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SETBACKS & FOOTINGS
Date / -/ ! By.* /
FOUNDATION WALLS
/a " d'a 3 `(/p c/�rJf' r r�kw • - �v �✓iRu s /QZAl
Date �) .. i By
PLUMBING GROUNDWORK
Date gv
7UNDERFLOOR
FRAMING
Date -3 cj `/ By 107/U
7
SNEAR WALLS
/- 3/- fV -
Date -a — By
PLUMBING ROUGH-IN.'<<,fy�cy..¢�
Date ' - 5- -ql/ By7
GAS PIPING
Date jj By
7
MECHANICAL ROUGH -IN
Date By
7
MECHANICAL (OTHER)
Date By7
FRAMING
®® % 1 0
f' 4 a c7
Date �n� j
INSULATION7
Date -3-CI C% By/yrt/
7GW8
1ST LAYER
Date By
GWB - 2ND LAYER
Date �� By
7SUSPENDED
CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
7
FIRE FINAL
Date By
BUILDi G FINAL 11
�� _d /-5(-/ Al/j' �G'rla4, I "t C /n�/�G f�✓I/,
Date By
- ,� - � z G ! P
7OTHER
��� y Px� c
o .� Ao ."
Date By
OTHER
Date By
�A
CDO193
City of Federal Way
W_,_=�i�_iLUE-v_APPLICATION FOR BUILDING PERMIT
N 0 v 1993F ILE
PLEASE PRINT �l✓J 9J
v APPLICATION #:
SITE LOCATION ,�llL
pi(vG ���'�•'
Address
Tenant (if known)
Lot # Assessor's Tax #
�G] r �OQgi'l �7�1 �•3
Building Owner N a
Address
2%
City Jy L� l
State
Zip
Phone el,f" 3 - ;?J
Nature of Work S j
APPLICANT
Name (F,,KL) /} .,
pv i I ,s / '1 rd k4-1-
Address
City
State Li 1A
Zip q, 00 -�
Contact Person �j /
SD tl h /VOf f i S
Day Phone
416 / — lam%,?l
Other Phone p
'vs-3- %-���1sJ
Fax
gUII:DRiG ;CANTRACTOR.: ` `
Company Name
Address r
City
State
Zip
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
ARCHITECT
Name
C jP eV1GS f� y
Address
City per �y�
State
Zip 972 /V
Contact Person
Phone
Fax
=GAL DESCRIPTION
Please Comvlete Reverse Side
CD0492 (Rev 4;83)
STRUCTURE
Exi, Use
Permit includes:
k Building
Plumbing
Type of Work:
)K Residential
+� New
❑ Remodel
❑ Commercial
❑ Addition
❑ Garage
Enter 1 st Floor
t sq ft
2nd Floor L sq ft
3rd Floor sq ft
Area Basement
sq ft
Decks — sq ft
Garage - sq ft
Water Availability f81 Sewer Availability % On -Site Septic System Availability ❑
Zoning
I
Lot Size
;LENDER
Name r
6s-.
City Sec, iffi'd
MECHANICAL CONTRACTOR
Contractor Name
—f-eI -mvfir, i!• 4s.
City
Contact
i
License #
r 4P r•-r
el
PLUMBING CONTRAC'TD.R.
Contractor Name
City A t� b a r
Contact
LT®�, h
License #
Pro-^sed Use
rviechanical ❑ Other
❑ Number of Units ❑ Deck
❑ Shed ❑ Other
Existing Floor Area sq ft
Proposed Total Area sq ft
Project Valuation
Existing Bldg Valuation I S
Address
State L1111)
Address
z 7-Gl
State LJA
Phone
. y' !isy/
Expiration Date
Address !�
State L A
Ms 7 - /.S
Expiration Date
Zip
01
Verified ❑ Yes ❑ No
y. E 5t,;le /04
zip 96oyz
Fax
-1 66 _
Verified ❑ Yes ❑ No
PLIfNrBWG
Water Closets
Sinks
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains
Other
Showers
Electric Water Heaters
Sumps
Lavatories r.
Washing Machine
Drains
Total Fztu►e Cotint
MECHANICAL UNIT COUNT
Fuel Type (electric/other) 4:5g;�S
Gas 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 Unit Count
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge and further that 1 am authorized by the owner
of 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.
end 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
out only where such claim arisar out of the reliance of the City, including its officers and employees, upon the accuracy of the information supplied to the City as a part of this
epplieation.
Owner/Agent: 'f�- J , __ _ _Date: ` 2— �]�
E�tb
Al, p roved By:
Date:
/fir n � 1 ����� � i ✓�P�
10 . . . ...............
�9 .
pin
FiECEIVED
(;IL[y OF FED"'IAL WAY
BIJIWANG DEPT.
I L E
I