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APPLICATION FOR BUILDING PERMIT
APPLICATION # L
PLEASE PRINT
: .............. :. :x; .
Address
Tenant (if known)
Building Owner'ty am
city
�-L�ti State
Nature of Work
`
Lot #
Address
BMMINGDIVISION
33530 First Way South
Federal Way, WA 98003
(206) 661-4000
Fax (206) 661-4129c
ssor's Tax #
Phone (0;7-0— D160
Name (F,M,L)
Address
city
State
zip
Contact Person
Day Phone
Other Phone
Fax
Company Name
F C
J
Address
J
City 1
State
.sue
Zi o�
Contact Person
Phona.0
Fax <5S
Contractor's # (card must be r sented)
Expiration Det
Verified ❑ Yes ❑ No
'�6' ••tea• �%�`: `--'i`-c-`-_-__j:<: '-x<i« %_��M�j�it\"k���•�
Name
Address
City
State Zip
Contact Person
Phone Fax
LEGAL DESCRIPTION
B6&7s fP CgLup-&tHi2veCSe S&1�2
s. •;,tlk.
Existing Use
Proposed Use
Permit Includes:
6 61ding
Cl Plumbill
❑ Mechanical
13
Other
Type of Work:
❑ Residential
❑ New
❑ Remodel
❑ Number of Units
❑
Deck
❑ Commercial
❑ Addition
❑ Gara e
_
❑ Shed
❑
Other
Enter 1st Floor
sq ft
2nd Floor
sq ft 3rd Floor sq ft
Existing Floor Area
sq ft
Area Basement
sq ft
Docks
sq ft Garage aq ft
Proposed Total Area
so ft
Water Availability
11 Sewer Availabili
❑ On -Site Septic System Availability 0
Project Valuation
8
Zanlna
Lct tt;rc
I
Existing Nag Valuation
I u
Water Closets
Bathtubs
S ho wa rs
Length of Gas Pi ii
Furn <100K BTUs
Furn > 100 BTUs
Gas Hwt
Conv Burner
BBQ's
Sinks
Dish Washers
Electric Water Haste
Drains
Lawn
MECHANICAL EVALUATION ONLY $
Gas Dryer
Air Handling < = 10,000 CFM
15-30 Tons
Range
Air Handling > = 10,000 CFM
30-50 Tons
Gas Log
Unit Heater
50+ Tons
Fans
Miscellaneous
Fuel Tanks
Hood
Boilers
Above Ground
Duct Work
0-3 Tons
Under round
Wood Stoves
3-15 Tons
;• .d :s< • tltt -y-ex
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is tow artd correct to the best of my knowledge, and further, that I am authorized by the owner of
the above premises to perform (lie 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, and
attomeye 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, but only
where such cl • arises ut of the reliance ofthe city, including its officers and employees, upon the accuracy of the information supplied to the ciL as a pail ofthis application.
OwnerlAgant: Date:
0— An
Rfvaco 12111Io9