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F•� rr :8 • � • r � . 1••A li I C • 7� _ C II rpo it 10 V T' • • " . .. .. a 3> ' Ei yr�'1 T I it .. .. .,a T ,�,� a [-" f rv.•1 � ppp % O CD Q C v x y ` It �- G -•' T T I It IpI x ~ K u # •9a � r V: CIS � II � � 10 cn 1.='iil i Z�� N � 1 Q 1•'� r s Q n m rl m0G 1 � " u '. / \ r 5 : N tiJ » sn► M *+► k fti •U WT CO W i+ _v 0 a � CDO193 BuamiNG DIVISION 33530 First Way South amra� G Federal Way, WA 98003 (253) 661-4000 Fax (253) 661-4129 APPLICATION FOR BUILDING PERMIT PLEASE PRINT APPLICATION # Address Tenant (if known) Lot # Assessor's Tax # Building Owner's Name4a-w relt e 0 Address Uj city �`' _ �-� State W H 1zipPhone,63 Nature of Work Name (F,M,L) SGO- Address 36 City-_ � Contact Person C' . _ I Day Phone I IS Company Name Lk)Q. f _ t- roC) rp Address Q r r% Gity�� Contact Person 0,T- Contractor's # (card must be presented) IF 1 ,U LI q!} c v- Name Address City Contact Person LEGAL DESCRIPTION State Oth i Fax 3 State Phone Fax r Expiration Date Verified ❑ Yes ❑ No Phone Fax Existing Use Permit includes: ❑ 8uildin Type of Work: ❑ Residential X New ❑ Commercial ❑ Addition Enter 1st Floor sq ft 2nd Floor Area Basement s ft Decks Water AvsilabilitY Sewer Availabilit On -Site ZoningLot Size Name r� City Contractor Name Contact License Contractor Name Contact nse # Proposed Use ❑ Plumbinu 0 Mechanical ❑ Other ❑ Remodel ❑ Number of Units _ ❑ Deck ❑ Gara e 0 Shed ❑ Other sq ft 3rd Floor sq ft Existing Floor Area sq ft s ft Gera e s ft pro Deed Total Arcos ft tic System Availabiiit ❑ Project Valuation $ Exisiing_Bidg Valuation 16 Water Closets Sinks Bathtubs Dish Washers Showers Electric Water Heaters Lavatories Washing Machine Fuel T e (electric/other) Gas Dr er Len th of Gas Pi in Ran a Furn [ 1 OOK BTUs Gas La❑ Furn > 100 BTUs Fans Gas Hwt Flood COnV Burner Duct Work BBQ s Wcod Stoves Address State Address State Phone n Date Address State Phone Date Urinals Drinking Fountains VA Fax Verified ❑ Yes ❑ No Fax Verified ❑ Yes ❑ No Lawn Total Fixture -:Count MECHANICAL EVALUATION ONLY $ Air Handling c = 10,400 CFM 15-30 Tons Air Handling > = 10,000 CFM 30-50 Tons Unit Heater 50 4. Tons Miscellaneous Fuel Tanks Boilers Above Ground 0-3 Tons Under round 3-15 Tons r„f�i i r ;. r, -..— DISCLAIMER: I certify under penalty of perjury that the inforrrlation famished by me is true and correct to the best of my knowledge, and further, that I am authorized by the owner of the above premises to PCrform 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 attomeys' fees incurred in investigation and defense of such claim), which maybe 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 the information supplied to the city as a part ofthis application. Owner/Agent: Date: Bum -Am REVEEU 0126I97