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C* Lb e +pb � . • yQp .a 1 I •J 7Q •O C � •j • f 1 O �Ga � 1 1 •J = •? 1 I IN O is So O ' 1 r.7 VI �F •+ ^ pit M Aim ITT T Q - MTI -� rn a f � cn 1 fN tl I�f 71 N 4040 0 i 0Op r^ C4 x o il1 0 .. 0 OO to e 0 O f H 0 W Z N 1 z O j "I-1W0 0 f6 W 1-1 �au+--4 CD W -< a m W? a m m O C-4 ►- CD in-I►-r N (.44 I0 -•L O ul 4L CD CDO193 -zza c� e0F , City of Federal Way ' APPLICATION FOR BUILDING PERMIT PLEASE PRINT ------------------- -- ------ WE X.00ATX�- Address r t' Tenant (if known) Lot #� Assessor's Tax # `0 d Building Owner Name Address City State Zip Phone Nature of Work APPL-CANT Name (F,M,L) Address City State Zip Contact Person Day Phone Other Phone Fax BC]......DING; CONTRACTOR Company Name 1 Address City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No ARCHITECT Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION Please Complete Reverse Side CD0492 (Rev 4/931 `RUCTURL Permit includes: 'xisting Use ❑ Building ❑ Plumbing Proposed Use ❑ Mechanical ❑ Other Type of Work: ❑ Residential ❑ Commercial ❑ Now © Addition ❑ Remodel ❑ Garage ❑ Number of Units ❑ Shed ❑ ❑ Deck Other Enter 1 st Floor Area Basement sq ft sq ft 2nd Floor Decks sq ft 3rd Floor sq ft sq ft Garage sq ft Existing Floor Area Proposed Total Area sq ft sq ft Water Availability ❑ Sewer Availability ❑ On -Site Septic System Availability ❑ Project Valuation S. Zoning Lot Size Existing Oig Valuation I s 'LENDER Name Address City State Zip WCHAMCAL CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No 1'Li9',MBWG :CONTRACT.OR Contractor Name Address City , 1 State V4 IV Zip Contact 1 � • \ Phone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUMBING FIXTURE COUNT Water Closets Sinks % Urinals Lawn Sprinklers Bathtubs 2 Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories �� Washing Machine / Drains Total Fixture'Coiint.. I MECHANICAL MIT` 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 Tanke Gas Hwt Hood Boilers Above Ground Conv Burner Duct Work 0-3 Tons Underground BBO's Wood Stoves 3-15 Tons Tatsl 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 owner of the above promises 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 c}y'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. % 1 1 1