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7-4
SETBACKS & FOOTINGS
Date — — Gj By
FOUNDATION WALLS
Date -7 By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Dat 1�=
By
SHEAR WALLS
Date By
PLUMBING ROUGH -IN
Date Z Sr "� % % By
GAS PIPING
Date—1 - 9 -1 By
MECHANICAL ROUGH -IN
Date - I — Tol By
MECHANICAL (OTHER)
Date' B
FRAMING
Date By
INSULATION
Date •— By
GWB - 1 ST LAYER
Date s r By
GWB . 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL
ENTE - �U
Date By
OTHER
Dat B
Ll
OTHER
Date By
CDO193
BUILDING DivislON
■
FIN" Fri
PLEASE PRINT
q
33530 First Way South
,4 Federal way, WA 98003
(206) 661-4000
)F FEDERAL WAY
OCA'y C Fax (206) 661-4129
BUILDING DEPT.
APPLICATION FOR BUILDING PERMIT
A PPI 1rfi T1nN &-v
jAddress
Tenant (if known)
Lot ?
'r 11
Assessor's Taxry� #
Building Owner's Name
Address
City state W,4
Zip
Phone
Nature ofWork We%ot� -
Name (F,M,L)
Address
city istate izip
Contact Per Day Phone Other Phone
Ll 22
7o it r� Fax q!��
iUfLDWQ..-
Company Name
Address
City !�74-0 4 - 10-A
State LAA
Zip
Contact Pe
Phone
Fax
es
Contractor's # (card must be presented)
Expiration Date
Verified 0 Yes 11 No
Name t t
Address
C't State 1-4.A 0 zip
Contact Person VOL Phon o Fax
LEGAL DESCRIPTION / 197,
• >•Y•
Existing Use
Proposed Use
<.s.
Permit includes:
El
BBuildin
b4lumbing
br Mechanical ❑ Other
J
Type of Work: V Residential
P new
❑ Remodel
❑ Number of Units _ N-05eck
❑ Commercial
❑ Addition
❑ Garage
❑ Shed ❑Other
Enter 1 st Floor /Z sq ft
2nd Floor 1t
sq ft 3rd Floor sq ft
Existing Floor Area c: 5 J.' ■ �7sq ft
Area Basement eq ft
Decks
s ft Garage sq ft
Proposed Total Area sq ft
Water Availabilii Sewer Availabilit
12 On -Site Septic System Availability ❑
Project Valuation
$
Zoning s .- 7 2 691--H,0) I
Lot Size n k / ®T
Existing Bldg Valuation
$
Name d, A' S A,_ (d V'
C a M r►'I � A 0 _
Address/ 6 1� � �
lu, �.
City+ 4�
®� 'I
I , O I I �! 7�
State LU/- .
Zi 1`It /'®
CASt'
Contractor Name ALL W A, L^5 1 QA) L
f -}
Address e3 o .9 !i, .3/ 2- -r
City� � �n Z t, 6blwtl
State /'"A. a
Zip 96 7 io"
Contact
Phone
2*3 e 7 7/ ?
Fax
License #
Ex :ration Date
Verified ❑ Yes ❑ No
Contractor Name a
Address
City UL, (r(� /i E 1
State Gt,J A I
Zip qf? Q % /
Contact 1 k-05.-PhoneG
h
d B y67
3 3
Fax
,, ,�/�y�
License # 4. / /-) to
Expiration Date
Verified ❑ Yes ❑ No
Water Closets
Sinks /
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers /
Drinking Fountains
Other
Showers
Electric Water Heaters t/
Sumps
Lavatories 3
Washing Machine I
Drains
Total (=fixture Count I "
MECHANICAL EVALUATION ONLY $
Fuel Type (electric/other) &A<
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
r
Fans
Miscellaneous
Fuel Tanks
Gas Hwt SO•js
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.
A
Owner/Agent: )ZI &4—K ] ✓ Date: �l-
B-u —A�
nE—. 8121196
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