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ermit # 94)--0-2---
APR 1 199 Pf
CITY OF FEDERAL WAY
O EDE 'BUILDING PERMIT APPLICATION
-l"vi 1 Y —Please Print—
V
BOX 1 TENANT NAME:
OWNER LEE P. 5(1)-n Im7/k / Z SITE LOCATION "727co5p . 3d - ,
OWNER'S ADDRESS ?& 5 ,a 3 !Y� L C- Via, CITY_TE , PHONE - 56 2-2--
DESCRIBE JOB ' / 2 /'- , r l'
THE PROPERTY IS OWNED BY: SINGLE/MARRIED /71,94 i%fl, PARTNERSHIP CORPOR TION
BOX 2 CONTRACTOR'S NAME , ./f' CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON A' \_ /,ei/79,,,Cile. PHONOV—. Z2 ed? 97y5'1
BOX SE STRICT &• WATER DISTRICT ,tL-,01
BOX 5 ESTIMATED PROJECT COST ! i LV EXISTING BUILDING VALUATION ---- 67,WO
BOX 6 PROPERTY TAX ACCOUNT NUMBER cy/2IDy- 9 4-OZ
LEGAL DcsCRIPTION THE Nc(?rH€V L� (01 EGT of i e S r rzuy 911.06 e4 ckikle WEST II o�-t%i SG INaC
+tip $W t �"SrcT�w 44 7Ctatt5Ni,2I Norm, rh'�llaE gkilepT,[tl.J�1,ii7 74 / V u%t ryr Lo_ hibiail
(If necessary, please submit a separate page with the legal description. VA 20T;�O T7
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD )1.00R / BASEMENT / DECK / GARAGE //72?
BOX 8 ( SINGLE FAMILY ( EW CONSTRUCTION 19 Q
( ) MULTIFAMILY(NO. OF UNITS = ) ( r XISTING STRUCTURE \ . . , 4 7 /
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY ' SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. -e' WATERCLOSETS GAS PIPING, FEET d $
BATHTUBS NO. - FURNACE, ELEC. GAS .4 $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES ,try CONVERSION BURNER $
, Y SINKS BOILER, SIZE BTU $
DISHWASHERS IR HANDLING UNITS $
.tf ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS — AIR COOLING UNITS, SIZE $
-er DRINKING FOUNTAINS COMMERCIAL HOOD $
i?' SUMPS, SPRINKLER VACUUM BREAKERS sfr/OTHER $
:B DRAINS $
y4THER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KN LEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF 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 ATTORNEYS'
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 OF THE RELIANCE OF THE CITY,INCLUDING ITS
OFFICERS AND EMPLOYEES,UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
/ ) ,
OWNER/AGENT: i �.`�r )K(� v•-4- -�L-- DATE: —/ — -
ANP-008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
•
ZONEWS12' SETBACKS: FRONT .JCJI SIDE a REAR � r HEIGHT LIMIT
•
_.,
PLANNING DEPARTMENT APPROVAL fg9�- t t-fZ- n.
REMARKS:6040
..t'�11f1^' /��o! 7G� /� cal Ll/ C)7u T 4 t lfLY i1. .1 t L"i -,i
SEPA: EXEMPT V NOT EXEMPT
FIRE DEPARTMENT APPROVAL ��/,, /% DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE 4-- - � 7-
REMARKS: 16'7GI/V gym t /N?O . 7.mu -G T4,t tPd rs P s,007-
'TAivK PPicQ 7?b cexi.t v6 £cbF DRAlovS, Vi ,Fy Dt J /S
Po per.
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT X NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS
MULTIFAMILY ADD/ALT TENANT IMP. OTHER /
OCCUPANCY /t � TYPE OF CONSTRUCTION VA - STORES
GuV-Gce- BUILDINGSQ. FT. t 7z5 t @ f c 3�. = 3(1, zZ 4
/ BUILDING SQ. FT.' • @
BUILDING SQ. FT. @
BUILDING SQ. FT. '` • @ _
BUILDING SQ. FT. @ rr =
BUILDING SQ. FT. @ `mac ( r(Q f- d ` p
TOTAL SQ. FT. TOTAL VALUATION 2-.7 S2-7,_ I
BUILDING DEPARTMENT REMARKS: PERMIT FEE S
PLAN CHECK FEE 1 o Sr
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
s
S.B.C.C. FEE L/� 5 D
OTHER FEES 5-DP.
AMOUNT DUE
ASSIGNED ADDRESS: $e-E- X S
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
�j
RECEIVED BY DATE 1 - - I - ACCEPTED FOR FILING
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SET BACKS AND FOOTINGS �� O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE_..S.2I e/ZBY _ -._.._-. DATE ..... .27 �2. BY /7\ DATE BY _-
PLUMBING ROUGH IN WATER LINE O.K. _...... MECHANICAL INSPECTION
DATE.... -.....BY GAS PIPING O.K. - ..- -_....__ DATE
BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE/o-/3-5ZBY 414./ __..._ DATE _.. .._..BY DATE BY _.
FINAL O.K. TO OCCUPY
,/ DCD PSD FD
DATE jQ-'3-qZ BY "1