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Ca ` III, I!FFD K9ny 0 41996 APPLICATION FOR BUILDING PERMIT APPL/CATION #. BUILDING DIVISION 33530 First Way South Federal Way, WA 98003 (206) 661-4000 Fax (206) 661-4129 aan r-0-4 Tenant (if known) Lot # Assessor's Tax # 13;2 '7,0,2,7- o/ Building Owner's Name Address 4 - 66 o �� - G4 D.-. S �✓ . City A C o.r.._ A State t+% a Zi 9 Phone 2 0 L� SW V- � Nature of Work c Name (F,M,L) Address City State Zio Contact Person Day Phone Other Phone Fax Gx A tot. SS'y- &7 ?oL- 765- 97 2aL-SSB'^ibl Company Name Address city State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No �A1tG��T��C'�E y'==>===- Name Address CRY Zip —State Contact Person Phone Fax LEGAL DESCRIPTION w :tii; :.:.;i°•i'•i'ii== ing Use (_ 7 posed Use Permit includes: '10—Building❑❑ Pluum�mbin 0 Mechanical 13 Ot or Type of Work: Residential ❑ New I3-del ' mo ❑ Number of Units ❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other Enter 1 st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft Area Basement s ft Decks y sq ft Garage sq ft Proposed Total Area sq ft Water Availability ❑ Sewer Availabilit ❑ On -Site Septic System Availability ❑ Project Valuation $ o 0 0 Zoninq I Lot Size ExistinR Bldg Valuation $ FEk Name ` Address City State Zip Contractor Name Address i City State zip Contact Phone Fax License # Ex iration Date Verified ❑ Yes ❑ No Contractor Name Address City State Zi Contact Phone Fax License # , Expiration Date Verified ❑ Yes ❑ No rctz:V J 1.11 1 / Water Closets W S,rftks urinals Lawn Sprinklers Bathtubs / Dish Washers Dri NnU Fountains Other Showers Electric Water Heaters Sum s Lavatories _ Washing Machine Drains Total Fixturct Count MECHANICAL R ALUATION ONLY $ Fuel Type (electric/oth ) Gas Dryer Air Handling < = 10,0�Q CFM 15-30 Tons Len th of Gas Piping/Range Air Handlin > 10,000'�FM 30-50 Tons Furn <1OOK BTU,/Gas Log Unit Heater 50+ Tons Furn > 100 BTUs Fans Miscellaneous 114el Tanks Gas Hwt Hood Boilers ""Above Ground Conv Burner Duct Work 0-3 Tons Un)er round 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. Owner/Agent:, Date: