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FRAMING Date By 7 SHEAR WALLS Date By PLUMBING ROUGH -IN Date By GAS PIPING Date By MECHANICAL ROUGH -IN Date By 7MECHANICAL (OTHER) Date By 7 FRAMING Date INSULATION Date By GWB • 1ST LAYER Date By GWB - 2ND LAYER Date By 7SUSPENDED CEILING Date By PLANNING FINAL Date By ENGINEERING FINAL Date By 7F.IRE FINAL Date By 7 SUILDIV FINAL , A Date ByffF OTHER Date By 70THER Date By CDO193 mvcrcg--- � - On — �ED F ER 2 91994 PLEASEMF, PE,DERAYVAy L WIP.. City of Federal Way APPLICATION FOR BUILDING PERMIT APPLICATION #: 61 `' �1 ✓ 6/V 7 ITE LC3G010 Address — 7l)-3 b 5 • QN-) -P.>0 I` Tenant (if known) Lot # / Assessor's Tax A Building Owner Name Address City State Zip Phone Nature of Work APPLiCAN� Name (F,M,L) Address City State p� zip Ct �, 4 Contact Person Day Phone Other Phone Fax BUILDING CONTRACTOR Company Name CvZ - Address City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified 70 Yes ❑ No C C> - - � t f!{ ARCiIiTEICT Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION 7Gu:ly Li<j 7T /� r-°� r C7r I/IAA 1 AzSf��✓C Please Complete Reverse Side CD0492 (Rev 4/931 APPLiCAN� Name (F,M,L) Address City State p� zip Ct �, 4 Contact Person Day Phone Other Phone Fax BUILDING CONTRACTOR Company Name CvZ - Address City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified 70 Yes ❑ No C C> - - � t f!{ ARCiIiTEICT Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION 7Gu:ly Li<j 7T /� r-°� r C7r I/IAA 1 AzSf��✓C Please Complete Reverse Side CD0492 (Rev 4/931 BUILDING CONTRACTOR Company Name CvZ - Address City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified 70 Yes ❑ No C C> - - � t f!{ ARCiIiTEICT Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION 7Gu:ly Li<j 7T /� r-°� r C7r I/IAA 1 AzSf��✓C Please Complete Reverse Side CD0492 (Rev 4/931 t f!{ ARCiIiTEICT Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION 7Gu:ly Li<j 7T /� r-°� r C7r I/IAA 1 AzSf��✓C Please Complete Reverse Side CD0492 (Rev 4/931 LEGAL DESCRIPTION 7Gu:ly Li<j 7T /� r-°� r C7r I/IAA 1 AzSf��✓C Please Complete Reverse Side CD0492 (Rev 4/931 i /! L A.A3 ->r~- 2 A z-% C RiICT[]RL Permit includes: F .Ming Use ( `7' 'i U- Euilding [gyp-© [ o�4� plumbing 9 Posed Use �y� X, Li Mechanical �+�� ❑ Other Type of Work: ❑ Residential Cam -Commercial ❑ New ❑ Addition CIS --Remodel ❑ Garage ❑ Number of Units _ ❑ ❑ Shed ❑ Deck Other Enter 1 at Floor Area Basement ft 13GI0 sq ft 2nd Floor sq ft Decks sq ft 3rd Floor Garage sq ft sq ft Existing Floor Area G erf U sq ft Proposed Total Area /,E9 0 sq ft Water Availability ❑ Sewer Availability ❑ On -Site Septic System Availability ❑ Project Valuation:!; :$ c Zoning Lot Size WT Existing Bldg Valuation s LENDER Name Address City State Zip MLCkANiCAL CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUM ING CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLU.W1NG F XTW COUNT: Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains -Total Rxture Cou.n.t. . MOEC 1".CAL T7NlT 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 UniuCount 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 againet 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: Dato: DECLARATION OF CO,PLIANCE WITH SECTION 705 UBC. The exception herein referenced shall apply to group "B" occupancies only and shall not diminish any other requirement of the Uniform Plumbing Code or Seattle -King County Health Department. G•.here conflicts exist with other regulations, it shall be the responsibility of the applicant to comply with those regulations. affirm that as owners)/authorized agent(s) of r i at Na-:e of Firm Address we will employ employees at this location. Number I(We) understand that Section 705 of the uniform Building Code requires a minumum of two separate toilet facilities when the number of employees exceeds four. I(�;e) request consideration by the City of Federal I -ay of our firms current and projected staff size in requiring such facilities att this time. I (We) further understand and declare that when our firm employs greater than four employees at this location, we will provide the required nummber of toilet facilities. (Note: Separate tenant ir;provement and plu:—abing permits will required.) Additionally, I(we) understand that this require,<<ent beco-mes a condition of continued occupancy of this space and failure to comply with said condition may result in the suspension or revocation of the certificate of occupancy by the City of Federal Way. k Signature L Date Name 1 • <<^ CU �n `�' tom- Title Federal Way Tracking Number deccompl.frm Phone 7, fl 9 - 4 0Z 0 s s o ti ter] txj tt2i �b! 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