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SUN CITY OF FEDERAL WAY (4\
arvoFFE ER BUILDING PERMIT APPLICATION
e utwiNG DeptwA -Please Print—
BOX 1 TENANT NAME:
OWNER I ZJ G 14, SITE LOCATION `i,7G 7 2 7 a It _� ,4
OWNER'S ADDRESS / SC', ?s7. L CITY .&E L to 'HONE 4 �-- SC
DESCRIBE JOB '-FC
THE PROPERTY IS OWNED BY: SINGL ARRI9 PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME T2 8 OIL 1 l8 T7- 04/ .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 P OOF OF RE ISTRATION.
BOX 3 CONTACT PERSON / k PHONE y —06,0
BOX 4 SEWER DISTRICT ('I ttiL Oct,o, WATER DISTRICT C—S- ~
►
BOX 5 ESTIMATED PROJECT COST "7; EXISTING BUILDING VALUATION
u BOX 6 PROPERTY TAX ACCOUNT NUMBER 7S 7 c c .- -or'sd 1-/.&
)( LEGAL DESCRIPTION pls44_4j
(If necessary, please submiWepa at _page wl he legal description.)
K.C. Plat Recording# j?1 V I � ,_—
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK 2 7Z)/ GARAGE /
BOX 8 ( ) SINGLE FAMILY ( NEW CONSTRUCTION 2 i L....., ).._ _ 4--1�"'
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE I� (JUL)‘/ �\
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY '( J SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$ N �,
�
N . WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS dd AIR HANDLING UNITS $
A ELECTRIC HOT WATER HEATER f1 ‘ HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
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 MYtKNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT AFLICATION IS
MADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,ANI3ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE U1illERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY,BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, IW.UDING ITS
OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLI GMION.
OWNER/Witt: t-ICa/t ,/` ,,a(ai'!e4 DATE: (o "//- 9/
ANP-008 3/90
OFFICE NLY (PLEASE DO NOT WRITE BELOW THIS •-" "
ZONE 77. ." SETBACKS: FRONT < SI REAR HEIGHT LIMIT ;S
PLANNING DEPARTMENT APPROVAL CY, 6- /7- 7/ , ' '
REMARKS: i . i
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS: 7
PUBLIC WORKS DEPARTMENT APPROVAL 404l4 DATE 1 C-
REMARKS:
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 til 2- TYPE OF CONSTRUCTION Vti STORES
DP BUILDING SQ. FT. O @ ( Q = Z7 0 c)
BUILDING SQ. FT.
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ J ,[_-
BUILDING SQ. FT. @ AkC C `� �er ` at la g
TOTAL SQ. FT. TOTAL VALUATION Z3 76
BUILDING DEPARTMENT REMARKS: - PERMIT FEE S�'f
PLAN CHECK FEE �s
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES `A
PART P/C FEE
SEPA REVIEW
P1.✓ 3(,s;oo
S.B.C.C. FEE I S6
OTHER FEES
AMOUNT DUE i 4-8.SD
Q ASSIGNED ADDRESS: .5e-e- e-, iS
PARTIAL PLAN CHECK FEE RECEIVED
� W
VAmount
Date Receipt#
W 6- / BUILDING DEPARTMENT APPROVAL
Q/
crtEIVED BY 1-' t/ DATE b- Z l f ACCEPTED FOR FILING
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4 / (Ts--" TIMBER RIDGE CONST CO.
, --,.,__Al Wayne G. Gilmore
D 720 151st Street S W
I Lynnwood , WA 98037
(p ( 206 ) 745-6210
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