90-100109CITY OF
NG
FEDERAL WAY BUILDING PERMIT BUILDI941!N 55ECTION
96-/00/04
PERMIT NO. 90-151 OWNER'S NAME
TOM MOSLEY/GAGNON HOMES JOB ADDRESS 30541 26 AVE SW
CONTRACTOR GAGNON HOMES
ADDRESS 19011 WEST VALLEY HWY A101 KENT- CONT PHONE 251-0732**DON
CONT. REG. NO. GAGNOH115103 1/91
OWNER'S PHONE 251-0732 OWNER'S ADDRESS SAME AS ABOVE
TYPE JOB: NEW RESIDENCE XXX 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. 416660-0670
LEGAL DESCRIPTION LOT 6 BLR 7 LAROTA
ISSUED BY ELIZABETH SNYDER
DATE OF ISSUE DATE OF APPLICATION 3/21/90
BUILDING INFORMATION
NE RS15 OCCUPANCY R-3
TYPE OF CONSTRUCTION 5-NBLDG. SO. FT. 4550+832 GARAGE
SET BACKS: FRONT 20 SIDE
5' EACH REAR___ _ 5 _ STORIES 2 HEIGHT LIMIT 301 MAX
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS 4 ELEC. HOT WATER HEATER
GAS PIPING FT. 3.50 BOILER
BATHTUBS 4 LAUNDRY DRAINS
1
COMPRESSOR TANK(S)
RECEIVED _
SHOWERS 1 URINALS
FORCED AIR FURNACE 10.00 AIR HANDLING UNIT
NUMBER _
LAVATORIES �_ DRINKING FOUNTAINS
_
GAS HOT WATER HTR. 6.50 MISC.
SINKS 1 MISC.
CONVERSION BURNER BASIC FEE
RETURNED _
DISHWASHERS I TOTAL FIXTURES
18X5.00
UNIT HEATER TOTAL MECHANICAL 20.00
AMOUNT NONE
VALUATION $2861,865-010
PERMIT FEE $1294_ OD__
PLAN CHECK FEE R41-00
PLUMBING FEE 90-00
FEE _ 20-0 0
SCHANICAL
TAL BLDG. FEES $4 S _ 0 0
PART PIC FEE
DATE PAID
SEPA REVIEW
C� -
WATER SERVICE
AMOUNT PAID
WATER MAIN CHG.
S.B.C.C. FEE 4.50
RECEIPT #
OTHER FEES
AMOUNT DUE $2249.50
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 INFORV.kTION FURNISHED BY ME
IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE
N
OWNER OR AGENT
DATE-
/ V/
0
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNER ILI h yu`�L_ `G C-f.-/vU/v I OB LOCATION
OWNER'S ADDRESS 0? WF W -10 CITY EN, 1 W PHONE F-51- 7
DESCRIBE JOB Sj�t3� ]�A-M.
THE PROPERTY IS OWNED BY: SINGLE/MARRIED v'1'_ PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME G C7/\)0Nu H- Q m En ZA)C CONTRACTOR'S REG.Card # T be presented \,
CONTRACTOR'S ADDRESS 11 O I1 YJF_j VtI..1=31 ad W CITY Kt PHONE 25_1 —0%3Z
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 VUN Llm-n Iyu N PHONE Ztl 1—CJ
BOX 4 SEWER DISTRICT �7 r, I IU) WATER DISTRICT t-). Vl nLr
BOX 5 ESTIMATED PROJECT COST 2.00. QQD EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 4 / / /.V ECY,-7 0
LEGAL DESCRIPTION L-CT.
'7 L._A Y_ oT-A-
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST FLOOR 2ND
FLOOR
3RD FLOOR / BASEMENT
/ DECK /
GARAGE.��
BOX 8 (SINGLE FAMILY
(�EW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY �95--GQ Q SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
N0. + WATERCLOSETS
MECHANICAL APPLIANCES — BASIC FEE $ p
GAS PIPING, FEET
BATHTUBS
NO.FURNACE, ELEC.
$
GAS $ O
__SHOWERS
GAS HOT WATER HEATER
C)01 000$ j 40
LAVATORIES
CONVERSION BURNER
riv $
t SINKS
BOILER, SIZE(X-,, L , 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
$
`�:-:�TOT L 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 KNOWLEDGf AND FURTHER THAT I AM A JTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER-
FORM THE WORK FOR HI �-I APP ATION S MADE.
OWNER/AGENT: DATE:
ANP -006 2/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE S I SETBACKS: FRONT 20' SIZE 5 ` REAR 5� HEIGHT LIMIT 30'
PLANNING DEPARTMENT APPROVAL 4•/0.90 • Ale,
RFMARKS: M[.7MvU41i 64MA6e 15 NOT 5191ENirD �4,5 1044ujt4 oAl Sirr PLA -rHe NG-trbf 510C-
> ,r"' Mi N [ f Sn `3 TNI RD P.4R K/N4 Sri -- EXGEQeS ro DE' Aly D
a -ED --.IofxA(,L A V_64
SEPA: EXEMPT X NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
DA'
PUBLIC WORKS DEPARTMENT APPROVAL &2r, DA
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.
ROOF OTHER
OCCUPANCY TYPE OF COS
RUCTION L 't/
STORES
SFR BUILDING SQ. FT.
l @'
.3111611)
60[k�e-� BUILDING SQ. FT.
@
1777
BUILDING SQ. FT.
d @
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
TOTAL SQ. FT.
@
_ --
TOTAL VALUATION 7
EBUILDING PERMIT N0. PLAN CHECK FEE REC'D
RECEIPT NO.
PERMIT FEE Z PLAN CHECK FEE
PLUMBING FEE
--= ^''--- MECH. FEE
TOTAL FEES SBCC SURCHARGE
ENERGY SURCHARGE
AMOUNT DUE '#
BUILDING DEPARTMENT APPROVAL -----------------------------
DATE
REMARKS
RECEIVED
ASSIGNED ADDRESS: 35 y� " t4A-
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
BUILDING PERMIT BUILDING
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. 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
MECHANICAL FEE
TOTAL BLDG. FEES
DNAT i PAID
PART P/C FEE
SEPA REVIEW
SOS W PAID
WATER SERVICE
WATER MAIN CHG.
•.
RE�� # ..."
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
SET BACKS AND FOOTINGS
DATE �-� BY
O.K TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN 0
DATE IL- BY r--C-
WATER LINE O.K. -... . .. . . ...... .
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE . . . ... ....
O.K. TO ENCLOS�AMING
DATE .. . . . . BY
INSULATION
DATE BY
WALL BOARD AND FIRE WALL
DATE
FINAL O.K. TO OCCUPY
DATE -.4�e7/77";/BY-
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