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R 199 CITY OF FEDERAL WAY
, t, w BUILDING PERMIT APPLICATION
vow
othr."NG ow - Please Print—
BOX 1 TENANT NAME:
OWNER FEDERAL WAY SCHOOL DISTRICT SITE LOCATION Decatur High School
OWNER'S ADDRESS 31405 1 8th Ave. S. CITY Federal Way PHONE 941 -0100
DESCRIBE JOB Softball field renovation
THE PROPERTY IS OWNED BY: SINGLE/MARRIED n/a PARTNERSHIP n/a CORPORATION n/a
BOX 2 CONTRACTOR'S NAME 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 MARTY A. LYON, LANDSCAPE ARCHITECTS, P.S . PHONE 627-2324
BOX 4 SEWER DISTRICT Federal Way Sewer & Water WATER DISTRICT FEderal Way SEwer & Water
BOX 5 ESTIMATED PROJECT COST 197, 000 . 00 EXISTING BUILDING VALUATION N/A
BOX 6 PROPERTY TAX ACCOUNT NUMBER see attached
LEGAL DESCRIPTION see attached
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR n / a 2ND FLOOR n/a /
3RD FLOOR n/a / BASEMENTn/a / DECK n/a / GARAGE n/a /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) n/a ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. 0 WATERCLOSETS GAS PIPING, FEET 0 $
0 BATHTUBS NO._ 0 FURNACE, ELEC. GAS $
0 SHOWERS 0 GAS HOT WATER HEATER $
0 LAVATORIES 0 CONVERSION BURNER $
0 SINKS 0 BOILER, SIZE BTU $
0 DISHWASHERS 0 _AIR HANDLING UNITS $
0 ELECTRIC HOT WATER HEATER 0 HEAT PUMPS, SIZE $
0 LAUNDRY WASHER OUTLET 0 UNIT HEATERS $
0 URINALS 0 AIR COOLING UNITS, SIZE $
0 DRINKING FOUNTAINS 0 COMMERCIAL HOOD $
1 SUMPS, SPRINKLER VACUUM BREAKERS 0 OTHER $
DRAINS $
0 OTHER $
T A 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 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, UPO THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
, ► ,�3
OWNER/AGENT: DATE: ‘;
ANP-008 3/90
maid
OFCEUSE ONLY (PLEASE DO NOT WRITE BELOAiIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
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
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS: PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING