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98-101629. . I . jP , . A BUIIDING DIVISION Ir �-� pl��I'3 E 33530 Fust Way SoudL o- 'o Federal Way, WA 98003 � Ems= " (253)661-4000 MAY Q 6 Fax (253) 661-4129 L'11'r i.1r I-�l}tri/1- .VII r c sko olW,' DEPT. APPLICATION FOR BUILDING PERMIT & -5 PLEAS' PRINT APPLICATION # Rs:; Address Tenant (if k own} Lg�� P Lot # \` Assessor's Tax # Building Owner's N e Address .S, SOL Zip Phone City Nature of Work " Name (F,M,L) Address ^ Cit State I - Zi Contact,Pproon � Day Phone f .. Other ne � Y Fax ,. .._., Company Name C Address Ci State pS zi13 Contact Person Phan$ Fax d Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No Name Address city State Z{ Contact Person . ' Phone Fax r' LEGAL DESCRIPTION . . I . jP , . A . # Vl3\i: i: i;F'"' " Existing Use Range Proposed Use Gas Lo Permit includes: Fans ❑ Buildin ❑ Plumbing ❑ Mechanical ❑ Other Type of Work: entia ❑ New ❑ Remodel pIrNumber of Units ❑ Deck ommorcirrl ❑ Addition ❑ Gara a _ 13 Shed ❑ Other Enter 1st Floor Area Basement sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft sq ft Decks sq ft Garage eq ft Proposed Total Area sq ft Water Availability 0 Sewer Availabilit ❑ On -Site Se tic System Availability ❑ Project Valuation $ Zoning___Lot Size Existing Bldg Valuation S Contractor Name Contact License # Contractor Name Contact License Water Closets Sinks Bathtubs Dish Washers Showers Electric Water Heaters ruei i YPO terectnclother) Gas Dryer Length of Gas Piping Range Furn <100K BTUs Gas Lo Furn > 100 BTUs Fans Gas Hwt Hood Conv Burner Duct Work BBQ's i Wood Stoves Address Phone Fax Expiration Date Verified ❑ Yes ❑ No Address State Zi Phone Fax Expiration Date Verified ❑ Yes ❑ No Urinals Lawn Sprinklers Drinking Fountains Other Sumps Drains i:c5ta. F DISCLAIMER: I eartify 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 ownerof 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 (including costs, expenses, and attomeys' 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. ti Owner/Agent: Date: 9<1 BULD-HD AW BEVEEDS/20/97 MECHANICAL EVALUATION ONLY $ AirHandling < = 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 Underground 3-15 Tons foial:Urlit Caurit> DISCLAIMER: I eartify 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 ownerof 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 (including costs, expenses, and attomeys' 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. ti Owner/Agent: Date: 9<1 BULD-HD AW BEVEEDS/20/97 m aP1 7To G7 .� o ud r -i G7 'T, G7 Tr O • • -1 • • O r-, ---1 � fl � , ._-- - - - - - - I D D GCI O a C D C �F f--, • J -G • J rl m< r If N r" N u c 7O ►•-1 cry z Ln .o s cn m o a n c z r Is C m C [19 m• J ijIi W C7 C.L, z 0 1�••i CSA r r'.�l d 2 i. IS TJ -p C •• I I r • r 7 T O cc N I--1 --� f! 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