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CDO193
City of Federal_Vva RECEIVED
APPLICATION FOR BUILDING PER 17 -; 1994
. 19 L�_ /U z .. G��� Z23o 3, CIT OF FF� o L; AY
P L ��clvvqo
p� PG�Gb/� �2� - A��uca r�onl �v:
SITE
LOCATIaN Address 3�z.f -3Zn .S1 .
-{
Tenant (if known) Lot # A.gp-r'C Tax #
% -b �--6
Building Owner Name
Address X,
City
State
Zip Phone
Nature of Work G'C
APPLICANT
Name (F,M,L)
Address
City
State
Zip
Contact Person
Day Phone
Other Phone
Fax
ARCIMECT
Name
b
Address
City
State
Zip
Contact Person
Phone
Fax
LEGAL DESCRIPTION
JC
Please Complete Reverse Side
CD0492 (Rev 4/9?
E ng Use
includes: >< Building
3osed Use'911v5z
,<Plumbing >4:� Mechanical ❑ Other
�i
ype of Work: )K Residential ,New ❑ Remodel
Enter 1 st Floor 16
sq ft 2nd Floo
Area Basement VC
7 sq ft Decks
Water Availability
Sewer Availability
Zoning
I Lot Size
TENDER
n arage
r 3q ft 3rd Floor I sq ft
sq ft Garag• ., O7 sq ft
On -Site Septic System XvailabifitV ❑
❑ Number of Units _ Deck
❑ Shed ❑ Other
Existing Floor Area sq ft
Proposed Total Area sq ft
,..Proja"et'Valgaticti ::$=....
.....
Existing Bldg 1laiviititin : $
C-� Z�1
Name
Address
6 1.
City
State
Zip
NiECHAMC.A,"L CONTRACTOR
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ElYes ❑ No
PLUMING C01WRACTOR
Contractor Name �`
Address
City
State
Zip.
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
FLUARI v'G FlNTME COU.W
Water Closets
' Sinks
Bathtubs
Dish Washers
Showers
Electric Water Heaters
Lavatories
WashingMachine
MECHAMCA L: UNIT COUNT
Fuel Type (electric/other)
Gas Dryer
Length of Gas Piping
Range
Furn <100K BTUs
Gas Log
Furn > 100 BTUs
Fens
Gas Hwt
Hood
Conv Burner
Muct Work
BBQ's
- Wood Stoves
I
Urinals
Lawn Sprinklers —
Drinking Fountains
—
Other
Sumps
Drains
'-
.Total Fixture Count
Air Handling < = 10,000 CFM
15-30 Tons
Air Handling > = 10,000 CFM
30-50 Tons
Unit Heater
50+ Tons
Miscellaneous
Fuel Tanks
Boilers
Above Ground
0-3 Tons
Underground
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 Jr
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 asto 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 information supplied to the City as a part of this
application. �n
J �
Owner/Agent: y Y'�� _�/%� Date: r
r
u-06?D
A 6 _A
zi
t�Q*
TqF
• I
— S4' N bq°40'2" E
B
srrE PLAN �tfly�1#•
pbrnrit Nwnber: � � `� "
Appoved By. -
Date:
.E6AL DESCRIPTION
SPROUSE FT II OT 3n
ADDRESS
T.5P
DATE PJS
■❑u'JL' DRAWN BY q-20-G4
CHAFFEY CORPORATION
■ ■ ■ ❑ ❑ 205 LAKE STREET SOUTH, SUITE 101, P.O. BOX 560
.■.❑❑ KIRKLAND, WASHIMSTON g8089 HOUSE ORIENTATION
■ ■ ■ ■ ■ (206) 822-5481 I
STREET
lr u _ 7"
R=25'
L = 3q.5'
0 = a0°31'51"
RECEIVED#�
NORTH
SEP 2 91994