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SET BACKS AND FOOTINGS
O.K TO POUR FOUNDATION WALLS
DATE _ _ _BY _
_
DATE BY
PLUMBING ROUGH IN
WATER LINE O.K. _
DATE _ BY
_ -
GAS PIPING O.K. _
O.K. TO ENCLOSE FRAMING
INSULATION
DATE BY__
DATE __-_BY
FINAL O.K. TO OCCUPY
dCd
P5d
DATE. �'/Ss2BY
v Z_ A
10000.Z
PLUMBING GROUNDWORK
DATE -- -- BY - __--
MECHANICAL INSPECTION
DATE _ _BY
WALL BOARD AND FIRE WALL
DATE _ BY
FD
r t-1-4 64v�X X-04 / C
Permit # �i
l —�.? 6 vt
RECEIVE] "►� toss
CITY OF FEDERAL
WAY
0IR '16 iN BUILDING PERMIT
APPLICATION
— Please
Print —
i'sERALWAY
DEPT.
BOX 1 TENANT NAME:
OWNER 'S
SITE LOCATION !1'L-5. IN. 33u'r�
OWNER'S ADDRESS - i1 rry
CITY Fc, W 4)� PHONE
$52Z6 6
DESCRIBE JOB I lys-TALL d rf -
GeO c,44-D 'Poe t--
THE PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ` _ Gl�l-
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 CONTACT PERSON
PHONE
BOX 4 SEWER DISTRICT Eli�/��-- L(I/t�
WATER DISTRICT ^'
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER_ 3 306 2 070-"d6-
LEGAL DESCRIPTION _ 6.07 %, ]�rLd c Z.
/SfaL I►ut= V/ P,A1 ¢ 1-44 Ag-SeC_
F/JeS-7 Abbi
(if necessary, please submit a separate page with the le al
descriptl n.)
K.C. Plat Recording # 1/a 5 i d r C
H7' CE 1�
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST FLOOR / 2ND FLOOR 1
3RD FLOOR / BASEMENTS DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = J
( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —
BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET _
$
BATHTUBS
NO. FURNACE, ELEC. GA5
$
SHOWERS
GAS HOT WATER HEATER
$
LAVATORIES
CONVERSION BURNER
$
SINKS
BOILER, SIZE BTU
$
DISHWASHERS
AIR HANDLING UNITS
$
ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
__t ACOOLING UNITS, SIZE_
$
DRINKING FOUNTAINS
L�IR
0MMERGIA0O
$
SUMPS, SPRINKLER VACUUM BREAKERS
t__ -OT EF�R—
$
DRAINS-r
$
OTHER
�'tl'.h r -�
"ram $ _
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 PfRMIT,APPLICATION IS
MADE. I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY ASTO ANY CLAIM (INCLUDING COSTS, EXPENStS,'AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING.'PE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFIr -RS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
.7
01 m` DATE:
ANP-008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONEB 7 Z SETBACKS: FRONT # , • IDE �REAR :f HEIGHT LIMIT _ k1
PLANNING DEPARTMENT APPROVAL �._�� :.Z. S/,:'
REMARKS:
r
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
DA
PUBLIC WORKS DEPARTMENT APPROVAL %G DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALTO NEW INDUSTRIAL IND. ADD/ALT.
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY( (UNITS
MULTIFAMILY ADD/ALT TENANT IMP. OTHER , iW VASt t ✓`^ : G
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SO. FT. @ _
BUILDING SO. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SO. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
RECEIVED
APR 2 61991
` BUILDING DEFT AY
RECEIVED
ASSIGNED ADDRESS
Amount
BY
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
DATE
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE S 6
OTHER FEES
AMOUNT DUE
ACCEPTFr