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/717S 0/1/001
. Permit #
ReceivEDCITY OF FEDERAL WAY
la APR 23 1992 B ILD NG PERMIT APPLICATION
0 atALDING DPFEDeL —Please Print— s`�i\U C /�J/1T 3
BOX 1 TENANT NAME: 11Y
OWNER / RUC:6 d-MA-dey" /2/1i . avtint8ITE LOCATION
OWNER'S ADDRESS �`s': �c, -2, 5 �"//ti �� CITY f- -Z n1L 4.4th f' PHONE 5/`/y`?5
DESCRI BE JOB 730/4!) .5`72-5/e46 6L1/4 /it% egcie Y 1`eo
THE PROPERTY IS OWNED BY: SINGLE/MARRIED /YIAER/,'E-L PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME a�-e...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 "`- _ PHONE wki,---11,<-(ci
ROX 4"S€WER�TRICT rt=/._'A �v/3 v WATER DISTRICT r O }
BOX 5 ESTIMATED PROJECT COST'f`' ' CC, EXISTING BUILDING VALUATION '4rJ31c.'c. o0
BOX 6 PROPERTY TAX ACCOUNT NUMBER 9 2 2 2 /O ciao
LEGAL DESCRIPTION /07 1 cF ,1:C. z Rs-
vev. uin'= 9 z c'PeAl'S 1 �l - .�a RG Ca/2DS' c,/= /ei.eiC cuiQ
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording#
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOI' 2ND = _ -
3RD FLOOR / BASEMENT / DECK / 5,/r ,CAfi/GE5--f y / l jh
BOX 8 SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) C4 EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY /5 3-'50 SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRIN ING FOUNTAINS COMMERCIAL HOOD $
S PS, SPRINKLER VACUUM BREAKERS OTHER $
Al NS
OTHER $
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‘WLEDGE
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: ` ,c.c.v_`�J��la,c_ �c�I DATE: 7//S79Z—
ANP-008 3/90
41
OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE2--SETBACKS: FRONT < ' _ SIDE J( REAR ( HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL S1/-27/9--2-
REMARKS: r r.,...,_..r rre.vr�'r6cr 6 onto any building setback lino or�cG7G;it,c"G.;'�r. not
SEPA: EXEMPT t.7 NOT EXEMPT
FIRE DEPARTMENT APPROVAL f' C-"'" DATE ,S - /S " r?-
REMARKS: £ 't,L-L7,-Ge-7 (O tic /,C 77447?M reduce, �! �
.0 -7rn . ,A.)/ 7r,E . cc3 4 Sct.c0 tit. 1NSDC-z..7 Pic <0
PUBLIC WORKS DEPARTMENT APPROVAL DATE `g70-q�-
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW """'--
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY M TYPE OF CONSTRUCTION STORtS'
bc(vc1 qe BUILDING SQ. FT. $q6 @ /6. 30 = /6 3F6, 3
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ 1 F r =
BUILDING SQ. FT. @ Mo d, 0. 85
TOTAL SQ. FT. TOTAL VALUATION 1 w y Z 9
BUILDING DEPARTMENT REMARKS,: PERMIT FEE l6
PLAN CHECK FEE (dS
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
R.)2Lic /4;0245 3 w
S.B.C.C. FEE LI/' 0
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS: -SLe-- e-K ( S
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE 5-- ($ - (17- ACCEPTED FOR FILING
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