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tS
1 SETBACKS & FOOTINGS
Date By
2 FOUNDATION WALLS
Date gy
3 PLUMBING GROUNDWORK
Date By
4 ISLAB INSULATION
Date By
5 FOOTINGtJDOWNSPOUT'DRAINS
Date By
6 UNDERFLO.OR FRAMING . .
Date By
7 J
Date /G _ By G
8 PLUMBING ROUGH -IN.
Date By
70AS PIPING
Date By
10 MECHANICAL ROUGrH-IN.
Date By
11 J.FRAMING
Date By
12 INSULATION
Date By
13 OWB - 1ST 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 FI1�iAt
Date By
19 >3UILDING FINAL
Date,- 4 — gy J
20 OTHER
Date By
= I!
C00101 (Rev 4,B7) IC
1.
�j
BUILDING DIVISION
33530 First Way South
Federal Way, WA 98003
(253) 661-4000
Fax (253) 661-4129
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT ` 7 APPLICATION #
`> y> Address �7 4PF
G-Z "
3` ::
Tenant (if known)` _ Lot # Assessor's Tax #
-/ —Building Owner's Name Addres `
Ci
� C---��}•].."'_ State ' zipd 1 Phone
Nature of Work l
Name (F,M,L)
Address
Contact Person
Company e � 1.
Address
city
Contact P r n
Contractor's [aard must be presented)
Name
Address
City -
Contact Person
LEGAL DESCRIPTION
State
Day Phone Other Phone
FEDERAL WAY BUSINESS LICENSE #�
D.cr4r. y1,01-
Expiration Date
State
Phone
Fax
Verified ❑ Yes ❑ No
Fax
CompleteLlaase V r 1
r-"'_ -' ":
F'•';�
Existing Use
Permit includes:
Proposed Use
Type of Work:
'Q Residential
��Bulldln
New
❑ N
❑ Plumbing
❑ Mechanical C] Other
❑ Commercial
❑ Addition
❑Remodel
❑ Number of Units ]S ❑ Deck
Enter 1st Floor
sq ft
2nd Floor
❑ Gara o
❑ Shed ElOthrr
Area Basements
ft
❑acks
aq ft Floor sq ft
Existing Floor Area
Water Availabilit
❑ Sowa: Availahiiit
0s
s ft Gar GAYa o s ft
Pro osed Total Area - sq ft
ft
Zonin
C n-.iite Se tic S st❑rn Availabiiit ❑
--J— Pra•ect Valuation
Lot Size
$
Frictinn
Name
Address
Address
State
Contractor Name
Address
ck
Contact
State
Zi
Phon
Fax
License #
x iration Data
Verified ❑ Yes ❑ No
00
ractor Name
7
Address
7Contact
S18(a
Zi
Phone
Fax
se #
Ex.)iration Daw
Verified ❑ Y❑s ❑ No
Water Closets
Bathtubs
Sinks
Urinals
Lawn S rinklers
Showers
Dish W ors
k
Drinin Fountains
Otter
Elect c Water Heaters
gum
Lavatories
s
ShID9 Machine
Drains
h
.:
Total:FJAiti'i
..# _-
•
Fuel T o lelactriclothorj
MECHANICAL EVALUATION
ONLY $
L i in
en th of Gas Pan
Gas Dr or
Air Handlin < = 10,00t7 CFM
15-30 Tons
Furn <1OOK 8TUs
Re
Air Handlin > = 10,0f]0 L'FM
30-50 Tons
Furn >100 8TUs
Gas Lo
Unit Heater
50+ Tons
Gas Hwt
Fans
Miscellaneous
Fuel Franks
Cony Burner..-"
Hood
Boilers
Above Ground
BBq's
Duct Work
O.3 Tons
Under round
Wood Stoves
3-15 Tons
DISCLAIfVfER; I certify under penally ofpetjurylhat i12c irtfannation furnished by me istruc and correct I t)rc best of my knowlcdge, and furtlier, that I ant authorized by the owner of
the above premises to Perform the work for wlrich pcmrit application is rnadc- I further agree to save harmless the City ofPcdvral Way as to anyctaim {including costs, expclues, and
at[orncys' fees incurred in irrvestle regat lia ce defense ❑fsuch claim}, which may be made by any pers❑r> inctudirrg the undcrsi�red, and filed against tare City of Federal Way, but only
wlrcrc such claim sss out af�lre refiancc o£tlre city, I c uding' officers and employees, upon tlrc accuracy of t}ic i:tfonnation supplied to Urc city as a part of4ris application
OwnerlAge ,\
BIntonuc.Am
Date: R` I L01
HEMS0 8126197