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APPLICATION FOR PERMIT <br />BUILDING DEPARTMENT <br />CITY of TUKWILA <br />6200 SOUTHCENTER BOULEVARD <br />TUKWILA, WASHINGTON 98188 <br />433.1849 <br />DATE (PERMIT NO. WHEN VALIDATED +EXPIRESrr� <br />JOB ADDRESS <br />LEGAL LOT NO. BLOCK TRACT v <br />DESCR. 9SEE ATTACHED SHEET <br />OWNER PHONE <br />ADDRESS (ZIP <br />CONTRACTOR PHONE <br />ADDRESS ZIP <br />LICENSE NO S ST NO. <br />BUILDING USE TENANT <br />CLASS OF WORK <br />NEW ADDITION REMODEL REPAIR OTHER (Specify) <br />BLDG. 1st I 2nd FL. 1 BASEMENT I GARAGE I DECK I MEZZANINE I, T OF STORES I TOTAL S.F. VALUATION <br />AREA JS l� 9`f' 135 I I y741a I .1-5 74o <br />NAME OF APPLICANT (PLEASE PRINT) 6 13 5' 7 0 D <br />ADDRESS PHONE <br />I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT AND THAT THE APPLICABLE CITY OF <br />TUKWILA REQUIREMENTS WILL BE MET. <br />SIGNATURE OF APPLICANT <br />DO NOT WRITE BELOW THIS LINE <br />COMMENTS: <br />rr.rn..r..urr <br />S AKE <br />TYPE CONST. I <br />OCC. GROUP <br />OCC. LOAD FIRE ZONE <br />USE ZONE <br />AUTO SPRINKLERS RED. I DETECTOR <br />V <br />3 ,M l <br />/V"/ <br />❑YES D No YES [3 NO <br />PLAN PLANS: I <br />RVW. <br />SENT <br />I RETURNED I APPROVED <br />FEE <br />BUILDING <br />r �j 3 ob <br />FIRE DEPT. I <br />I <br />DISTRIB. <br />PLAN RVW. C 1 q, 00 <br />DEMOLITION <br />PLANNING/ <br />I <br />i <br />BOND <br />SEPA <br />OTHER <br />PUBLIC WKS. <br />COMMENTS: <br />rr.rn..r..urr <br />