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SET13ACKS & FOOTINGS
Date By
7
FOUNDATION WALLS
Date By
7PLUMBING
GROUNDWORK
Date q— B
UNDERFLOOR FRAMING
Date By
7SHEAR
WAILS
Date By
PLUMBING ROUGH -IN
Date - (o 8y��
GAS PIPING
Date By
7MECHANICAL
ROUGH -IN
Date By
7
MECHANICAL (OTHER)
Date By
7
FRAMING
Date - c '— B
INSULATION
Date By
GWB - 1ST LAYER
Date By
GWB 2ND LAYER
Date B
7
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
7ENGINEERING;
FINAL
Date By
7FIRE
FINAL
�o By
Date a L �j
=G,-FINJ%L
Date j B
OTHER
Date By
OTHER
Date By
CDO193
City of Federal Way Receiver)
APPLICATION FOR BUILDING PERMIP 171996
Uf►'r U� Ftp -
$�+�t�ffv� � �r Ay
APPLICATION #:
Address 2 3 % u 3 3� �`� �� d�S
Lot Assessor's Tax X
d.r Address
State Zip I?q/j-9 Phone
PLEASE PRINT
Is LOCATION.
Tenant (if known)
Building Owner Name
City S
Nature of Work
r
APPLICANT
Name (F,M,L)
�a
Address
City
Contact Person
W
Day Phone
I3vn.DING CONTRACTOR
Company Name
Address
31Sr
City
Contact Person
Contractor' X (card must be presented)
- 76; .2 3
State Zip
Other Phone Fax
State k- f Zip % ';bG 3
Phone Fax
Expiration Date Verified 8--Yes ❑ No
'�)y 02 �G
Name
Address
City �l
State Zip
Contact Person Phone Fax
5r 4 G 5 3G
LEGAL DESCRIPTION
r r� •I+G•�
Please COmnleta Reverse Side
CD0492 (Rev 4/93
STRUCTURE
I : ;sting Use
r IL
Permit includes:
N Building
Plumbing
Type of Work:
❑ Residential
❑ New
Remodel
Commercial
❑ Addition
❑ Garage
Enter 1 st Floor 4,200 sq ft
2nd Floor
eq ft 3rd Floor sq ft
Area Basement
sq ft
Decks
sq ft Garage aq ft
Water Availability
❑ Sewer Availability ❑ On -Site Septic System Availability ❑
Zoning
I Lot Size
LENDER:
Nome
^roposed Use
`l Mechanical ❑ Other
❑ Number of Units ❑ Deck
❑ Shed ❑ Other
Existing Floor Area 4/.1pr) sq ft
Proposed Total Area 'Y 44] eq ft
Project Valuation $
Existing Bldg Valuation $
Address
/4 A
City, I State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING'C.ONTRACTOR
Contractor Name Address
City
State tvA
Zip
Contact
LEE M'J"A J
Phone
236 - 9laa
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
PLUM'IBING`FITUR' COC7NT;:>;
Water Closets
Sinks ],
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains
Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains
Total Fixture Count
MECHANICAL'VNIT'COUNT "``; :<:>
Fuel Type (electric/other)
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
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 owr
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, expen-
end 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 V.
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
application.
Owner/Agent:'
Date: