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Date �j._f(— ��` BY G�� 12 INSU LATION Date By 13 GWB - 1ST LAYER Date -l�-qGj BY j / _ 14 GWB -2NL1 LAYEq ;: Date By 15 SUSPENDED GEIUNG > Date By 16 �f�LANN�IN(3 �(NAL"� Date By 17 PUBLIG WORKS F1NAL : Date By 18 FIR� FINA�. Date ��, _2`?--'� ' BY ehr� `� 19 BUILDING FINAL`' Date �"7 —� By ��L. 2o a-rHel� Date �, _ �r� By �� � CD0193(Rev 4/B� BUII,DING DMSION «"'°F G 33530 First Way South --`� ���;�����`� ' ; Federal Way,WA 98003 �V Ay��L (253)661-4000 Fax(253)661-4129 ���T � 5199�' � �� ��.���, ;,,, : ., ' '- � 1 D P.,� +� APPLICATION '��R BUILDING �RMIT PLEASE PR/NT APPLICATION # �;� ��I � I`�� ` `:::::':: S' ... ite address `���:;:�:����.�.'�;��:;:<:.:;:::`:?:::`;;;:``::;[:::::::::i::::::»�>:>?:::�:::<:;::':::;';:::::.:.... �.;�,;�....:....................:.......................... Ten na e S � � Lot# Assessor's Tax# Buil ' O ner's Name a Address � S /�.k� �-1Z- -- `$ 3 r 3z S (�A-c., c,�� T' • Cit < <,t.1 , State (�t> , Zi O43 Phon L�-/'-�l.f � Descri tion of Work �L I l� 'h( (_l� ;:;:::::<>:::::::>::;::::..::.::.::..... ,:. ,. `;����+��:�.��'::::.:.. .:,.::.;:.;,:.: : ; ; �d(�77 C lR-,� 1�-G�- _l._N-1' , O f- S.[�.�. �o nl I,I Name (F,M,L) Address - Cit State Zi Contact Person Day Phone . Other Phone Fax , $����;?>:>'?.;;;>;<;>>:>::>::;::<::i:;>:::>:::>::�':�"'.';:':;:i:::<:::>'::»:<:>::>::::>::':>::::::? �11L'�;��N...T..#��T.f��i.:::::::::::::::::::.:::.::::::. Federal Wa Business License # Company Name � ,J �`��• � L^ . • r��, /J Address� �y� �� � � � • Cit _Fi�l7` State (�� - Zi �8a� Z� Contact Person P one Fax �✓z- l c.� � BzY��iS 1 zc� 8zY- ►3 I� Contractor's #(card must be piesentedl Expirat on Da e Verified ❑ Yes ❑ No N G2 U o .�r.t �5' t� zno D __................. ......................._..._._............................. :ARCHE7`E ';i:;:`:<:'::::::::::::<:>:::::::::::::>:::<:::>::::::::::::::>:::::::::>::>::::>;:.<::::;:'`:: C�'.............................................................. ................................ Name ( ( 4�-� �Y LU • Addres�.3�. �Ur �^ • b 3,�p ,� � Cit <�(Z/�' State ��/�' • Zi ���.�L Contact Person ��� r�� Phone�Y`(�� � ��1 ��/w(�i� LEGAL DESCRIPTION P/ease Comp/ete Reverse Side $�'};�j���� ;: ` ' xisting Use roposed Use Permit includes: ❑ Buildin ❑ Plumbin ❑ Mechanical ❑ Other Type of Work: ❑ Residential ❑ New � Remodel ❑ #of bedrooms ❑ Deck ❑ Commercial ❑ Addition ❑ Re air ❑ Gara e ❑ Shed Enter 1 st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft Area Basement s ft Decks s ft Gara e s ft Pro osed Total Area s ft Water Availabilit ❑ Sewer Availabilit ❑ On-Site Se tic S stem Availabilit ❑ Pro'ect Valuation $ Zonin Lot Size Existin Bld Valuation S ' »:::;;.:::::.:. . . . , �:EN�Ft::;;:;;;;;:::::;;::::;::.:;:::°:;.;..;::.........._: ;: ...;: For new residentia/on/ - Pro osed sellin cost: S Z9� 2 Name ���� n�, ,� � �d L Address io��y�� Cit State Zi _ ____ ..._. ..... _____ _ ... ........._................. .................... _..._..............................._................._........._......... _. _ _. _..... _......_......_.. .................._. _................................_._................... ., .. . .. ..... M�C hEAN I�A�::C�7�tiIT�kCTf?:R Contractor Name Address Cit State Zi Contact Phone Fax License # Ex iration Date Verified ❑ Yes ❑ No _............._..................... ....... ....... _.................................................. _.............._.............._....__........_._............ ...................................................... ; RI.tJM6:[I�E.4"`a:.�t�NT�CT�iR_:::.... _ ....................._.........__........_......_ . .. Cor,tractor Name � Address City State Zi Contact Phone Fax License # l' Ex iration Date Verified ❑ Yes ❑ No PLU�titIB�I�G<::F�X`:�1R�:��E�U�tiIT:::::::::::><:::`:>::::::>::::::>:>::: Water Closets Sinks Urinals Lawn S rinkiers Bathtubs Dish Washers Drinkin Fountains Other Showers Electric Water Heaters Sum s Lavatories Washin Machine Drains TaYal'FixYure Gount .......................................... ...................................................... ................................................................................... L ATI N NLY S I AL EVA U O 0 ����€a�v:rG;��::#�n�rr::C�i�i�:::::>::>::>::>:>:::<>::>:::'::>::: MECHAN C ....... ..... ........ .................... Fuel T e ( as/electric/other) Gas Dr er Air Handlin < = 10,000 CFM 15-30 Tons Len th of Gas Pi in Ran e Air Handlin > = 10,000 CFM 30-50 Tons Furn <100K BTUs Gas Lo Unit Heater 50+ Tons Furn >100 BTUs Fans Miscellaneous Fuel Tanks Gas Hwt Hood Boile�s Above Ground Conv Burner Duct Work O-3 Tons Under round BBQ's Wood Stoves 3-15 Tons Total`UnitCoUnt DISCLAIM ER:I certify under penalty of perjury that the infonnation fumished by me is ttue and correct to the best of my knowledge,and further,that I am authorized by the owner of the above premises to perform the work for which permit application is made.I further agree to save hamiless the City of Federal Way as to any claim(including costs,expenses,and attomeys'fees incurred in investigation and defense of such claim),which may be made by any person,including the undersigned,and filed againct the City of Federal Way,but only where such claim arises out of the reliance ofthe city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of Uvs application. Owner/Agent: (� Date: �v/��� Buaona.Arr R[vsEo 5/18/99