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Iolaex• REVISION DAB _ DEC 0 8 1994 SITE PLAN APPROVAL Permit Number. Approved By: Date: ��/`�'� Comments: Ur MM 14 5.F ff woUtME 51,WMT(& JV4 5F Ra& a.H. f90 5.P. PAW in 5P. E A&YM TC]TN. JWMIAM M4 BM lbF. t4.M NO 916NIFWW TOM OK 146 LOT 50ALt , I" = 20' PLEASE PRINT I.SITE LOCATION Tenant (if known) Building Owner Name City Nature of Work X , City of Federal Way APPLICATION FOR BUILDING PERMIT NOV 2 9 IM4 6,jti � rq lo Iq vq t GITY OF FEDERAL WAY ;4PPLlCA TION #: Lot # I j As�9 r s a5L� iE Usi Address ! I State Zip Phone Name (F,M,L) Address City Contact Person Day Phone State Zip Other Phone Fax r LDING CONTRACTOR _ Company Name d Address J� City 09p(- State zip Cantaot9Pr r) t� � Contractor's # (chard must be proserytedj � ARCHITECT Name 0 Address City Contact Person LEGAL DESCRIPTION / r Phone Expiration Data State Phone Fax Verified ❑ Yes ❑ No Zip Fax Plans le1a Raverso Side C004 B2 Ina. 4107) SI`RU(;Tl1RF; Existing Use N f Proposed Use 11 rd2� Permit includes: Building . Plumbing ><Mechanical ❑ Other Typo of Work: X Residential N�' Now ❑ Remodel ❑ Number of Units _><Deck �J ❑ Commercial ❑ Addition ] Garage ❑ Shod ❑ Other Enter 1st Floor ILVI(p sq ft 2nd Floor : sq ft 3rd Floor _ sq ft Existing Floor Area sq ft Area Basement sq ft Docks � [,_,,� sq ft GaragaL C)—sq ft Proposed Total Area sq ft Water Availability Sower Availability On -Site Septic System Availability ❑ Project Valuation: 5.:.. Zoning � ��� Lot Size "� �✓ 5 Existing Aldb Valuation $ _ LENDER Name Address City State Zip MECIIANICAL CONTRACTOR. Contractor Name Address City State Zip Contact Phone Fax License d Expiration Date Verified ❑ Yes ❑ No PLUMBING CONTRACTOR Contractor Name City Contact License N Address State Zip - Phone Fax Expiration Date Verified ❑ Yes ❑ No PLUMBING -Fl)ffURF COUNT Water Closets Sinks 1 - Urinals 1� Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other •�- Showers Electrter Heaters Sumps Lavatories lWashEingMachine Drains Total Fixture Count 19 MECItANI,CAL UNIT COUNT Fuel Type (olectric/other) , Length of Gas Piping Furn <100K BTUs Furn > 100 BTUs Gas Hwt Conv Burner BBQ's t Gas Dryer - j Range Gas Log 'Fans Hood Duct Work Wood Stovjr es -Air Handling < = 10,000 CFM 15-30 Tons Air Handling > = 10,000 CFM 30-50 Tons Unit Heater 50+ Tons Miscellaneous Fuel Tanks Above Ground - Underground Boilers _ 0-3 Tons 3-15 Tons Totul Unit Count DISCLAIMEn: 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 author.zed by the r 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 (includir•,g costs, expenses, and attorneys' foes incurred in investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of Fadoral Way, but only where such clala[ ISO lout of t r batten the Ci[y, including its ollicers end employees, upon the neeurney of the Information supplied to the r.:ity as a pnrt of this application. !, O1wnerlAgenl: _ V �� t...Data: