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02-104469 �,;� ��U� V,J " � r Crty of Fede14a1 Way Building - Commercial Permit #:02 - 104469 - 00 - CO Conununity Development Services 33�30 lst Way S Federal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: WASHINGTON CREDIT UNION LEAGUE Project Address: 33301 9TH S Parcel Number: 926501 0130 Project Description: COMM TI-Buildout of new of�ces,breakroom and private restroom. Includes plumbing&some mechanical.Rev.11/26/02 to include all mechanical(9 diffusers,5 return grilles,4 fans,2 VAV's,5 T stats. Owner Applicant , Contractor L,ender EQUITY OFFICE SUPERIOR BUILDERS INC SUPERIOR BUILDERS INC NONE 111 3RD AVE SUITE 2230 SUPERIOR BUILDERS INC SUPERBILL2D2 SEf\TTLE WA 98101 2112 CENTER ST SUPERIOR BUILDERS INC TACOMA WA 98409 2112 CENTER ST NONE Includes Census category: 437-Comm #1 #2 #3 #4 Occupancy Group: B A-3 Construction Type: Type III-N Type III-N Occupancy Load: 96 89 Floor Area(Sq.Ft.): 7920 2050 lst Floor Proposed Sq.Feet.................................2050 2nd Floor Proposed Sq.Feet................................7920 Building Pre-con.Meeting Required...................No Census Category.................................................437-Commercial albadd Fire Sprinklers................................................. Yes Mechanical................................................. Yes Number of Stories................................................i Permit for Building Shell Only............................No Permit for Foundation On1y.................................No Plumbing................................................: Yes Special Inspection Required.........................:......No Total Proposed Sq.Feet.......................................9970 Will Certificate of Occupancy be Issued?............Yes Sensitive Areas?................................................. No Plumbing Fixtures 7 �x t� �1 �� i i r . g , h; �. } � Des .�(; r .��,. Cluant� .. -�� ;; D�sc'ri t�Qn��P��.�3,,��°C2ua f� �::;�� R �v, t' r P .. !�: ,��_-.�. . „:,. Quantit; Dishwashers 1� Sinks � 2� WaterClosets �� Mechanical Fixtures "� � : :`Qescra�tio� �"� ]Quanti �...,Descri M °r�, �,w ._ = Qtaanti � ,�- Desc�iptian ,t„i;,� C�u��,tit " ��_: p �,�, ;. �Au HandlingUnits 2� Ducts 1 10 Fans � I I PERMIT EXPIKES May 11,2003,IF NO WORK IS STARTED. Pernut issued on October 30,2002 I hereby certify that the above information is conect and that the construction on the above described property and the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and the City of Federal Way. ._,..___,, Owner or agent: Date: /��'�2. r r y City of Federal Way ' ' Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code certifying that at the time of issuance,this structure was in compliance with the various ordinances of the City regulating building construction or use. This certificate is valid ONLY when endorsed b�itv staff. Tenant Name: WASHINGTON CREDIT UNION LE� Permit number: 02- 104469-00 Address: 33301 9TH S #1 #2 #3 #4 Occupancy Group: B A-3 Construction Type: Type III-N Type Ill-N Occupancy I.oad: 96 89 Floor Area(Sq.Ft.): 7920 2050 Owner EQUITY OFFICE Name: 111 3RD AVE SUITE 2230 Address: SEATTLE WA 98101 Building Official Date The priority focus in the review and inspection made by!he City prior to issuance ojthis Certificnte wns on lhose mntters which erperience has shown most severely a�j'ect the henith and snfery of the general public. A[though the City has made as complete a review nnd inspection as is reasonnbly possrble(within budgetary time and personnel limitations),the City neither guarantees nor warrants to the owner/occupant or to any other person that this Certifrcate evidences strict compliance with each and every ordinance or regulntion of the City or the State of Washington aJJ'ecting the construction or use ojsaid structure or the land upon which it rs sih�aied. Such complinnce is the responsibilrty ojthe owner and/or occupant ojthe premises. .+ i . ` 1 } ; � ' City of Federfil Way Building - Commercial Permit #:02 - 104469 - 00 - CO Communi:y Development Services 33530 lst Way S rederal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: WASHINGTON CREDIT UNION LEAGiTE Project Address: 33301 9TH S Parcel Number: 926501 0130 Project Description: COMM TI-Buildout of new offices,breakroom and private restroom. Owner Applicant Contractor Lender EQUITY OFFICE SUPERIOR BUILDERS INC SUPERIOR BUILDERS INC NONE 111 3RD AVE SUITE 2230 SUPERIOR BUILDERS INC SUPERBILL2D2 SEATTLE WA 98101 2112 CENTER ST SUPERIOR BUILDERS INC TACOMA WA 98409 2112 CENTER ST NONE Includes Census category: 437-Comm #1 #2 #3 #4 Occupancy Group: B A-3 Construction Type: Type III-N Type III-N Occupancy Load: 96 89 F'loor Area(Sq.Ft.): 7920 2050 1 st Floor Proposed Sq.Feet.................................2050 2nd F]oor Proposed Sq.Feet................................7920 Building Pre-con.Meeting Required...................No Census Category.................................................437-Commercial alt/add Fire Sprinklers................................................. Yes Mechanical................................................. Yes Number of Stories................................................1 Permit for Buildin Shell Onl No g Y............................ Permit for Foundation Only.............:...................No Piumbing................................................. Yes Specia]Inspection Required................................No Total Proposed Sq.Feet.......................................9970 Will Certificate of Occupancy be Issued?............Yes Sensitive Areas?................................................. No Plumbing Fixtures s��.�". ��z;pe;scriptir�n '�:M��J.Qiiariti � ��:D scjri tion ; ��;,�2„�.r�ritity = °�w: Description : ° `.Quanti ` Dishwashers � �Sinks 2 � Water Closets � Mechanical Fixtures J� �' ' �esrription Quantif" '. '. D`escr►ptior�i0��°°',�;.,�.:,=.Quanfit Descrip#ion ' QUa�i itµ; ,,��da � � � Fans ------� 2� PERMIT E S April 28,2003,IF NO WORK IS STARTED. Pe 't issued on October 30,2002 I hereby certify tha t a ati ' conect a t the construction on the above described property and the occupancy and us be i wit he la s,rules and regulations of the State of Washington and the City of Federal a . Owner or a ent: J�� Date: /� � p C� g � //—/�-�(L- `r�►y�.r;�, /.�J6�` P�S �K� ��L S�c• �/. { " , 1� .+ ' � � � City of Federal Way � ' Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code certifying that at the time of issuance,this structure was in compliance with the various ordinances of the City regulating building construcrion or use. This certificate is valid ONLY when endorsed bv Ci staff: Tenant Name: WASHINGTON CREDIT tJNION LE. Permit number: 02- 104469-00 Address: 33301 9TH S #1 #2 #3 #4 Occupancy Group: B A-3 Construction Type: Type III-N Type III-N Occupancy Load: 96 89 Floor Area(Sq.Ft.): 7920 2050 _ Owner EQUITY OFFICE Name: 111 3RD AVE SUITE 2230 Address: SEATTLE WA 98101 Building Official Date The prioriry jocus in lh.e review and inspec(ion nmde by the City prior to issuance of tl:is Certificnte wns on those matters which experience has shown most severely nJj'ect the hea[th and safely ojthe genera!public. Although the City has made ns complete n review nnd inspection as is reasonab[y possible(within budgetary time and personnel limitnlions),the City neither gtmrantees nor wnrrants to the owner/occupant or to any ofher person that this Certificate�vidences sbict complinrice rvi�h ench nnd everV ordinnnce or regulntion of the Ciry or the State of Wnshington nJfecting the cautruction or use of said sbuc[ure or the land upon which it is si�unted. Sur.h contp/innce is the responsibility of the owner nnd/or occupant ojthe premises. � ' ' . � � . ' PO^'"'"'HIS CARD ON THE FRONT�F BUILDI"Tr ' , , � . � G BUIs..,ING DIVISION , , uv ��- INSPECTION RECORD INSPECTION REQUEST PHONE#: 253-835-3050 PERMIT#: 02-104469-00—CO OWNER'S NAME: EQUITY OFFICE SITE ADDRESS: 333019TH S ( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL ��; ..t_3= .� . ,��,y� ...DU 3�10T PUUR CONCRETE T�NTII.;:THE ABOYE�S��>PROVED ��. ��y '��t ��„,� ( ) DRAINAGE: Line ( ) Connection �. �x � ��,.'°TS�?,�1'��y�'�U�2��A�'�NTIL�7`�HEABOVE I�S' R(1V�D � �,.� � � � �; z;� _�,��. �.r�.. ��y �. , �.� , . .;.��s�� _�.:��,u � , ��. ry��,h :.y, F. .. .�.: . ( ) UNDERFLOOR FRAMING O ROUGH PLUMBING: DWV Water piping ( ) ROUGH MECHANICAL %� � �`� ��/ Gas piping ( ) SHEATHING Roof Floor ( ) SHEAR WALLS ( ) ELECTRICAL ROUGH-IN Ditch Cover ( ) FIRE/DRAFTSTOPS �� "°� ' �� .AI"i � �T�B� �R(�`��l►`� RT(�1Y�`TU��MMII�TIG�NSPECT��]Y � „ � �� " ,.,�.��:� . �o,.a��+z......._.t��_._.._a&�s,,�,'��.�`-`.� �ar,•.�k-zrn.,._.,,,�.w1a�c�_.,,?,��?^Y.w. .��v.,,�.s,,.,,, ,::: . ,-. .:: ��.z>&?�,��.�...,,;��:,.ya�e..�,t'�x,_. .__.'� _._x.o�.�:: .t��:.,.�'s� ( ) FRAMING/FIRESTOPPING : _,� `� � � � a '� � E:� +aVED`�'R�4R`�U�Il1TSi7LAT�NG t�R;�SHEETItOCKI1�G �� ?�,a.�i,'.. � ��F..,., ;'�`,a. ,z: .��.,,.s...�� d.,,�y",�� Ti'�,�, � <�. .,x�.��.°�s.�sh``nc„ ..� ,,,,,,�.: ..aa..�,,,,,: �-�.F . .�,.�€'eva�.� >,,.�f,x,��:�'a,.:&s�_....... �... � .k �.�...... ( ) INSULATION: Floors Walls Attic � �, ,� ��rr�'��U �� : (��, �k�qY2�0�iP� ';; G��EE�' � : &e' �� . �..�..fi �.. �� ,...,�,�� ': ,* ��-� , .�.2�,.�.. , ,�..��..w��.,.�,�� ,� ,�..��,� ��.:�.� ( �) WALLBOARD NAILING O SUSPENDED CEILING Z�� l�Z�� .��'t��,��:: _y�•THE� 0�� ,M �t.�'lYED��OR�T��APING OR�STAL��G�EI��I��'IXs�E �.� �` � ..� ra•-� .:��€ �,, . �•,t� �� vn ��, ��s,,, ;;�,y�w�... �,..��o: , __� . . s... ( ) ELECTRICAL FINAL ( ) PLANNING FINAL ( ) PUBLIC WORKS FINAL ( ) FIRE FINAL �� r�_ '��i�'�E N�'ST��ROVED��tIOR�TO BUILDIN`C��t,T��N`:��A�� .�';:: v,� ,,,.�<,,,; ��, ;, ,,��.�_�,_. ..,�� -�,. �.,�: ;. �_ � �,.. ��... _ �. , ,.: ( ) BUILDING FINAL I�/��O�n� ✓!1�� .� Q��OC�, '��S�TT��T�A�Il�C:��T��L BU�I�D �� ,.�..: ��,�� ? O..r,: D�� ,��._�.� �. ,�� _� � �� , Y� � •�, • • ` � k INSPECTION LOG DATE ' INSPECTOR : OK GORR/REJ ' .AREA A.ND TYPE OF INSPECTION �� : 6 � � � �� a��-� ,�%� til --� � �l.�a� w � � �� . -��I � Sc_o�- ��n��e� - �L� � —��1/�J� -- �.o. G p2 �or.� c�(�c�p� CONSTRU C,. �ON PERMIT APPLI ATION � EC]�ZF�-- PPLICATION NUMBER: �Z - - uV (�Y — — — — PPLICATION NUMBER: - - PPLICATION NUMBER: - - **The following is required information—Please print(in ink)or type** Please note: Electrical,Fire Prevention Systems and Engineering permitr may require a separate application. . • . • • • • SITE ADDRESS: �� "t� T'tV� �lH ASSESSOR'S TAX/PARCEL#: �2 � S O ' -V � �� LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): TYPE OF PROJECT(This application): � BUILDING ❑ PLUMBING � MECHANICAL ❑ DEMOLITION � ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): REL�C �- � � �1�"'f"us ��'V�N e�v-�L-t t�t.._ �1-Db � �Ci1� i �_ _ � — G � _S PROJECT NAME: �%vF�"j`r1j' v 2Et7t T cJNiDN L-�� /9��F�-/�`�� PROPERTY OWNER: NAME: �^ DAYI7ME PHONE: �G't��"rY t�i-4-lC.E ��G1�G�{, �U�� ) - � MAILING ADORE55(STREET AODRESS;CIfY,STATE,ZIP): i ! CONTRACTOR: � DAYRME VHONE: ! NAME�G�L��I C, �V L U�' { �� J -lY� MAILING ADDRESS(STREEf ADDRESS;CITY,S7ATE,Z1P): EVENING PHONE: ! � : C,�'ec:�c �L �i o� ��.�.u�� rl c2� >�S -%2� 1 I Cff`(OF FEDERAL WAY BUSINESS LICENSE NUMBER: � �-YF; fAX NUMBER: °2 � - � o �O� Z�c� `�`J d (2��.) p -227C� j EXPIRATION DATE: CONTRACTOR'S REGISfRATION NUMBER: c�,��> P f 9-C�L G�3�� _ • �'� � � APPLICANT: NAME: ' DAYTIME PHO � ��-�� TtN� �D C� )l"�2 -�339 MAIUN6 ADDRESS(STREEf ADDRE55;CI7Y,S7ATE,Z1P): � EVENING PHONE: � l Z C�f e.tzi� �-w . � - � (,,(� �ZU )Z - �� RElATI0N5HIP TO PROJECf: F NIJMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): `�,�0 -Z L 7D E-MAIL ADDRE55: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT �CONTRACTOR �� ""-��`�'^�� . . . • ' • EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE• PROPOSED VALUATION FOR IMPROVEMENTS: $ .%✓� �'J✓} SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRNATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ � . . • - FLOOR EXISTING S .FT. PROPOSED S .FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHETt FLOORS(DESCRIBE) ' ' ' DECK GARAGE HOW MANY FLOORS? TOTAL: VIndicate number of fixture C�� t-I��r-/�«-�- � C+� Cool,rn�(�-onlL� �._._ AIR HANDLING UNIT(S) EV PORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) , FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( . ) COMPRESSOR(S) FURNACE(S) �_ DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLEf GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) 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 I am authorized by the owner of the above premises to perForm the work for which the permit application is made. I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim arises out of the reliance of the city,including its o�cers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE: DATE: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR FOR OFFICE USE ONLY: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION : BUILDING SHELL ONLY? D YES ❑ NO COMP PLAN DESIGNATION BASIC PLAN? . ❑ YES ❑ NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO COMMUN[TY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTN•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-66111000•FAX:253-661-4129 � ��« ��L ` ��t�E� CONSTRI -ION PERMIT APPLICATION . �� Ay PPLICATION NUMBER: % � � - �?"j,x OCT O 9 ZOOZ PPLICATION NUMBER: _ _ - _ _ _ _ _ _ - _ _) PPLICATION NUMBER: - - The f�1�a FEDERAL WAY p . �. � �Pe — — — — *' ��d-�'nformation-Please nnt in ink or '�* Please note: Eledrical, Fire Prevention Systems and Engineering permits may require a separate application. I • . . • . ISITE ADDRESS: �� ' ��l f�v e. J, ASSESSOR'S TAX/PARCEL i3: � � co S O � - d � � � LEGA DESCRIPTION F SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LE THY): �j-�_ �� (1.1 . ��-.^ZP�S 'i D ��c.e P �� . �� -`- �.�c-c c� r� c �=�-��-- � �3 ,� S G�� r,� �� S� „�� f� . . . . . � TYPE OF PROJECT(This application): BUILDING �'PLUMBING `� MECHANICAL ❑ DEMOLITION �ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM r -, . PROJECT DESCRIPTION (Provide detailed description : �� `� � �� '��C.�� -� � �: � �C`` " .:� ( �5 C�� • � �` \ �J PROJECT NAME: ��-1'��1� .�l �e�?C_., f �iL./U� , i'V �. �..L� � � , � . � PROPERTY OWNER• �+�rt[: �� Rrnr+E�i+or+E: t .�Q•t��y �ce (�c��) �fy7-77`l7 � r.r.Il1wG�poR[ss( FECr aD��[s�;ct7Y,STaTE,ztr)� 1 t i 1 Tl..; � v� �.; z ZZ S c.��-�1 e t.� �} 98/o ( CONTRACTOR: �ti�'� OhYTIh1E PI10NE: �C��d � �� s �r� (�S3 )�3 -i(o `l� � rv,1UwG�.D FC55(S'TFEC�tiDDF[55;Clrr,S�TE,11�): � EVEdIr�G P��O�aE: ! � I C�rJ-4-�c- s-f, . l�i4 `� 8 Y v�t 6zo�) ��(� -g� r� CfTY OF FEDEF�.I wtir 6US1uE55 UCCt:S[�+U,:GE�: Fqx�+U�•�BER: , po - � � 1 � `_( � - � � (253 )s�3 - 1797 i � COI:TFl.C�OR'S RCGISTFAT70t�IaU�•'Fi:R� — — — EXPIFA7lON DATC: <<�,o<<a�a�ro�„ro� .s � � �- � Q �. � f � D � � � y �a�� i APPLICANT• "��M� l oamr+e t�i+or+E: I o`} �/t�`�ar- ( ) - , MhfUNG�DDafSS(SFCCT aD�RCSS:CIT�',SF�E,Zlr): EVEt:;r+G�rtONG: k c � - �cv.nor,�s�,ir�To rao�ccr: rr�c r�ur�sEF. ❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): � � ' • i � E�F;AIL�DDFESS: � � CONTACT PERSON FOR THIS PRO]ECT: ❑ PROPERTY 01NNER ❑ APPLICANT �CONTRACTOR i . � . 1 � • • � EXIS7ING USE: � � � 'L' EXISTING EiUILDING ASSESSED/APPRAISED VALUATION $ ��i ��Q PROPOSED USE: �.�'T l CP PROPOSED VALUATION FOR IMPROVEMENTS: $ � L-�-' � '� . , SPRINKLERED E3UILDING? (�YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES �NO WATER SERVICE PROVIDER: I� LAKEHAV[N ❑ HIGHLIN[ ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER: � LAKEIIAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) / •'NEW RESIDENTIAL CONSTRUCTI< �LY'` NUMBER OF EiEDROOMS: ESTIMATED SELLING PRICE: $ • . . . • FLOOR EXISTING 5 . FT- PROPOSED S . FT. TOTAL E3ASEMENT i FIRST ��`� c�i� v ' V SECOND CX �� t (. + THIRD 1 I � I i � FOURTH 1 � OTHER FIOORS(DESCRIEiE) DECK GARAGE � NOW MANY FLOORS? ______ _�____ —_— TOTAL• I 1 � �(� � • • � Indicate number of each type of fixture MECHANICAL ' �� -��-U� AIR HANDLING UNIT(5) EVAPORATIVE COOLER(5) GAS LOG(5) REFRIG. SYSTEM(5) gpQ(S) �� FAN(5) HOOD(5) WOODSTOVE(5) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(5) FURNACE(5) DUCT(S) GAS PIPE OUTLET(S) NEAT SOURCE: ❑ ELECTRIC ❑ GAS �� ` ~ �� PLUt•1E3ING J j [SATIiTUD(S) LAVATORY(5) URINAL(5) WATER f1EATER(S) _�_ DISHWASHER(5) RAIN WATER SYS. VACUUM [iREAKER(5) ❑ ELECTRIC ❑ GAS i DRINKING FOUNTAIN(S) StiOWER(5) �1IASH MACtiINE OUTLET GAS PIPE OUTLET(5) —�� SINK(S) J VVATER CLOSET(5) MISC. ( ) INTERCEPTOR(5) SUMP(5) � u � I �• '/ . « �i I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, th� I a auihorized by the owner of the above premises to perform the work for which the permit application is made. I further agre o h Id harmless the City eral Way as to any claim (including costs, expenses, and attorneys'fees incurred in the investigation d f ns of such d,' �), whi may bc made by any person, inciuding the undcrsigncd, and filed against thc City of Federal �Nay t o I �v c �ses the reliance of the city, induding itr officers and empioyees upon the accuracy � of thc inform ' n li d t t ity a a p of t � � tion.� + � � �-�� NA�1E/TITLE: DATE: ❑ PROPERTY O V ER ❑ A C NTRACTOR , ' - I FOR OFFICE USE ONLY: ❑ NEVJ ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPR01/EMENT j CENSUS CODE: 1 LOT SIZE: � ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO I COMP P�AN DESIGNATION E3ASIC PLAN? _ ❑ YES ❑ NO { SECTION TOWNSHIP RANGE � NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? _❑ YES ❑ NO ___ _ _ 1 CHANGE OF USE?_ U YES _C] NO _____ r,, ...��.�„v�.�, i,,,...i :� '.�t:��r��.. �i�.-tn��1:�.tv:r.v _vi,��. �•„ �u;. ,,,�. .�i � . ., �•.r.� :.n ��•..v,1 �,�t1 . ,�.ir.,., . .�r�.lr.. �� , ,, � :, �� 1 ... ..._ ._ . .. . ....,� ... . .. .