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SET BACKS AND FOOTINGS
DATE BY
O.K TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE
PLUMBING ROUGH IN
DATE BY
WATER LINE O.K.
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE _ _BY
O.K. TO ENCLOSE FRAMING
DATE 3 ' BY
INSULATION
DATE _ BY
WALL BOARD AND FIRE WALL
DATE _ ���Il BY
FINAL O.K. TO OCCUPY
I �y;� h�
DATE ����-C)/ BY ✓L1�-/_� J-
DCC]
PSp
FD
S��[LC� �I� ��4�/Cf7l✓v
C{E-Gfffiv
Li�iF'✓Q �J l,rL6
.'
rmit #
1 �U-r'- -4
�I I�lO-L 0S8
RECEIVED CITY OF
FEDERAL WAY
BUILDING PERMIT APPLICATION
FEB 19 1991
—
Please Print
CITY OF OF FE "Epal 141
_
OWNER 13CEZ
SITE LOCATION f 1
OWNER'S ADDRESS k, nd
V, I CITY
FPHONE 9. -Z 7_ �
DESCRIBE JOB Ica+r & I L'st:,
THE PROPERTY IS OWNED BY: SINGLE/MARRIEb
PARTNERSHIP
CORPORATION x
BOX 2 CONTRACTOR'S NAME i
U CONTRACTOR'S REG.
CONTRACTOR'S ADDRESS ` CITY
Card MUST be presented',,"
PHONE C-X3� -303.3
EXPIRATION DATE i -_ I
+
—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- ^ h �i r
PHONE., 5=3 =
BOX 4 SEWER DISTRICT
WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
-- — 07
LEGAL DESCRIPTION -
- -
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # c2, t � ,I Z 1 ZLC er-:� I !�!
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST FLOORS a 2ND
FLOOR 1
3RD FLOOR / BASEMENT
DECK I
GARAGE /
BOX 8 ( } SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = }
(ISTING STRUCTURE
( } COMMERCIAUINDUSTRIAL
TOTAL AREA OF PROPERTY
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES
— BASIC FEE $
NO.__�__WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
NO. —FURNACE. ELEC.
GAS_ $
SHOWERS
GAS HOT WATER HEATER
$
LAVATORIES
CONVERSION BURNER
$
_SINKS
BOILER, SIZE* BTU
$
DISHWASHERS
AIR HANDLING UNITS
$
__ELECTRIC HOT WATER HEATER
BEAT PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER
$
DRAINS
_ $
4OTHER
TOTAL FIXTURES
$
"-_ 2, k) , 0 0
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 CITN 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 THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGEN
ANP-008 3/9C
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE t26' SETBACKS: FRONT &2'a
PLANNING DEPARTMENT APPROVAL
nr_RAARICC•. J.,. . Ra. �rr1��.rY' 1
SEPA: EXEMPT_ NOT EXEMPT
FIRE DEPARTMENT APPROVAL C7
REMARKS:447iZ PYIC04171
SIDE REAR i(/X_,4? HEIGHT LIMIT
DATE 2-- __,� -9 r '71
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS: Alllfi
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT_ _X, NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY + - TYPE OFCONSTRUCTION �A�l STORES
BUILDING SQ. FT. .1-ti @ 3y, 7D = _
f BUILDING SQ. FT. 6 @
BUILDING SO. FT. @ _
BUILDING SO. FT. @ �--- _
BUILDING SQ. FT. @
BUILDING SQ. FT. @
TOTAL SO. FT.
BUILDING DEPARTMENT REMARKS:
FEB 19 1991
CITY OF FEDERAL 4
BUILDING DEPT.
RECEIVED
ASSIGNED ADDRESS: S�F
Amount
BY
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
TOTAL VALUATION
Z7 Y 3
PERMIT FEE
_s 7
PLAN CHECK FEE
3$'
PLUMBING FEE
Zo vd
MECHANICAL FEE
TOTAL BLDG. FEES
- 1LS, _ e)
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE y° S`p
OTHER FEES f=D 7 O
AMOUNT DUE ' zl- % 7o
++ BUILDING DEPARTMENT APPROVAL q
tr� ? r i
DATE