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CITY OF FEDERAL WAY
BUILDING F RMIT k.PPLICATIOr ���
— Ptease Print — 12J1,L0f 1 !� '-
�llf��
NT NAME: b
:R e.\\ W\c-' s . SITE LOCATION L '= 1.
ER ;OO ESS , ' - I'...- CITY -o-! Ia -19:71
RISE J06 \V ci \\ 1 .
)ROPERTY IS O, CEO SY: SI,:GLF1::ARRIE0 PARTNERSHIP CORPORATION
R.ACTOR'S NAME Northwpat w..'-.. r Fso..+-o,- CONTRACTOR'S REG. # NORTEWHI03R2
Card MUST be presentel
•
R.ACTOPP'S ADDRESS 8207 Dcz�anQn S4- crs'T ' • CITY Tacoma PHONE 984-6404
iATION DATE 12-22-97 •
— OR —
E READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
TER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
ACT PERSON Angel Foster D-
PHONE4Rd_�n ,r ' -
ER DISTRICT WATER DISTRICT -
.tA E0 PROJECT COSTA 2b EXISTING BUILDING VALUATION
ATIQN
•
ERTY TAX ACCOUNT NUMBER S\S Lc' - N2clO .. •
L DESCRIPTION % •
cessz.y, please submit a separate page with the fecal description.) - - - ••
•
'tat ;Recording L - - .
DING SQUARE FOOTAGE:. (Existino/Proposed) 1ST. FLOOR / 2ND FLOOR - / -
• FLOOR / BASEMENT_____/ . • • DECK • / GARAGE • / -
SINGLE FAMILY ( ) NEW CONSTRUCTION .
MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE _. _.. _.....
COMMERCIAL/INOUSTRIAL TOTAL AREA OF PROPERTY - - SQ ;i •
DING FIXTURES UREa (including rough-ins • _•- ME-L� ' ---"-
- -. ( g cough-ins) ,�cc,,.ertilCAL APPLIANCES BASIC FEE S
WATERCLOSETS - GAS PIPING, FEE ( . . . S..
£ATHTUSS NO. FURNACE, ELEC. GAS S •
•• SHOWERS - - .. _..r. - GAS HOT WATER HEATER•• - - - ---- S--•---_
LAVATORIES . - - . . . CONVERS`ZON BURNER - - •• . _--- S- - .
SIN<3 BOILER, SIZE BTU S
DISHWASHERS . .. . •• - -----AIR HANDLING UNITS --- S'—"--
ELECTRIC HOT WATER HEATER -.. -..-. .. . HEAT PUMi>,, SIZE
LAUNDRY WASHER OUTLET UNIT HEATERS S
URINALS ' - • - -—'--_ 'AIR COOLING UNITS, SIZE ' - fvy - S.—... -"-
DRINKING FOUNTAINS •.• -•,. - • COMMERCIAL H000 . •• •• S
SUMPS, SPRINKLER VACUUM BREAKERS OTHER S
DRAINS .._ ._ . .. •
-- S - - -- -
OTHER $':
- TOTAL FIXTURES . . . . ....... . . . _ . . _ S ------
TOTAL MECHANICAL FEE tit S
:DER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE -
:R THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
t HER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
RED IN INVESTIGATION AND OEFENSE OF SUCH CLAIM),WHICH MAY SE MAOE 6Y ANY PERSON. INCLUDING THE UNDERSIGNED,
'GAINST THE CITY OF FEDERAL WAY,GUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
'•!O EMPLOYEES, UPON T - ACCURACY OF THE INFORMATION SUPPLIED TO THE CIrf AS A PART OF THIS APPLICATION.
NT: _ '
DATE: b- .) l