91-100198CITY OF
FEDERAL WAY
BUILDING PERMIT
q/ -/001 9s>
BUILDING INSPECTION
941-1555
91-165 RA RON
L BROSMER
30255 24TH AVE SW
PERMIT NO. OWNER'S NAME
JOB ADDRESS
CONTRACTOR OWNER ADDRESS
CONT. PHONE --
CONT. REG. NO. OWNER'S PHONE 661-0984 OWNER'S
ADDRESS P.O. BOX 3177 FEDERAL WAY
TYPE JOB: NEW RESIDENCE ADDITION Xx NEW INDUSTRIAL
NEW COMMERCIAL COMMERCIAL
ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN
GRADING OTHER
BASEMENT
TAX ACCOUNT NO. 089375-0001
LEGAL DESCRIPTION LOT 1
BLOCK 1 VIEW CLIFF
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE .7 —13TL�
DATE OF APPLICATION 2-13-91
BUILDING INFORMATION
ZONE OCCUPANCY
TYPE OF CONSTRUCTION
BLDG. SO. FT.
T BACKS: FRONT SIDE
REAR
STORIES HEIGHT LIMIT
LUMBING NO. NO.
MECHANICAL APPLIANCES AMT.
AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER
GAS PIPING FT.
BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS
COMPRESSOR
TANK(S)
SHOWERS URINALS
FORCED AIR FURNACE
AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS HOT WATER HTR.
MISC.
RETURNED
SINKS MISC.
CONVERSION BURNER
BASIC FEE
DISHWASHERS TOTAL FIXTURES
UNIT HEATER
TOTAL MECHANICAL AMOUNT
VALUATION 2 nen 0
BUILDING
DEPT APPROVAL:
MM 2-26-91
PERMIT FEE 4 5 _ n n
PLAN CHECK FEE 29-0 n
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
T P/C FEE
PA REVIEW
WATER SERVICE
ATE:
Q
3 -/a //1
WATER MAIN CHG.
S.B.C.C. FEE 4 _ 50
OUNT:
78.50
OTHER FEES
AMOUNT DUE 7R-50
CEIPT:
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS
STARTED. -RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BEM
OWNER OR AGENT
DATE _/pl / 1
Permit #
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME: r,�c) Aj �pS'��► ie
OWNER X0 N L . V.5 W. S fIIE&C SITE LOCATION 504-'�5 a{'t-- Ayl: SW , Fea9&4 ( wa
OWNER'S ADDRESS F-0, Ac K 3177 CITY F ee&_m ( A.. PHONE 666-0WV ?71-�c
DESCRIBEJOB F:jwQ4 AN oPjEyiS'1FED AWIVNEWT
THE PROPERTY IS OWNED BY: SINGLE/MARRIED S/ni G4, PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME 6LJ 1kJek — See "ove. CONTRACTOR'S REG. #
CONTRACTOR'S ADDRESS
EXPIRATION DATE
CITY.
—OR—
PHONE
Card MUST be presented
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 I-0 N L, 8R0,5°aHDA
BOX 4 SEWER DISTRICT SEPT(C WATER DISTRICT F-ewe.'a 1. wqt ,
cif? 773-26v7
BOX 5 ESTIMATED PROJECT COS - 000 EXISTING BUILDING VALUATION /7 5f TO
BOX 6 PROPERTY TAX ACCOUNT NUMBER % 13 z — o of) I
LEGAL DESCRIPTION Lair .1, Mock I- i IV/e- w C1_IFF0 MING CQUA;TY
(If necessary, please submit a se arate ge with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Propos d) IST FLOOR / 2ND FLOOR /
3RD FLOOR_____J_ BASEMENT_ DECK______J_ GARAGE /
BOX 8 ( SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS EXISTING STRUCTURE
( ) COMM ERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY INMewle cf = 6a 0 SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
N0. 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 0!F MY KNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APpL1CATION 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, INCLUPING 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: 2-0
ANP4= 3/90
OFFICE USE ONLY (PLEASE -DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL T�2
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL h/a DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL, DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT -Y NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY 92, TYPE OF QONSTRUWTION VAI _ r STORES
„ - � BUILDING SO. FT. ��� @
BUILDING SO. FT. @ T =
BUILDING SO. FT. @
BUILDING SO. FT. @ _
BUILDING SO. FT. @ _
BUILDING SO. FT. @ _
TOTAL SO. FT. — TOTAL VALUATION Coe)
BUILDING DEPARTMENT REMARKS:
00 G •
EIVED
ASSIGNED ADDRESS: .Sem 64.1
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
PERMIT FEE _ y- -�
PLAN CHECK FEE 0
PLUMBING FEE
MECHANICAL FEE _
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
Receipt #
BUILDING DEPARTMENT APPROVAL
BY DAT
ACCEPTED FOR FILING
CITY ^OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
BUILDING INSPECTION
661-4140
PERMIT NO.
OWNER'S NAME SITE ADDRESS
CONTRACTOR
ADDRESS
CONT. PHONE
CONT. REG. NO.
EXP. OWNER'S PHONE OWNER'S ADDRESS
TYPEJOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD.
NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY
(UNITS ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO.
LEGAL DESCRIPTION
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
NE
SET BACKS: FRONT SIDE REAR
HEIGHT LIMIT
OCCUPANCY
TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG. SQ. FT.
STORIES
PLUMBING
NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS
LAUNDRY DRAINS
FORCED AIR FURNACE DUCT WORK
SHOWERS
URINALS
GAS HOT WATER HTR. AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
CONVERSION BURNER MISC.
RETURNED
SINKS
MISC.
BBQ BASIC FEE
DISHWASHERS
TOTAL FIXTURES
DRYER TOTAL MECHANICAL
AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
RT P/C FEE
SEPA REVIEW
PUBLIC WORKS
S.B.C.C. FEE
FIRE FEE
DATE:
OTHER FEES
AMOUNT:
AMOUNT DUE
RECEIPT:
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
OWNER OR AGENT
DATE
SET BACKS AND FOOTINGS
DATE BY
OX TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE_0041 BY
.1
WATER LINE O.K.
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE BYIt O
O.K. TO ENCLOSE FRAMING
DATE (O BY
INSULATION
DATE BY
WALL BOARD AND FIRE WALL
DATE /D �1 BY -� -
FINAL O.K. TOO CUPY
DATE BY
DCD
PSD
FD
0 - 0
CITY OF
FEDERAL WAY
BUILDING
PERMIT
BUILDING INSPECTION
941-1555
PERMIT NO.
OWNER'S NAME
JOB ADDRESS
CONTRACTOR
ADDRESS
CONT. PHONE
CONT. REG. NO.
OWNER'S PHONE OWNER'S
ADDRESS
TYPE JOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL
NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC
PUBLIC ADD.
NEW MULTI -FAMILY (UNITS
) MULTI. ADD. SIGN
GRADING OTHER
TAX ACCOUNT NO.
LEGAL DESCRIPTION
ISSUED BY
03 In i
DATE OF ISSUE
DATE OF APPLICATION
BUILDING INFORMATION
ZONE
OCCUPANCY
TYPE OF CONSTRUCTION
BLDG. SQ. FT.
SET BACKS: FRONT
SIDE
REAR
STORIES HEIGHT LIMIT
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT.
AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT.
BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR
TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE
AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS HOT WATER HTR.
MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER
BASIC FEE
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER
TOTAL MECHANICAL
AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
sm
UMBING FEE
HANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
Elk
SEPA REVIEW
WATER SERVICE
�j
WATER MAIN CHG.
G� /
S.B.C.C. FEE
®�OT�
OTHER FEES
B
AMOUNT DUE
V •
ALL PERMITS EXPIRE 180 DAYS
AFTER ISSUANCE IF NO WORK IS
STARTED.,RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
REQUIREMENTS WILL BE MET:
AND THE APPLICABLE CITY OF FEDERAL WAY
�� n
' u \M
0
y\„
OWNER OR AGENT
DATE
• 0
SET BACKS AND FOOTINGS
DATE BY
OX 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 c _BY
O.K. TO�EN O FRAMING
DATE �%"' BY _�
INSULATION
DATE BY
WALL BOARD AND FIRE WALL
DATE —71,e BY —
FINAL O.K. TO OCCUPY
DATE BY
DCD
PSD
FD