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RECEIV Permit # , h VC ,C1
eiA:
JUL
1 - 1992 CITY OF FEDERAL WAYOISCAEDERALFEw `1
AYBUILDING PERMIT APPLICATION (, A ���
- Please Print— "^'d�
BOX 1 TENANT NAME: 1.- --/ 5 142 29(,
OWNER Nf n f-till IA r (9a M1-- SITE LOCATION 5/=a-- e
OWNER'S ADDRESS 1)-f 5 X1'6 CITY Fel u/47I PHONE l 6/6 E fr/
DESCRIBE JOB /2 i/4. po 4.-GI
THE PROPERTY IS OWNED BY: SINGLE/MARRIED ( PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME 6.1: ,� e r 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 j,. etr-i (A-i' b PHONE k 3 "s G I/c
BOX 4 SEWER DISTRICT WATER DISTRICT - - --
BOX 5 ESTIMATED PROJECT COST g' r ISTING BUILDING VA SAT : 1
BOX 6 PROPERTY TAX ACCOUNT NUMBER 1 (L3-'7 G 7 — O U 0 S U
LEGAL DESCRIPTION L, 1- / /3c r•C / Qc,n'- vtC el « '.:f.r---,
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording# ---
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE }
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY .-4 /)5-ti C:: 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 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 KNO LEDGE
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: /i,z,,i, � /
DATE: '7 - /- r 2--
ANP-008 3/90
i
•
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE I5'0 SETBACKS: FRONT c" SIDE St REAR 5 HEIGHT LIMIT ; at f f:t
PLANNING DEPARTMENT APPROVAL 7710/92
REMARKS: /fa w c r- . in1� !h /-�° Gt r-G y t.d .:2� eAl ,i#;
SEPA: EXEMPT tr' NOT EXEMPT
FIRE DEPARTMENT APPROVALd(A DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE Z.--
REMARKS:
iREMARKS:
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. OTHER n-tht(A-t5 ((/q (t
OCCUPANCY TYPE OF CONSTRUCTION ¶1/V STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION 2- 2-a 0
BUILDING DEPARTMENT REMARKS: PERMIT FEE
PLAN CHECK FEE _ 3,r
PLUMBING FEE
MECHANICAL FEE •
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
Pt16Gb0 3S`ro
S.B.C.C. FEE 1-(e-S-0
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS: S C°2--
PARTIAL
°2 -PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE C Z ACCEPTED FOR FILING
411 • • 72.9? - eepy6,-
. Ik/ - cf,.0 ,2•16 -6et.
GEOTECH
CONSULTANTS, INC.
13256 N.E.20th St.(Northup Way),Suite 16 November 2 , 1992
Bellevue,WA 98005
(206)747-5618 JN 92285
FAX 747-8561
John Urban Jr .
29805 Pacific Highway South
Federal Way, Washington 98003
Subject : Final Letter
Geotechnical Engineering Observations
921 Southwest 296th Street
Federal Way, Washington
Dear Mr . Urban:
Geotech Consultants , Inc . provided geotechnical engineering
observation and testing services during the construction
of your rockery, which was placed south of the existing
residence in Federal Way, Washington. We also provided a
Rockery Detail and recommendations for the design of this
rockery. Our work began on June 29 , 1992 , and was completed
on August 18 , 1992 .
To the best of our knowledge, the work which we observed, in
accordance with the scope of our services , was generally
performed in conformance with our recommendations .
Field memos and letters regarding our observations have been
attached. If there are any questions , or if we can be of
further service, please contact us .
Respectfully submitted,
GEOTECH CONSULTANTS , INC.
Burton R. Holt P.E .
Geotechnical Engineer
FIAT/
w5
C..
-e . ;.�
--'4 �f � 141
11
+ ' SS'ioNAL 1t17-
EXPIRES 8/ t7/ 73 ,
'k . James R. Finley, Jr . P .E.
Principal
ttachments
110 1110
•
CITY OF POST THIS CARD ON CF,)r)T OF BUILDING
= ® � BUILDING DEPARTMENT
N:)-: INSPECTION RECORD
NSPECTION REQUEST PHONE NO. 661-4140
Request must be received by 3:30 PM for next day inspection
SEE REVERSE FOR ADDITIONAL INFORMATION
PERfv11T NO.: 92-0986 SETBACKS-FRONT: 20.00 SIDE: 5. 00 REAR: 5. 00
OWNER'S NAME: JOHN URBAN
SITE ADDRESS: 912 SW 296TH ST
( ) FOOTINGS-SETBACK
( ) FOUNDATION WALL
:C30.NOT POUR OO.N. CRETE:UNTIL THE ABOVE IS`APP:ROVED
( ) PLUMBING GROUNDWORK
) UNDERFLOOR FRAMING
) ROUGH PLUMBING: Drain/waste vent Water line Service line
( ) MECHANICAL Gas Pi*g
( ) SHEATHING Exterior vv&is Roof Floor
g' C }4.3' ',! :.�.lT'l. Z�nr.��'A'/: ! 'f ll�:R ++11a'a�� s�;}y► �� r w,lra� rs...= r+ — ' X
—.:. . Y mss. r ■ -..A ilr ra+.r#iw:}I..:�O.v i td.`- r+e►"e�rvC'i M_L�:1,111.1J\1.'S'C fl a t:c:�`C.1:-f'1,aVAi: :
INSPECTION DIVISION MUST BE GRAN o EU PRIOR TO FRAMING INSPECTIOIII
( ) FRAMING
lDO I`,OT GOFER 1 N'Y WORK UNTIL T IE ABOVE I'S APPROVED
( ) INSULATION: Floors Walls Attic
DOF NO 'r APPLY' WALLB ARt"1. NTIL THE ABOVE IS APPROV:EC3. " '
) WALLBOARD NAILING
APPLY NOT PING MATERIALS UNTIL `'9`HE ABOVE IS APPROVE[9:
SUSPENDED ACOUSTICAL CEiLI\'G FRAMING '
( ) PLANNING DEPARTMENT
( ) PUBLIC WORKS DEPARTMENT
( ) FIRE DEPARTMENT
( ) FINAL INSPECTION (Building Department) 4(5 C 6/
DO N;OT OCCUPY TI.-1IS BUILDING UNTIL FINAL APPRO1fAL
1110 •
•
The following information is provided as required by Washington State Law for ttFiose projects costing more
than five thousand dollars: (REF.: RCW 19.27.095)
OWNER — CONTRACTOR
JOHN URBAN I *OWNER IS CONTRACTOR*
912 SW 296TH
FEDERAL WAY WA 98023
946-6911
*OWNER*
LENDER
PARCEL NO.: 195460-0005
4
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INSPECTION LOG
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SET BACKS AND FOOTINGS 0.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE BY DATE _Bv DATE BY
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DATE _BY -_ _ _ GAS PIPING O.K. __ DATE _-_ BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE 8Y_-_____- _ DATE _- ____BY DATE Bv
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