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TO OCCUPY DATE � $'� DCD PSD FD ' G L •�Qv �CJC - 93 /�lz D ��.4i� /v c/z J��-£'/i GlZ 3j 2 Ir,4 .SoTi4 Y.&tlx l • /ASS �� /� ^ r,� � -z ra 7 /�./' C'./it�E%� ire [i/� ,_ -/'D e _L l" L ACC S 3 �. 90-IolasLA CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 OWNER HZ,1 G Lr /'cf' 1�1��I .+� JOB LOCATION 7 d/ 9 s6v 3 40_Z= ��/ _ —. OWNER'S ADDRESS ZP/9 5W 3 4o r ICI CITY f=tVa! PHONE 74 - 67.36 DESCRIBE JOB -El rtz /•eee '� ,JrCA� THE PROPERTY IS OWNED BY: SINGLE ARRI PARTNERSHIP- _ CORPORATION BOX 2 CONTRACTOR'S NAME CONTRACTOR'S ADDRESS EXPIRATION DATE . CITY _ — CONTRACTOR'S REG. # PHON Card MUST be presented — 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 6/A //ac c /4 '%3 _ PHONEZV/<' 9 3 / - S6// BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST — EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER O / 09 Z 0- 0 Z Se -o LEGAL DESCRIPTION Z 5 I 4 1 Div (If necessary, please submit a separate page with the legal description.) BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR J/ 2ND FLOOR 3RD FLOOR / BASEMENT —/ DECK / GARAGE / BOX 8 ;kj SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) COMMERCIAL/INDUSTRIAL BOX 9 PLUMBING FIXTURES (including rough -ins) N0. WATERCLOSETS y,/o o Wsr v ` BATHTUBS w /-r.4 e /e c T'.c i s _SHOWERS /o wtrt LAVATORIES SINKS _DISHWASHERS ELECTRIC HOT WATER HEATER LAUNDRY WASHER OUTLET URINALS DRINKING FOUNTAINS SUMPS, SPRINKLER VACUUM BREAKERS DRAINS OTHER TOTAL FIXTURES ( ) NEW CONSTRUCTION Oe EXISTING STRUCTURE TOTAL AREA OF PROPERTY -7oa o + SO FT MECHANICAL APPLIANCES — BASIC FEE $ GAS PIPING, FEET $ c' NO. —FURNACE, ELEC. GAS $ GAS HOT WATER HEATER $ CONVERSION BURNER $ BOILER, SIZE _ _ BTU $ AIR HANDLING UNITS $ HEAT PUMPS, SIZE $ UNIT HEATERS $ AIR COOLING UNITS, SIZE $ COMMERCIAL HOOD $ '�OTHER 144 a /•l Se,c % _ $ _ As:4O!Q-Pt cvIi*Vs $ 40kti.j n e A -c c-77 $ . YsA rc W $ — TO AL 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 PER- FORM THE WORK FOR WHICH PERMIT APPWATIDUla- LADE. OWNER/AGENT: DATE: 3/l z / 9a ANP-006 2/90 OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZONE SETBACKS: FRONT SIZE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL REMARKS: SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL REMARKS: DA 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. ROOF OTHER OCCUPANCY TYPE OF CONSTRUCTION STORES BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SO. FT. @ BUILDING SO. FT. - @ BUILDING SQ. FT. _ _ @ _ BUILDING SQ. FT. @ TOTAL SO. FT. TOTAL VALUATION EBUILDING PERMIT NO.. PLAN CHECK FEE REC-D RECEIPT NO. . PERMIT FEE PLAN CHECK FEE - PLUMBING FEE -------- MECH. FEE TOTAL FEES SBCC SURCHARGE ENERGY SURCHARGE AMOUNT DUE BUILDING DEPARTMENT APPROVAL - - - - - - - - - - - - - - - - - - - - - - - - - - - - - DATE REMARKS ASSIGNED ADDRESS: RECEIVED MAR 12 1990 CITY ❑F FEDERAL WAY BllI�RRAE ?T. ACCEPTED FOR FILING