90-10031490 . /00 3/
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
TENANT: SHOP RITE
90-432 TI
WEST COAST GROCERS 35447 21ST S.W.
PERMIT NO. OWNER'S NAME
JOB ADDRESS
CONTRACTOR DWINELLS CENTRAL NEON
ADDRESS 3614 6TH AVE S SEATTLE
CONT. PHONE 292$865
CONT. REG. NO. DWINECN204M1
OWNER'S PHONE 572-0112 OWNER'S ADDRESS 1525 E "D"
STREET TACOMA
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 CONSTRUCTION OF AN AWNING
TAX ACCOUNT NO. 252103-9002-02
LEGAL DESCRIPTION (SEE ATTACHED)
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE DATE OF APPLICATION 4-24-90
BUILDING INFORMATION
BC OCCUPANCY
M2 _ TYPE OF CONSTRUCTION VN
BLDG. SQ. FT.
7NE
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 x.480-0-0-
MUST
MEET REQUIREMENTS OF ZONING CODE, SEC 115.85
3
PERMIT FEE 99-00
_
SEPA EXEMPT
PLAN CHECK FEE 64.00
PLUMBING FEE
CHANICAL FEE
DATE:
TAL BLDG. FEES
PART P/C FEE
AMOUNT:
SEPA REVIEW
WATER SERVICE
RECEIPT: o
WATER MAIN CHG.
S.B.C.C. FEE 4 _ 90
OTHER FEES
AMOUNT DUE 167-50
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,�,,,,
-�
OWNER OR AGENT l�c-�'l.✓us� -
DATE
•
famit # (� o — `(
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER JA; �..Si +kV. r 0.p ,F S SITE LOCATION s - 1'N 7�-
OWNER'S ADDRESS l5�� >c `'(L�T�gF�r `!gwal CITY PHONE 7-2-
DESCRIBE JOB jN.s MoN -- get u1&
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION iZ
BOX 2 CONTRACTOR'S NAME DA)l u F t , N F pli CONTRACTOR'S REG. # o u osW I
Card MUST be presented
CONTRACTOR'S ADDRESS 3&f Li roT AoF- S PHONE .292 2N�A-"
EXPIRATION DATE
IM
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 150NNIG nLNj1a.u4e A- % 6i2uC& 010,.j gNT- PHONE ca.12-t9_86S7
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST s& -6,560 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER a52 /03 q00 �Z 0.7,
LEGAL DESCRIPTION ajar—H E!O
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION X30 1,1^54,L Fwew-
( ) MULTIFAMILY (NO. OF UNITS = ) ( EXISTING STRUCTURE )--0OT0kG4�_.
(�4) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9
PLUMBING FIXTURES (including rough -ins)
N0. WATERCLOSETS
BATHTUBS
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
$
GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE 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:, DATE: :.tG- 90
ANP -008 3/90
0
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE__ SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL ['_ r�=' ` . .5"` /5— yFo
REMARKS: `f"J el�, c,,C, , s4;G, l t S, xs
SEPA: EXEMPT___ NOT EXEMPT
FIRE DEPARTMENT APPROVAL 4 DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL A A DATE—
REMARKS:--
TYPE
ATEREMARKS:_
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 _�/� Z TYPE OF CONSTRUCTION ✓AJ STORES
k BUILDING SQ. FT. @
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @
BUILDING SQ. FT. @ A/It) OTt -V U `
TOTAL SQ. FT. TOTAL VALUATION 7 y d'd . c U
BUILDING DEPARTMENT REMARKS:
ASSIGNED ADDRESS:
Amount
RECEIVED
PARTIAL PLAN CHECK FEE RECEIVED
Date
PERMIT FEE
C_l-__
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
b
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE 167
Receipt #
BUILDING DEPARTMENT APPROVAL
DATE 5_ f G
ACCEPTED FOR FILING
CITY OF
FEDFRAL 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
xs'i ,�: ie, .i .a a.E� ..•s __ . _ ZLI, .L,vi ,.0DE4, iii. I.L5.
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
+
SEPA REVIEW
.�. ...,
WATER SERVICE
£+ EIPT:
WATER MAIN CHG.
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:
•'rt
OWNER OR AGENT
DATE
o
mol
PSD
PLUMBING GROUNDWORK
DATE BY
MECHANICAL INSPECTION
DATE BY
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