN
Date By 4,k1/ll
MECHANICAL (OTHER)
Date By
FRAMING
Date-5-a —5- By
71NSULATION
Date — 46/ By ltjlV
7Gwa
- 3 ST LAYER
Date — C By
7GWB
- 2ND LAYER
Date By
7SUSPENDED
CEILING
Date By
7PLANNING
FINAL
Date By
ENGINEERING FINAL
Date By
7FIRE
FINAL
Date By
BUILDING FINAL
Date '- By
OTHER
Date By
7
OTHER
Date By
CDO193
City of Federal Way
_ APPLICATION FOR BUILDING PERMIT
'LEASE PRINT
S1
t, 4l ,, APPL/CAT/ON tt
SITE LOCATION
Tenant (if known) +~ Lot # Assessor's Tax #
8 'Id' p Owner Name Address
1 fit.
i
City r te'c-, . State f. Zip �h;; `,' Phone
Nature of Work 41e��� . r
APPLICANT
Name (F•M,L) %
�
Address
l�� /J 12 5
City 1 _ I State Zip 1.i�i�r:' `>1
Contaa^ctt P�rson Day Phone r� O Other Phone Fax /53
BUILDING CONTRACTOR
Company Name
JTGe e
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) -' ExpirationHDate "' Verified ❑ Yes ❑ No
ARCHITECT
Name
Address
//
City in r� ..a. State .Zip
Contact Person Phone ty Fax
:GAL DESCRIPTION.
Please Com Jere Reverse Side
CD0492 (A.v 4,13)
APPLICANT
Name (F•M,L) %
�
Address
l�� /J 12 5
City 1 _ I State Zip 1.i�i�r:' `>1
Contaa^ctt P�rson Day Phone r� O Other Phone Fax /53
BUILDING CONTRACTOR
Company Name
JTGe e
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) -' ExpirationHDate "' Verified ❑ Yes ❑ No
ARCHITECT
Name
Address
//
City in r� ..a. State .Zip
Contact Person Phone ty Fax
:GAL DESCRIPTION.
Please Com Jere Reverse Side
CD0492 (A.v 4,13)
BUILDING CONTRACTOR
Company Name
JTGe e
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) -' ExpirationHDate "' Verified ❑ Yes ❑ No
ARCHITECT
Name
Address
//
City in r� ..a. State .Zip
Contact Person Phone ty Fax
:GAL DESCRIPTION.
Please Com Jere Reverse Side
CD0492 (A.v 4,13)
ARCHITECT
Name
Address
//
City in r� ..a. State .Zip
Contact Person Phone ty Fax
:GAL DESCRIPTION.
Please Com Jere Reverse Side
CD0492 (A.v 4,13)
:GAL DESCRIPTION.
Please Com Jere Reverse Side
CD0492 (A.v 4,13)
STRUCTURE
E 'sating Use
Permit includes:
�.k Building
kPlumbinp
Type of Work:
X Residential
X New
❑ Remodel
❑ Commercial
❑ Addition
❑ Garage
Enter 1 st Floor
sq ft
2nd Floor
sq ft 3rd Floor —sq ft
Area Basement
sq ft
Decks —
sq ft Garage 14 sq ft
Water Availability
❑ Sewer Availability ❑ On -Site Septic System Availability ❑
Zoning
I Lot Size
LENDER
F 1 /
City
MECHANICAL CONTRACTOR
r- 'oosed Use
k Mechanical
❑
Other
❑ Number of Units _
❑
Deck
❑ Shed
❑
Other
Existing Floor Area
sq ft
Proposed Total Area
sq ft
Project Valuation
r/a Q®0
Existing Bldg Valuation
$
Address t�
State 1-1
Zip
Contractor Name
Address
_ r
City C ,7
State
ZP
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
PLUAMING CONTRACTOR
Contractor Na
�-T 77C,,,,1 J l,l
Address „ J
3 /y A � L';' ' S114C /0V
Cityid al
State A
Zip f FQ0, ti
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
PLUNIBNG FDCTURE COUNT
Water Closets 3
Sinks /
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers /
Drinking Fountains
Other
Showers /
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains
Total. Fzture .Count13
MECHANICAL UNIT COUNT
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 <1OOK BTUs
Gas Log
Unit Heater
50+ Tons
Furn > 100 BTUs I
Fans
Miscellaneous
Fuel Tanks
Gas Hwt ,
Hood
Boilers
Above Ground
Conv Burner
Duct Work Yip's
0-3 Tons
Underground
BBO's
Wood Stoves
3-15 Tons
Total Unit Count
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the beat of my knowledge and further that am authorized by the owner
A the above premises to perform the work for which permit application is made. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenses.
,nd attorneys' fees incurred in investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way
.ut only where such claim arises out of the reliance of the City, including its officers and employees, upon the accuracy of the information supplied to the City a. a part of this
.pplication.
OwnarlApant: l7a ss D
III
It
N. 100 � 1 3 4,;w!
�et TEZP F
1� 4
6
SITE
J L Numben.
�;'Oved By:
Date:
Comments:
051=7
r
AN AP 0
41-6
41
00