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1 ISETBACKS & FOOTINGS
Date By
FNDATION WALLS
727
S
-------------------
Date By
7PLUMBING GROUNDWORK
Date By
4 ISLAS INSULATION
Date By
FOOTING/DOWNSPOUT DRAINS
5 S
Date By
6 UNDERFLOOR FRAMING
Date By
7SHEAR WALLS
Date By
8 PLUMBING DOUGH -IN
Date By
9 GAS PIPING
Date By
10 MECHANICAL ROUGH -IN
Date By
7FRAMING
Date By
12 INSULATION
Date By
13 '6. B --3ST LAYER
Date By
14 GWB - 2ND LAYER
Date By
15 SUSPENDED] CEILING
Date By
16 PLANNING FINAL
Date By
17 PUBLIC WORKS FINAL
Date By
18 FIRE FINAL
Date By
19 BUILDING FINAL.
Date By
20 OTHER
Date By
CD07 D3 (qev nre7J
{
WYOF �^
-= �J7FJZF[L
PLEASE PRINT
APPLICATION FOR BUILDING PERMIT
BUILDING DIVISION
33530 First Way South
Federal Way, WA 98003
(253) 6614000
Fax (253) 6614129
APPLICATION # R� Q'4)C},— C -)H n � ,
Address 62 33 91 Ah f .
Tenant (if known)
v)N MWN D . LDRo
Lot # Assessor's Tax #
Building Owner's Name
J)A 2d0N M 4- DAWA) Z
Address
�'ll0 SA" 335d-
Ci FED e eqL- t),q V
I State W 4
Zip gkeZ3
Phone
Nature of Work d o n/ sT-eu c r- A V,4P B
•��-E ::::" '•.fir °�a" ,`�"
Name (F,M,L)
W /J /Y) , LORD
Address 3 3 q ' -5
r, /,oc "RL 6L/i�
State it/ 14
Zip%�O Z 3
rCon�t3actPerson
AeA/I A1 Looel6
[Dayhone
aS3 - q,3 6 i-4 .a
Other Phone
as3-6(o/-0607
Fax
as3-&/al- S&Oy
Company Name
Al a ic,5 -r,e-i
Address
City
State
Zip
Contact Person
Phone
FO0 -& y7-098Z
Fax
Contractor's # (card must be presented)
14ER,2-r .zI o / &,T
Expiration Date
& -/-'?
Verified ❑ Yes ❑ No
Name
Address
City
State
Zip
Contact Person
Phone
Fax
LEGAL DESCRIPTION
Permit includes. -
Type of Work:
Residential
❑ Commorcial
Enter 1 st Floor
sq ft
Area Basoment
s ft
Water Avaitobility
CI Sewer A
Zoning
Name
Contractor Name
Contact
License #
Contractor Name
Contact
License rk
Water Closets
Bathtubs
Showers
Lavatories
Fuel Type [al
Length of Ga
Furn < 100K
Furn > 100 E
Gas Hwt
Conv Burner
BBQ's
Existing Use Proposed Use S&p Y.l 0 70� 1-7
Building
❑ Piumbing
❑ Mechanical
❑ Other
K New
❑ Remodel
❑ Number of Units
❑ Deck
❑ Addition
0 Garacia
_
VI Shed
❑ Other
2nd Floor
sq ft 3rd Floor sq ft
Existing Floor Area
sq ft
Docks
sq ft Gars e s ft
Proposed Total Area i.
s ft
❑ On -Site Septic System Availability ❑
Project Valuation
$
I n1 Cirn
Existing Bldg Valuation
t $ I
Sinks
Dish Washers
Electric Water Heaters
Washinc Machine
Gas Dryer
Ftange
Gas Log
Fans
Hood
Duct Work
Wood Stoves
Address
State
Address
State
Phone
Expiration Dato
Address
State
Phone
Expiration Date
Urinals Lawn
Drinking Fountains Other
Fax
Verified ❑ Yes ❑ No
Fax
Verified ❑ Yes ❑ No
MECHANICAL EVALUATION ONLY S
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
Under round
3-15 Tons
" tea. MIS, ,
DISCLAIMER: I cerlify under penalty of perjury that the infonmation funtished by me is true end correct to the best of my knowledge, and further, that I am authorized by the owner of
fiat above prcmiscs to perfoma kit 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
altomeys' 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 ofthe reliance ofthe city., including its officers and employees, upon the accuracy ofthe information supplied to the city as a part of this application.
.i
Owner/Agent: %'��I.g-' Date:
BUIDm.Am
REvmc 9/29/B7