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SETBACKS & FOOTINGS
Date By
7
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
7UNDERFLOOR
FRAMING
Date By
7SHEAR
WALLS
Date By
PLUMBING ROUGH -IN
Date �� �/ � 5/ BY /tv/7r
�.
GAS PIPING
Date By
MECHANICAL ROUGH -IN
Date By
MECHANICAL (O7fiER)
�►� �y,✓ ?� 'G 2 ]i,t� �� el"
Date By
7
FRAMING
Date By
71NSULATtON
Date By
GWB - 1 ST LAYER
Date By
7GWB
- 2NO LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
7ENGINEERING
FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL
Date it By
7
OTHER
Date By
OTHER
Date By
CDO193
Permit # (,3bbgq OZ Y
CITY OF FEDERAL WAY
BUILDING PERMIT" APPLICATION
— Please Print —
BOX 1 TENANT NAME: �Z !e TI-VII —e
w~ OWNER SITE LOCATION 03 3 3 - '51✓ 33 G 13 sT -
OWNER'S ADDRESS.- _ CITY PHONE
DESCRIBE JOB .erg`
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
1 BOX 2 CONTRACTOR'S NAME �7 �� �JU CONTRACTOR'S REG, #ie2 1
Car MUST he presented
CONTRACTOR'S ADDRESS I- C I T PHONE n L
EXPIRATION DATE -
IIIIIIM�
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION -
BOX 3. CONTACT PERSON PHONE G 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
f OX 6 OPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION _
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
B ?'BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE.-�
s0( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = } ( ) EXISTING STRUCTURE
,()n COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SO FT
BOX 9 UMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —
BASIC FEE $
O. WATERCLOSETS
GAS PIPING, FEET .-
$
BATHTUBS
NO. FURNACE, ELEC. GAS
$
SHOWERS
GAS HOT WATER HEATER
$ —
LAVATORIES
CONVERSION BURNER
$
SINKS
BOILER, SIZE BTU
$
DISHWASHERS
AIR HANDLING UNITS
$
C ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
—OTHER-
$
DRAINS
$
OTHER _
$
.TOTAL FIXTURES
$ -
TOTAL MECHANICAL FEE
$
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 OIF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION
l�