92-100460CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
q'.�_ Joov/'fo
BUILDING INSPECTION
661-4140
92-382 RA S R WAGENHALS 30643 21ST AVE SW
PERMITNO. OWNER'S NAME
SITE ADDRESS
CONTRACTOR S R WAGENHALS ADDRESS
30643 21ST AVE SW FEDEAL WAY CONT. PHONE 874-4031
CONT. REG. NO. WAGENC141NR EXP_ 8/92
OWNER'S PHONE 874-4031 OWNER'S ADDRESS 30643 21ST AVE SW FEDERAL WA
TYPEJOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL
NEWCOMMERCIAL COMMERCIAL ADD INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER RF.MODET. -- Ann nFTACHED SHED /GRADING
TAX ACCOUNT NO. 416770-0010-04
LEGAL DESCRIPTION LOT 1; LAKOTA PALISADES DIV 1
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE DATE OF APPLICATION 3-12-92
BUILDING INFORM TIO
ZONE RS SET BACKS: FRONT 20
SIDE -51 REAR 51 HEIGHT LIMIT
OCCUPANCY Ml TYPE OF CONSTRUCTION VN
CENSUS NO. TYPE OF HEAT BLDG. SQ. FT. 440 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
PLANNING
DEPT APPROVAL�I. DRIVEWAY TO CARPORT PARKING AREA SHALL BE PAVED
VALUATION 7,085.76
PER FWAC - 10 5 6.10 5 . PAVING TO SHED NOT REQUIRED.
HEMLOCK SHALL BE RETAINED AND PROTECTED PER
99.00
PERMIT FEE
64.00
FWZC 90.15 (ATTACHED) DB 4-17-92
PLAN CHECK FEE
PLUMBING FEE
PUBLIC WORKS DEPT APPROVAL: PROOF OF SEPTIC TANK PUMPING SHALL BE PROVIDED
ECHANICAL FEE
PRIOR TO FOOTING APPROVAL. JS 4-17-92
FWRT P/C FEE
SEPA REVIEW
BUILDING
DEPT APPROVAL: KC 4-16-92
PUBLIC WORKS
S.B.C.C. FEE 4 - -tin
FIRE FEE
DATE:
OTHER FEES
AMOUNT:
$167.50
AMOUNTDUE 167-Sn
RECEIPT:
J
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 F FINISHED 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
Q Q
DATE _ �L '!
Peep - qq r 3 6-;� el
�pR 12199,.E CITY OF FEDERAL WAY
�r BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME: W ,je��
OWNER S,1=• WA6tEMKA;t_S SITE LOCATION 5CIC-f'`t3 ZA Psvc
OWNER'S ADDRESS 3&&43 Z1 4U6 :W CITY 6 V PHONE 879
DESCRIBE JOB RaM12ML — AINQ
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERS IP I CORPORATION
BOX 2 CONTRACTOR'S NAME '- WA rte r+ALS CONTRACTOR'S REG. # 444SN C, 141 W �.
Card MUST be presented
CONTRACTOR'S ADDRESS 50(,13 M I Ay 15� S,\h/ CITY F- k1 PHON 37
EXPIRATION DATE S' —1 S-9 Z�
—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 �T )1) PHONE n1-40 3 1
BOX 4 SEWER DISTRICT `4% S WATER DISTRICT F5
BOX 5 ESTIMATED PROJECT COST ��,� "� EXISTING BUILDING VALUATION 110,5-00 s
BOX 6 PROPERTY TAX ACCOUNT NUMBER 4 l (eM — c0t I>
LEGAL DESCRIPTION I.Lr I "Ia A pALi S ji
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST FLOOR t �/ CQD 2ND FLOOR I
CW /IC
3RD FLOOR ---------I -, BASEMENT --------J '-- DECK LT_Z / i 242 GARAGES /
BOX 8 ( 'SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
(✓f EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY C :3 1 SOC)
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 CORRECTTO THE BE0,46F MY KNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERRlI APPLICATION IS
MADE. I FURTHER AGREE TO SAVE HARM LESS THE CITY OF FEDERAL WAY AS TO ANY CLAI M (INCLUDING COSTS; EXPENSES,'* ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, NCWDING 7'HE 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: :?�, -- ra-T z
ANP-(= 3/90
OFFICE USE ONLY PLEASE DO NOT WRITE BELOW T?iIS LINE
ZONE SETBACKS: FRONT SIDE �� REAR �� HEIGHT LIMITO
PLANNING DEPARTMENT APPROVAL
4Yti:� SUR AML 21��� If/1yA,
Wa buMna shall enemaefi onto anv bulydrna setback trop er paSemcnt *"AlAm nr "^$. "qam Y
SEPA: EXEMPT --V- NOT EXEMPT
FIRE DEPARTMENT APPROVAL
DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL Q
DATE
REMARKS: hemr- DF Sa:orc io,,JX &),m ,,fyg, S14,IGC
RG
IO Z oV6 14&-& U4 -t- ,
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 AJ
STORES
6" e. BUILDING SQ. FT. � ® @
3 O =
A C) 5- 2 -
BUILDING
BUILDING SQ. FT. @
_
BUILDING SQ. FT. @
_
BUILDING SQ. FT. @
_
BUILDING SQ. FT. @
BUILDING SQ. FT. @b
_
TOTAL SQ. FT.
TOTAL VALUATION
70 g -c 7
BUILDING DEPARTMENT REMARKS:
RECEI
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
PERMIT FEE T I
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
j/ BUILDING DEPARTMENT APPROVAL
BY DATE r
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
ONE
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
f
PART P/C FEE
�
SEPA REVIEW
1
PUBLIC WORKS
S.B.C.C. FEE
L
qFIREFEE
DATE:
1
OTHER FEES
AMOUNT:
ID
AMOUNT DUE
RECEIPT:
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
AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
OWNER OR AGENT
DATE
Ax 6 A (i — 9 o celz
SET BACKS AND FOOTINGS
"-
DATE
OX TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE--_ __ BY
WATER LINE OX. . ... .... . .... ..
GAS PIPING O.K.---,,,
MECHANICAL INSPECTION
DATE -BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE ... . . ... ... ____BY ___ . .... .....
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TO OCCUPY
DATE __.__BY
DCD
PSD
FD