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90-101963r D O (n D D-U U � K T T T < p (n r U) co D -0 r U) IN � Z X m � 0 0 m C) �C� r 3= W M m C. m r Cn Z <=� iZ cn T Z Z M Z � m n m m D r m Z D 2 r 1 � m 3 m im m D m -zi m 33 m z D 0 X m�� n D m 0: � D O m c� m n � cni c O� n� m �t o m m D m o n c m m z = m m m m m O oo m m-a 3 m U) m z< im G� r m '� m m �' U) D z z m GDj zD N m m m m m m -1 m z CI hj O rW m cn o� Fm m z m Z m o �jp� dNz z O HHOO L-1 CO �O m rr� mm o ~ 01 10 G N • W� za ul Ul O W �P 00 m 00 O- 0 �o 0 0 0 O O D n Z Z C> z O c CI7 CA O o N C m T Lri N O Z n w m { T D m m m �) vm H z m D ZE D m (�rj� D <0 o m G L=J Cam" y N z- C m 7C H d zi H z L z m C� cn M r m �o a) LTJ z Cl) p m G) T G n D F-� m p z O D O 0 a m m ❑ m G) m z m 01 r n m = z m In o M m 0 K(n m n n m m Om om id D c� H �Od fn j Ln m Z CO O \O p m m m O z D m m O n D m n 0 C r- c m FQ O N z O m W H N id S c m m D Z n y W r z D v c o m O 70 r �P v 00 H m a i H H N z CD Z m O O IM z 3 ',roi N N 70 c O 0 z p� 01 z m O �� l H C)i z z m r M o C13 m v o v v m N v C❑ D X O D D O x m dm Z 0 y C) n= r p '�' U, -A m r 3 m D z m m m O z n m o I ! o Z 0 c N = D z G1 D ' r D D Z_ ZT. O r- hi V y D r > D o 1 j rr[jj m I o C Fr N f 1 nIM 3 N nm � Z m G) v m g z W H m OT K m c m p H, S N m G r p C m M � D z a < m I 0 m m 0O I { mIM �� b co r I Lid n D ift v N I cc 11I Z H �a Permit # I'L' Rece/vIeCITY OF FEDERAL WAY 9 0 �� 19 63 CNN � C1T,�, 131990 BUILDING PERMIT APPLICATION Q��Q —Please Print — \� y au1� SRA w BOX 1 TENANT NA - _zel 7 OWNER fSGf_ �1�uylarrsk —1)1- LH"_ SITE LOCATION �LZ tS40r:E_�i 31/1/ 7� OWNER'S ADDRESS_ �• t:� 41ck:.z &/&. c AwCITY PHONE 5f3Z— el 70 DESCRIBE JOB 1,7t.joe rEle lGf- THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME _ CONTRACTOR'S REG. # APwiIIC71`d'174S`" Card MUST be presente CONTRACTOR'S ADDRESS 14 7-41 Alc —5 . CITY PHONE S_A�. 5 d 3 7 7 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 Q ` � ' PHONE_!E6,3 -- 0 2,J8 BOX 4 SEWER DISTRICT _ WATER DISTRICT BOX 5 ESTIMATED PROJECT COS J, EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 0$2-1d e/ -- LEGAL DESCRIPTION S. Z (If necessary, please submit arate page with the legal description.) K.C. Plat Recording # _ BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR / 3RD FLOOR / BASEMENT—J.— - DECK------]— GARAGE / BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = } Q--T EXISTING STRUCTUR f,\j COMMERCIAUINDUSTRIAL TOTAL AREA OF TY T a I i_C_ C --SO FT BOX 9 PLUMBING FIXTURES (including rough -ins) MECHANICAL APPLIANCES — BASIC FEE $ N0. 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 HEAT PUMPS, SIZE $ LAUNDRY WASHER OUTLET UNIT HEATERS $ URINALS AIR COOLING UNITS, SIZE $ DRINKING FOUNTAINS _COMMERCIAL HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS —OTHER. _ _. $ DRAINS $ OTHER $ 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 BYTHE OWNER OFTHE 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 E CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS OFFICERS AND EM LO EE$, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: U • DATE: ANP-003 3P ZONE SETBACKS:FRONT_ PLANNING DEPARTMENT APPROVAL REMARKS: SEPA: EXEMPT FIRE DEPARTMENT APPROVAL REMARKS: —_.— — PUBLIC WORKS DEPARTMENT REMARKS: OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) SIDE _ REAR HEIGHT LIMIT NOT- EXEMPT DATE ( --'- — 70 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. X OTHER OCCUPANCY Z TYPE OF CONSTRUCTION STORES ? r 1 BUILDING SO. FT. ©y @ -3 7 O = 3 8 /7 0 -d & BUILDING SQ. FT. @ _ BUILDING SO. FT. @ _ BUILDING SO. FT. @ BUILDING SQ. FT. @ 644 BUILDING SO. FT. @ _ TOTAL SO. FT. TOTAL VALUATION 76 3 BUILDING DEPARTMENT REMARKS: RECEIVED ASSIGNED ADDRESS: S _E -,( { t( V PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE TOTAL BLDG. FEES PART P/C FEE a SEPA REVIEW U S.B.C.C. FEE OTHER FEES AMOUNT DUE o PARTIAL PLAN CHECK FEE RECEIVED Amount Date _ Receipt # BUILDING DEPARTMENT APPROVAL BY� DATE ACCEPTED FOR FILING