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SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE 1D`4 Z- BY_ DATE L0-q-9 Z _BY "II/ -. DATE ..----..... ___BY
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE._ _._._BY .. GAS PIPING O.K._..... _._ .._.... DATE / " 7L AA BY __...
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE /2- 3'S-Z--.....BY A✓ DATE _12'3 5_1-- ..._....BY . i" _ DATE 1...2_?Z-........BY lr1"1/
FINAL O.K. TO OCCUPY
'/ DCD PSD FD
DATE ./S 3 BY My........_-.
43/g-z Dwr✓6-R fih #)r u-E NlI Io LOeh /j> 7I COA-4Arre- Iwc? lr R/4 s pooR6b
/9 % Z4�,.,02ovrc an S-Ap
Permit # 17TT`Z
MEWED (452 —?O
CITY OF FEDERAL WAY
AUG 0 4 1992 BUILDING PERMIT APPLICATION
OW ,�e�N��y AY —Please Print—
BUIBOX 1 TENANT
DEPT
ATT NAME:
OWNER DELVEN CORNEL CORPUZ SITE LOCATION 2007 S 279TH PL
OWNER'S ADDRESS 2007 S 279TH PL CITY FEDERAL WAY PHONE 941-7951
DESCRIBE JOB SEE ATTACHED PAGE ✓� � �'CL-e
THE PROPERTY IS OWNED BY: SINGLE/MARRIED MARRIED PARTNERSHIP CORPORATION
llt,LVr,N C:UKYUG
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS 2007 S 279TH PL CITY FEDERAL WAY) PHONE 941-7951
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 DELVEN C CORPUZ PHONE 941-7951
BOX 4 SEWER DISTRICT FF.DF.RAL WAY 98009 WATER DISTRICT FF])FRAT, WAY 98003
BOX 5 ESTIMATED PROJECT COST 10,000.00 EXISTING BUILDING VALUATION 148,000.00
BOX 6 PROPERTY TAX ACCOUNT NUMBER 757562-0460-08
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 754 / 954 2ND FLOOR 895 / 895
3RD FLOOR NA / NA BASEMENT NA / NA DECK 180 / GARAGE 418 / 418
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( X) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY 15.452 SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. 0 WATERCLOSETS GAS PIPING, FEET $ n
O BATHTUBS NO. FURNACE, ELEC. GAS $ 0
n SHOWERS GAS HOT WATER HEATER $ 0
n LAVATORIES CONVERSION BURNER $ 0
0 SINKS BOILER, SIZE BTU $ 0
0 DISHWASHERS AIR HANDLING UNITS $ 0
0 ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $ 0
0 LAUNDRY WASHER OUTLET UNIT HEATERS $ 0
0 URINALS AIR COOLING UNITS, SIZE $ 0
0 DRINKING FOUNTAINS COMMERCIAL HOOD $ 0
0 SUMPS, SPRINKLER VACUUM BREAKERS OTHER $ 0
0 DRAINS $ 0
0 OTHER $ 0
0 TOTAL FIXTURES $ 0
TOTAL MECHANICAL FEE $ 0
I CERTIFY 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 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: �✓'s? e QI�//�,-- DATE: 04 AUGUST 1992
d L/ ANP-008 3/90
OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE) 41111,
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS: PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS:
N
11.1 a' PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
uz
06
BUILDING DEPARTMENT APPROVAL
.cr
fiECEIVE BY DATE ACCEPTED FOR FILING