94-100857ij,41
City of Federal Way
APPLICATION FOR BUILDING PERMIT
MAY - J 18 qy - toe $57
PLEASE PRINT -�'�'• APPL/CAT/ON #: � l..J •Y�f -�
SITE
LOCATION
Address 3Q�
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Assessor's Tex #
oo zoBuilding
Owner Name
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City
State
Zip 6 0 ?
Phone — Q V
Nature of Work-�/],•, �: ,�/��❑ G-NytA�f�
APPLICANT
F, -
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AddressTe
1 a-4-, % off A& L
------ I.... ILDING' CONTRACTOR
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A
Company Name
Address ® t2 3
City Lk)
Zip
Contact Person
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Phcp a6fof
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Contractor's # (card must be presented)� rati 1n e_/ Veri "ad O Yes O No
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ARCInTECT
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Name h
1, -V
�fIN
Address
City
State
Zip
Contact Person
Phone
Fax
LEGA RIPTION
Please Complete Reverse Side
CD0492 (Rev 4/931
STRUCTURE
Ex. g Use
P, sed Use
Permit includes:
Building
❑ Plumbing
❑ Mechanical
❑
Other
Type of Work: l2f Residential
❑ Commercial
n1 New
F.l Addition
(' Remodel
❑ Garage
❑ Number of Units
❑ Shed
❑
❑
Deck
Other
Enter 1st Floor �)q sq ft
Area Basement sq ft
2nd Floor
Decks
sq ft 3rd Floor sq ft
sq ft Garage sq ft
Existing Floor Area
Proposed Total Area
sq ft
sq ft
Water Availability Sewer Availability On -Site Septic Sysj2nn Availability ❑
Project valuation"
'$
-`
Zoning (� G
I��'�- �
Lot Size
Existing.Bldg .Valuatjon.>
:$.
,,�A.�,,
LTINDER;::... .... .
Name
IAddress
City
State,....
Zip
MECIIANICAL CONTRA;CT{]R
■
Contractor Name
Address
-sr► �
State Zip
City
Contact 70 -
Phone
Fax
License # A
Expiration Date
Verified ❑ Zes ❑ No
PLUMBING CCINTRACTOR
Contractor Name
Address
City 1
State
Zip
Contact +
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
PLUMBING FIXTM SEAT � ( % L j 7 J
Water Closets
Sinks JO ,ir
Urinals ,r
Lawn Sprinklers
Bathtubs
Dish Washer
Drinkin untains
Other
Showers
Electric VY8ter Maier.
Sumps
Lavatories
Washing Machine
Drains
Total Fixture Count
M
MECHANICAL UM. COUNT
Fuel Type (electric/other)
Gas Dryer
Air Handling < = 10,000 CFM
15-30 Tons
Length of Gas Piping
Range r F
Air Handling > = 10,000 CFM
30-50 Tons
Furn <100K BTUs
Gas Log
Unit Heater
50+ Tons
Furn > 100 BTUs
Fans S
Miscellaneous
Fuel Tanks
Gas Hwt
Hood
Boilers
Above Ground
Conv Burner
Duct Work
0-3 Tons
Underground
BBQ's
Wood Stoves
3-15 Tons
Total Unit Count
DISCLAIMER: I certify under penalty of perjury that the information furnish y 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 perform the work for which permit application i)yfnada. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenses -
and attorneys' fees incurred in investigation and defense of such co' ], which may be made by any person, including the undersigned, and filed against the City of Federal Way,
but only where u h claim aris so of the reliance the Cit ncluding its officers and employees, upon the accuracy of the information supplied to the City as a part of this
application.
v
, Owner]Agau _ Date:
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GuStomer:
Mike � `sue Mayov5ky "
30041 5th Ave '-)W
Federal Way, WA g8023
Tax # 03g5g001200q
'-)'op e of work:
KeTIIJ the exi,,tin utility room in
the garage and 2 a toilet, Shower
and vanity ,ink. Ins a new window in the
existing exterior wall,
X- xi,, e-,terior wall
New window w/exist header in exist, exterior wall
atone OT200 200 Single hung F1 E
41' 30° 48'
30 insulation
\1 - 4
ew 2X6' wall w/5/8' GWB
OASS
THERE ARE TO BE NO DEVIATIONS
TO THE APPROVED DRAWINGS
UNLESS OTHERWISE APPROVED BY
.`> 7 I THE FEDERAL WAY RUI! DING [KEPT,
0
,r •', One piece top Sink.
FILE
.4--33
101 1/4"
F
ttfllruum rrmubrl fur:
+Mikr & RpVr AugouskV
ffrberttl Mau, WA 2.2V23
CO ® AKM +"2rmubrl & TonsfrAfrfiun
4 19 94 .23.2-9ar7�
w/new Sill and bommer hinge-,
RECEIVED
MAY ® 31994
GI TY OF WAY
SUILDING DEFT,