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C O k-+ O �.n .1i' +Y+ C• •7 O r, i-• -� � � k•� � � � a.t a In � $Y�j a n c rn rn -n ck�+ ro _ '- �ri as rn a CD �/ 1 Q 7A [11 .� r-> is .. -- '� w 1-•Z r i N O T ­i r Z ky c» rr- a, J_ rm ! CTcn�c �� a �a.�•+ s �aa T •JTD 1 +TD -n �+1 ua .O— �. R1 N (`, 1 t yC p C T Y i17 f L rt CD 31, .. .. .. O 1f F � �. 11 r • l A is �✓ IJ'1 � • � C P�'k ;k �' .0 �" FF� ►+ O N i•+ A k+ n.a iad O O O CJ h. C I f,J J .. A ((j . { " � LA ury ac $a�pp p •, � rr 1. MC m g 9 H M Cyr b•q � D � 3 4 T I•'! 9 inAq tl 1 Tor• v�• :. .. .. _. rn Q ►mON o I�r9 coCD o© 1= s dv mIT H 4 Ln CO • r J•••. r � N Ip? � C r � � .l tr R� ! fA cn 2 cn f••i �c r-'t ' 1 9 It h•-1 l .j vata�w.� cns a a � x .--• � -e ae ^ 40 06 O A 1— `�\J g ►•+ O V A 4.� U+ O O a !' '•a, -• i G CDO193 City of Federal Way • APPLICATION FOR BUILDING PER c�� � g4s;� �- 1001, vqq PLEASE PRINT k$R'�` ` APPLICATION #: � +J SITE L-OCATIOIM VV lV0k -5Add es W 4233 e Tenant (if known) Lot # A f + Assessor's Ta�f #. VIBGl�gCOf►hd `V e, 0 �2 Building Owner Name Address City State Zip Phone Nature of Work APPLICANT Name F,M,L) I�O//� Address ♦ d b 2-7 E o. f 4• d o l l e ,, L e �4 g 9Gb S/ City 6e,1t ev,, / State k/ Zip r7 QOp y/ Contact Person Day Phone Other Phone Fax Sol.,,, tjcvr; S I 637-003s 198-6739 Psi- 6s7-/79L BUILDING CONTRACTOR Company Name Sktn.•r bo�� Address City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No ARCHITECT Name Address City State Zip Contact Person Phone Fax LEGAL DESCg TION 1 Please Cam Ie[e Reverse Side CD0492 IRev 4/93) STRUCTURE Existing Use_ Proposed Use Permit includes: Building Plumbing Mechanical ❑ Other Type of Work: ^ Residential K New ❑ Remodel ❑ Number of Units ❑ Deck ❑ Commercial © Addit on ❑ Garage ❑ Shed ❑ Other Enter 1st Floor 2nd Floo Iz9v_ sq Ft 3rd Floor sq ft Existing Floor Area sq ft Area Basement sq ft Decks sq ft Garage _&Y&IL_ sq ft Proposed Total Area _ _ _ sq ft Water Availability ❑ Sewer Availability ❑ On -Site Septic System Availability ❑ Project Valuation $ /3S cXV0 Zoning — Lot Size 40-X4F Existing Bldg Valuation $ LENDER Name Address City I State I Zip CONTRACTOR Contractor Name I i Address 4-+• T 1''i01ehV n City Lr P State Zip 9 100 Z Contact Phone Fax 111,K 4 X ArZ 931-/3 0 39-Is64 License # Expiration Date Verified ❑ Yes ❑ No JMBING FIXTURE COUNT Water Closets Bathtubs Z Showers Lavatories IJ MECHANICAL UNIT COUNT Sinks Dish Washers Electric Water Heaters Washing Machine / Urinals Drinking Fountains Sumps / Drains Lawn Sprinklers Other Total Fixture Count Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons Length of Gas Piping qq 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 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 harmless the City of Federal Way as to any claim (including costs, expenses, and 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, but 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 as a part of this application, c OwnorfAgent' Date: �A'-L2 01, 0 to Al .► goo tl t7 iv Pb'n � f ,117 ��� pun iI 1 SvJ �G&L . ; � s 20 LIFr.G hL • LCYT Z°1 'PbLJILI& C'AK.I OP L O-T e. k : e i Z. 41 txl F',uIL'TOIUc-► AP-M', : ZZZI ll- 71 2960 v x " 7-4- 1- OcP4 SITE PL N APPROVAL