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SET BACKS AND FOOTINGS
DATE _ _ BY _ _ _ _
O.K TO POUR FOUNDATION WALLS
DATE ________BY _ _
PLUMBING GROUNDWORK
DATE ___. _ _ BY
PLUMBING ROUGH IN
DATE BY
WATER LINE O.K. _
GAS PIPING O.K._ _
MECHANICAL INSPECTION
DATE ___BY
O.K. TO ENCLOSE RAMING
BATE BY
INSULATION
DATE _____BY
WALL BOARD AND FIRE WALL
DATE
FINAL O.K. T OCCUPY
DATE_BY
DCD PSD
FD
RECEIVED
J U N Z 51990
Cl y of; FEDERAL BU LDINQ DEPT.
AY
BOX 1 TENANT NAME:
Per--iit # T
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
90-1019�e
OWNER _ 1.��;An� K II1r�`!!rti SITE LOCATION f3y. ,ems
OWNER'S ADDRESS 22o CITY 1Cjw r PHONE
DESCRIBE JOB %24e&L Lz
THE PROPERTY IS OWNED BY: SINGLE/Wffil D PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S ADDRESS
EXPIRATION DATE
CONTRACTOR'S REG. #
Card MUST be presented
CITY PHONE
—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 _�-zrf G- �f�i'- PHONE 9 31 - /)`/ I
,---BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COSTW EXISTING BUILDING VALUATION $_o, coo
BOX 6 PROPERTY TAX ACCOUNT NUMBER, 6 8"t `►`7 d "0 ° 10 -A
LEGAL DESCRIPTION Gd-f l SG1a+901,* ,r, a.VAijrJ .LW. I A! t4/-c- V 0iM- ,A.&cA00 .4
I)01_a1n6 ;-U 0y Ag7s — 41
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR ACD FL—O-jb �y
3RD FLOOR / BASEMENT / DECK J RAGE. 1
BOX 8 ( ) SINGLE FAMILY
( ) IFAMILY (NO. OF UNITS = )
( COMMERCIAUINDUSTRIAL
( ) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY _ _
SO 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
HEAT PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER
$
DRAINS �
$
[ _OTHER �,_j7^ o-S'r ;
$
t1�
TOTA FIXTURES
$
�c ao
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 CITY 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/AGENT:
DATE:
ANP-008 3/90
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
SIDE REAR HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL -
DATE Q
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL _A 144
DATE
REMARKS: / `'
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT
NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALTX NEW MULTIFAMILY
(UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY 6`►` TYPE OF CONSTRUCTION
0 A%
_ STORES
BUILDING SO. FT. _
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SO. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
TOTAL SO. FT,
TOTAL VALUATION
7 G
BUILDING DEPARTMENT REMARKS:
PERMIT FEE
R o va
PLAN CHECK FEE
54coc>
PLUMBING FEE
loy
MECHANICAL FEE
TOTAL BLDG. FEES
o O
PART P/C FEE
-
SEPA REVIEW
S.B.C.C. FEE
If -So
OTHER FEES
AMOUNT DUE
- So
Vl �b�j�Q3�j SO�ur0
06& 5 Z Nnr
-3Al.j0.jkj
RECEIVED
ASSIGNED ADDRESS: n
Amount
BY
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
DATE— 7
ACCEPTED FOR FILING