90-101720CITY OF
FEDERAL WAY
BUILDING
9b-/01 71�0
PERMIT, B�e'ECTION
90-1508
MH RAYMAN J. COREY 3&1-W
PERMIT NO.
OWNER'S NAME JOB ADDRESS
CONTRACTOR_ BRYCE BARTHOT,CiMEW
ADDRESS 10702 43RD ST CT E. PUY kT.T.TTP WA
CONT. PHONE AAS.—"l 0
CONT. REG. NO. BMMOBHSI2EDS
OWNER'S PHONE 941_-5162 OWNER'S ADDRESS Al R 1 3 21ST
AVIR SW FRflRRAT, WAY
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 MnSTT.F. Emmy. SRTTIP
TAX ACCOUNT NO. 1 221 03-9050
LEGAL DESCRIPTION SOUTIR 314 OF SR 114 OP SN
114 OF SE 114, LESS
ISSUED BY JAMA
JOHNSON DATE OF ISSUE DATE OF APPLICATION 9-18-90
BUILDING INFORMATION
ZONE RM 3600
OCCUPANCY R3 TYPE OF CONSTRUCTION vN
BLDG. SO. FT. R40
SET BACKS: FRONT 5
SIDE ( REAR -0- STORIES
HEIGHT LIMIT ZA
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 31,696
-no
BUILDING DEPT APPROVAL: KC 10-1-90
PERMIT FEE 63.00
PLAN CHECK FEE
41-00
LUMBING FEE
CHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
I
SEPA REVIEW
DATE:
WATER SERVICE
WATER MAIN CHG.
AMOUNT: I �._
S.B.C.C. FEE
4.50
OTHER FEES
RECEIPT: (1!/ �'
AMOUNT DUE
108_50
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:
3
BIER OR AGENT
'` DATE
RECEIVED 0 L _ iwilrit #
$gip 18 SO CITY OF FEDERAL WAY
YBUILDING PERMIT APPLICATION 7'g,;�zE K
— Please'Print —
BOX 1 TENANT NAME: 2�:':1�= <_ , LAJ
OWNER T SITE�IWN-.jt► �'` S• W
OWNER'S ADDRES 3 s . W. CITY PHONE
DESCRIBE JOB -
THE PROPERTY IS OWNED BY: SINGL RRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME1� ruGG. FBQ*+k(L(n r'M e_k2 CONTRACTOR'S REG.#,glM hFS M
Card MUST be presented
CONTRACTOR'S ADDRESS _107.09 f 3 r 4 Sf Cfi e' CITY 1 v . PHONE IY539/6
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 PHON
BOX 4 SEWER DISTRICT rVA P MA LOAte WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 70.D •�= EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION t f
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR______J_ 2ND FLOOR /
3RD FLOOR_____J_ BASEMENT______J_ DECK / GARAGE /
BOX 8 (•-)'SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
NO.__j__WATERCLOSETS
BATHTUBS
SHOWERS
_LAVATORIES
_SINKS
DISHWASHERS
_ELECTRIC HOT WATER HEATER
_LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
MECHANICAL APPLIANCES — BASIC FEE $
GAS PIPING, FEET
$
NO._I FURNACE, ELEC. GAS
$
GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE
$
COMMERCIAL HOOD
$
OTHER
$
MECHANICAL FEE
$
I CERTIFY UNDER PENALTY OF -PERJURY THAT THE INFORMATION FURNISHE-913Y ME IS TRUE AND CORRECT TO THE BEST OF MYWOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT AP LICATION 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: se,0:2-1
ANP -OW 3/90
0 _ '""' •
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONER��3�'SETBACKS: FRONT S SIDE REAR— HEIGHT LIMIT
PLANNING DEPARTMENT AP ROVAL '�V' e --
REMARKS: 11
CODA• CVC\ADT 61AT CVC&ADT
FIRE DEPARTMENT APPROVAL
REMARKS: d " .1,
PUBLIC WORKS
REMARKS:
DATE
DATE
BUILDING DEPARTMENT REMARKS:
ASSIGNED ADDRESS:
PERMIT FEE
63 ° c'a
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
MECHANICAL FEE
OCCUPANCY �� TYPE OF CONSTRUCTION I
--AJ " STORES
A BUILDING SO. FT. AMC) @
�� _ �{zt� O
BUILDING SO. FT.
SEPA REVIEW
BUILDING SO. FT. @
BUILDING SO. FT. @
00.
BUILDING SO. FT. @
_
BUILDING SO. FT. @
_
TOTAL SO. FT.
TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
ASSIGNED ADDRESS:
PERMIT FEE
63 ° c'a
PLAN CHECK FEE
• O
PLUMBING FEE
10
MECHANICAL FEE
0
TOTAL BLDG. FEES
PART P/C FEE
o
SEPA REVIEW
a
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
PARTIAL PLAN CHECK FEE RECEIVED
'ro118 3y unt Date Receipt #
a
`d.� `7 BUILDING DEPARTMENT APPROVA
BY C', DAT
CEIVED v�l ,
ACCEPTED FOR FILING
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
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
ZONE
OCCUPANCY
TYPE OF CONSTRUCTION _
BLDG.SO.FT.
SETBACKS: 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
Ull-DING
DR" APPROVA%-� lxO
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
i
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
_._�__
S.B.C.C. FEE
OTHER FEES
_
i.C�AMOUNT
DUE
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
,O -r /
DATE
PLUMBING ROUGH IN
DATE ___—. BY
O.K. TO ENCLOSE FRAMING
DATE __ __—.BY
FINAL O.K. TO OCCUPY
Tiiv L
O. ALLS
DATE 51-L-? 9_�L_BY �1S —_
PLUMBING GROUNDWORK
DATE
WATER LINE O.K. __ _ —_
GAS PIPING
MECHANICAL INSPECTION
DATE ____ —._— _BY
INSULATION
DATE -------BY ._
WALL BOARD AND FIRE WALL
DATE _ __ _ BY
DCD
PSD
FD
DATE _ S''02-9_1�?r
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