90-101942I v - I L31 fir.{
CITY OF
FEDERAL WAY
175 q's a c�o ti zd
BUILDING PERMIT BUILDING
PERMIT NO. 90-0050 OWNER'S NAME I]ORENBUSH HOMES JOB ADDRESS 4627 SW 327 PL
CONTRACTOR DORENBUSH HOMES ADDRESS
275 118 AVE SE #110 BELLEVUE CONT, PHONE 451-1994
CONT REG. NO. DORENI*21OM3 6f 90 OWNER'S
PHONE SAME AS ABOVE OWNER'S ADDRESS SAME AS ABOVE
TYPE JOB: NEW RESIDENCE ll�X ADDITION NEW INDUSTRIAL
NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD,
NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN
GRADING OTHER
TAX ACCOUNT NO. 189820-0120 LEGAL
DESCRIPTION Lot 12 DASH POINT GLEN
ISSUED BY elizabeth S]I'>:yder
DATE OF ISSUE DATE OF APPLICATION 312L90
BUILDING INFORMATION
ZONE RS9. 6 OCCUPANCY R-3
TYPE OF CONSTRUCTION 5-N BLDG. SO- FT 2987
SET BACKS: FRONT 20 SIDE 51 each REAR 51 STORIES 2 HEIGHT LIMIT_ 30 '
PLUMBING NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS 3 ELEC. HOT WATER HEATER
GAS PIPING FT, 3.50 BOILER
BATHTUBS 2 LAUNDRY DRAINS 1
COMPRESSOR ____ TANK(S)
RECEIVED
SHOWERS Ni 1 URINALS
FORCED AIR FURNACE 10.00 AIR HANDLING UNIT
NUMBER _
LAVATORIES 5 DRINKING FOUNTAINS
GAS HOT WATER HTR. 6_50 MISC.
1
RETURNED
SINKS MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS' 1 TOTAL FIXTURES 14
UNIT HEATER TOTAL MECHANICAL 20 pn
AMOUNT NC}AiF
VALUATION S1 5 7- 8 9 59 S_ O
PERMIT FEE $ 8.4 3 - 0 0
PLAN CHECK FEE S4,8nn
PLUMBING FEE 70. Of)
MECHANICAL FEE 90 - 00z
TOTAL BLDG. FEES $ 14 R ] _ n n
PART P/C FEE
[(�D_
SEPA REVIEW
PAID IN FULL
ON: 3jZ-)j)
WATER SERVICE
WATER MAIN CHG.
AMOUNT PAID:
�j L/
S.B.C.C. FEE 4.50
OTHER FEES $1485. 50
RECEIPT #:
3
AMOUNT DUE
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFOR?ATJPN FU a BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE T:
Cj
9 k �I
OWNER OR AGENT _ __ _
_ _ __ _ _ _ DATE [�
�Q
CITY OF
FEDERAL WAY
BUILDINGPERMIT BUILDING IN SSECTION
PERMIT NO.
OWNER'S NAME
JOB ADDRESS
CONTRACTOR
ADDRESS
"
CONT.PHONE
CONT. REG. NO.
u .
OWNER'S
PHONE OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL
NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL AD.D.
NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS
) MULTI. ADD SIGN
GRADING OTHER -
TAX ACCOUNT NO.
LEGAL DESCRIPTION -
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION.
BUILDING INFORMATION
ZONE
OCCUPANCY
TYPE OF CONSTRUCTION
BLDG. SQ. FT
SET BACKS: FRONT
SIDE-
REAR STORIES
HEIGHT LIMIT
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT BOILER
RECEIVED _
BATHTUBS -
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS _ ___-
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS HOT WATER HTR. MISC- _
^-
RETURNED _
SINKS
MISC. _
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES _
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE _
OTHER FEES
AMOUNT DUE
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS
STARTED. -RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE
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