90-100374CITY OF
FEDERAL WAY
BUILDING PERMIT BUILDING
941!N SSECTION
9 Al - /t)n 2-7v
PERMIT NO.
90-515 P OWNER'S NAME MUELLER DEVELOPMENT JOB ADDRESS 35420 25TH AVENUE S.W. (REC. RO
CONTRACTOR
SUNRISE PLUMBING INC ADDRESS 1415 2ND ST N.W. AUBURN CONT. PHONE 874-4083
CONT. REG. NO.
SUNRIPIL640A OWNER'S PHONE 824-2112 OWNER'S ADDRESS 19550 PACIFIC HWY S. SEATTLE
TYPE JOB: NEW RESIDENCE ADDITION NEWINDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY
(UNITS ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO.
810427-0543 LEGAL DESCRIPTION
ISSUED BY
JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 5-3-90
BUILDING INFORMATION
NE
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
_ 2 ELEC. HOT WATER HEATER
GAS PIPING FT. BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS 3_
COMPRESSOR TANK(S)
SHOWERS
—_1URINALS
FORCED AIR FURNACE _ AIR HANDLING UNIT
NUMBER
LAVATORIES
2 DRINKING FOUNTAINS
GAS HOT WATER HTR. MISC.
RETURNED
SINKS
_I MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES 9 X 5-4.5_ 0
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
45. 0!1
CHANICAL FEE _
TAL BLDG. FEES
q
DATE:
PART P/C FEE
SEPA REVIEW
AMOUNT: -----
WATER SERVICE
WATER MAIN CHG.
RECEIPT: V,
S.B.C.C. FEE
�xJ
OTHER FEES
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��G'
OWNER OR AGENT DATE
4)
Roo Rz-k
•
`rmit # 9") S /S
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNERa tn—o-,--` SITE LOCATION .ice/ '2,�
OWNER'S ADDRES 5- ct d w SO CITY PHONE
DESCRIBE JOB Z 7--
THE PROPERTY IS 0 ED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION X
BOX 2 CONTRACTOR'S NAME 5 h res Yl�w� 6�` -Z�l _ CONTRACTOR'S REG. #//D/XC/O14
Card WUST be presented
CONTRACTOR'S ADDRESS �%/`� Ni ft IV IN CITY ��u�h PHONE A2V-Yr&
EXPIRATION DATE >�'—! 90
—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 PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 2 SCO EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #//_,? /-/Z
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( SINGLE FAMILY (�,/j NEW CONSTRUCTION
( ) MULTIFAMILY (N0. OF UNITS ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
:� •
PLUMBING FIXTURES (including rough -ins)
NO. Z WATERCLOSETS
BATHTUBS
1 SHOWERS
_
LAVATORIES
_SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEET
$
N0. FURNACE, ELEC. GAS
$
—1—GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE / Z D BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE
$
COMMERCIAL HOOD
$
_ OTHER —_-�—
$
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, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
/
ANP -008 3/90
FEDERAL WAY°` BUILDING
CITY OF
PERMIT BUILDI941NG
55ECTION
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
ONE
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
PLUMBING FEE
ECHANICAL FEE
TOTAL BLDG. FEES
�Yy .. �..L
PART P/C FEE
✓
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
,e
S.B.C.C. FEE
OTHER FEES
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
CIO _qy� 90 -�Y�?o
0
0
SET BACKS AND FOOTINGS
DATE_ . ... .....
OX TO POUR FOUNDATION WALLS
DATE -_BY . ...... . ....
PLUMBING GROUNDWORK
DATE BY
PLUMBING IN
DATE k!�Q _;,0..BY_.,_
WATER LINE O.K. . .... ..
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
161f / BY
DCD
PSD
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