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SETBACKS Si FOOTINGS
Date By
7
FOUNDATION WALLS
Date By
PLUMBING GROUNDWORK
Date By
7UNDERFLOOR
FRAMING
Date By
SMEAR WALLS
Date By
7PLUMBING
ROUGH -IN
Date By
GAS PIPING
Date By
7
MECHANICAL ROUGH -IN
Date By
MECHANICAL [OTHER]
Date By
FRAMING
Date — 7 By
71NSULATION
{
Date By
7
GWB • 1 ST LAYER
Date By
7.GWR
- 2ND LAYER
he Z7 f� F
Date By
7;
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
7
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL
Date B
7
OTHER
Date By
OTHER
Date By
CDO193
BUILDINe DIVISION
F � 33530 First Way South
• E� AL RFrEl\/�P' Federal Way, WA 98003
On NOY' �y (206) 661-4000
Fax (206) 661-4129
(;I'I-Y Ui:` F LLL—'1",AL VVAk
APPLICATION FOR" UIED1NC PERMIT r
n na► ►r`n T►AA► A- R 1 I /� p 1 0— 6A-3
Address
Tenant (if known) o Jccj, (,Jn ,ten �0��
Lot # 13
Assessor's Tax #
Building Owner's Name 1�5� 'il„
Address
1
city '�{o "`�� / 1
state/c-
zip �
Phone ZQQ T Z-:-7 .37-2
NAhjrR of Wnrk ���/ -w-", f v•�Fkii' i7%+ �i�pa rts� �'�'��Yi 6LL �%ca3� [�,z Ccc rR.
NJ
Name (F,M,L) 0
r &1' q'z lc n ✓Jn
Address -2-C(3 '-p
11D C
City Cra? Cj o—
State
zip [ 603
Contact Person �j �/
Day Phone
Other
%C` �C
Fax 7� 7
Company Name
Address �+n• f�-�
city LnQ �� /�%
State
Contact Person /2L/z-�-
Phoneq�. 7
Fax q Z 7
[Contractor's # (card must be presented)
Expiit�
Verified ❑Yes ❑ No
Name /,, / A
Address �/
City
Contact Person
LEGAL DESCRIPTION W(sl
L 07—
State
Phone
Fax
..
u
L.dtlng Use
Posed Use U /`rlY
Permit includes:
Buildin
❑ Plumbing
❑ Mechanical
❑Other
Type of Work:
❑ Residential
D New
❑ Remodel
❑ Number of Units J
❑
Deck
❑ Commercial
❑ Addition
❑ Garage
❑ Shed
❑
Other
Enter 1st Floor
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
s ft
Water Availability
❑ Sewer Availabilit ❑ On -Site Septic System Availability ❑
Project Valuation
$
U, t�Q , Q d
Zoning
Lot Size
ExistingBldgValuation
$
"rJ "
Name
p
Address
CityJ
State
Zip
Contractor Name /
Address
cityV
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Contractor Name (�
Address
city
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Water Clo Sinks I Urinals I Lawn Sprinklers
Bathtubs Dish Washers I Drinkina Fountains _ Other
Showers I Electric Water Heaters I sumps
Lavatories ina Machine Drains Total i ixture:-Count:
k",
MECHANICAL EVALUATION ONLY $
Fuel Type (electric/other)
Gas Dryer
Air ndlin < = 10,000 CFM
15-30 Tons
Length of Gas PipingRange
Air Handlin = 10 000 CFM
30-50 Tons
Furn <100K BTUs
Gas Log
Unit Heater
50+ Tons
Furn > 100 BTUs.'
Fans
Miscellaneous
Fuel Tanks
Gas Hwt i
Hood
Boilers
Above Ground
Conv Burner
Duct Work
0-3 Tons
Uncle Laund
Bad'.
Wood Stoves
3-15 Tons
Total Unit Courit:->.. -,=:-..
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 bi
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, pan t a accuracy of the information supplied to the City as a part of this application. 9
Owner/Agent: _ Date: 2% Anh l �!
NILDI. AP
n FVMEO 9I21I99