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RECEIVED
SEP 0 6 1990 CITY OF FEDERAL WAY
CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION (..(....
BUILDING DEPT. -Please Print-
BOX 1 TENANT NAME:
OWNER W1641114 014 EDN)eA'rtou 49.9cd.SITE LOCATION 33434 1 AYE go. F WA.
OWNER'S ADDRESS .�...: "A - . CITY_LD. L IA PHONE94%—6'ka0
DESCRIBE JOB £ 'NQre GPAce To ou.W1=' USE. ( o?IQD 0i
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP COR RATION Y.
BOX 2 CONTRACTOR'S NAME DulNEIe (Lt„)E# 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 CONTA T PERSON N .3ML.F 946-4/so / 021S1'' M ILLS PHONE 94to "4'7A6
BOX 4 SEWER DISTRICT FIDE L.. I.UA LWATER DISTRICT FEDERAL. w44
BOX 5 ESTIMATED PROJECT COST As SICOO EXISTING BUILDING VALUATION a• 414 WI
BOX 6 PROPERTY TAX ACCOUNT NUMBER RA 6.501 —• D I20 - *0 5
LEGAL DESCRIPTION Lerr IA WE'S, 0.4mPv3 oFFIce.. PARK D 1.1• a
(If necessary, please submit rate page with the legal description.)
K.C. Plat Recording#
BOX 7 BUILDING SQUARE FOOTAGE: (Existin roposed) 1ST FLOORL� 2ND FLOOR /7 060/
3RD FLOOR -�-• / BASE ENT -� / DECK -B- / GARAGE
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) (X) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY /4a/6:3/ SO FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. ATERCLOSETS GA PIPING, EET $
— BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
W LAVATORIES CONVERSION BURNER $
W SINKS BOILER, SIZE BTU $
DISHWASHERS IR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS,SIZE $
1 LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS IR COOLING UNITS, SIZE $
A DRINKING FOUNTAINS COMMERCIAL HOOD $
M SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
MIL DRAINS $
OTHER $
MIK 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 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 HE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: ldZC:::-Kria-d *- . DATE: 9 —
ANP-008 3/90
OFFICE USE ONLY(PLEASETO NOT;WRITE BELOW THIS LINE) r 7;i0•-
ZONE SETBACKS: FRONT SIDE REAR_ HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL -
REMARKS: ,)/* Ala c Ali 2 ( CA (J.('e_ ocC c,(f q&C
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE e--(�/ -? y
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVALAO. 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 &Z TYPE OF CONSTRUCTION 1/-4.1 STORES
BUILDING SQ. FT: @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION 8c5c50
BUILDING DEPARTMENT REMARKS: PERMIT FEE fire oe
PLAN CHECK FEE 6N,00
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES (6 3-
PART P/C FEE O
SEPA REVIEW
S.B.C.C. FEE V.
OTHER FEES 1tb y Y S
AMOUNT DUE ( 7 Z- ' Y
c
ASSIGNED ADDRESS: SE- - QK(S
- 1--( fit
-fb 4;0
//M��0o y,��n8 PARTIAL PLAN CHECK FEE RECEIVED
y0
03 9O �°Amount Date Receipt#
tSO BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE -1 "1 Q - GTd ACCEPTED FOR FILING
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