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SETBACKS &:FOOTINGS
Date By
7
FOUNDATION -WALLS
Date By
7
PLUMBING GROUNDWORK
Date By
7-UNDERFLOOR:
FRAMING
Date By
7-SHEAFt
WALLS
Date By
7PLUMBING
ROUGH4N
Date By
GAS PIPING
Date By
7MECHANICAL
ROUGH -IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date '�� y -r-�' S By ke*-.
7
INSULATION
Date - .� 5' By /4,,/
7
GWB - 1ST LAYER
Date — s By J.VAI
GWB - 2ND LAYER
Date By
7SUSPENDED
CEILING
Date By
7PLANNINGFINAL
Date By
ENGINEERING FINAL
Date By
7FIRE
FINAL
Date By
7BUILDING
FINAL
Date - By lg-j
OTHER
Date By
70THER
Date By
CDO193
G, e%q City of Federal Way
00
n
� �1 b,,APPLICATION FOR BUILDING PERMIT
l_
PLEAsE PRINT1Lpl ERAS �� APPL/CAT/ON #:
SITE LOCATION ��ix�a� Address y
Tenant (if known) J /} Lot #
Buil g Owner N 7 vvl.,b Address
Citysn2 State Zip r
Nature of Work
/'), . 1 %A 0 e, —
Assessor's Tax #
Phone r V ;�-
BUILDING CONTRACTOR
Company Name o f ' �W w�,
Address
City
State
Zip
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
ARCH]r1,Lj" I'
Name
Address
City
Contact Person
LEGAL DESCRIPTION
State
Phone
Zip
Fax
Please Complete Reverse Side
CD0492 (Rev 4/93)
STRUCTURE
cisting Use
�+^
� � 1
'roposed Use <1 _
�/
,� D
Permit includes:
El' Building
El Plumbing
El Mechanical
El
Other
Type of Work:
❑ Residential
❑ New
,K Remodel
❑ Number of Units
❑
Deck
❑ Commercial
❑ Addition
❑ Garage
❑ Shed
❑
Other
Enter 1st Floor/464
sq ft
2nd Floor
sq ft 3rd Floor sq ft
Existing Floor Area
sq ft
Area Basement
sq ft
Decks
sq ft Garage sq ft
Proposed Total Area
sq ft
Water Availability
❑ Sewer Availability ❑ On -Site
Septic System Availability ❑
Project Valuation
$
G00c,, t�
Zoning
Lot Size
Existing Bldg Valuation
$
Name
City
CCHANICAL CONTRACTOR
Address
State
Zip
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
jMBING CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # I Expiration Date I Verified ❑ Yes ❑ No
PLUMBING MTURE COUNT
Water Closets
Bathtubs
Sinks
Dish Washers
Urinals
Drinking Fountains
Lawn Sprinklers
Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains
'total Fixture Count
MECHANICAL UNIT 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
BBO's
Wood Stoves
3-15 Tons
Total Unit Count
DISCLAIMER: I certify under penalty of perjury that the information furnlshp4 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 ork for wnd hich permitapplication' ada. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenses,
and attorneys' f rn d in gatian adefense such c ),.4ihcch maybe made by any person, including the undersigned, and filed against the City of Federal Way,
but only where uch cl imrreariiwthas u of the reliance o a uding its officers and employees, upon the accuracy of the infor a"on s pplied to the City as a part of this
application.
Owner)Agant• G Date: 3 / l