90-101437cl 0—
CITY OF BUILDINGlINSP INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
"INSPECTION REQUEST LINE -946-6794
90-1657 P DAVID SEIS
28222 MILITARY RD S
PERMIT NO. OWNER'S NAME
JOB ADDRESS
MT RAINIER PLBG POB 171 MCRENNA
531-6256
CONTRACTOR ADDRESS
CONT. PHONE
MTRAIP*196D7 3/91 271-8864
SPAM
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_ PLUMBING ONLY
TAX ACCOUNT NO. —..*A7 231240-0210 LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE
"INFORMA
DATE OF APPLICATION 10/12/90
BUIL
ZONE NA OCCUPANCY NA TYPE OF CONSTRUCTION_
PLUMBING ONLY BLDG. SO. FT NA
T BACKS: FRONT NA SIDE NA _ REAR ____ NA _
_ STORIES NA HEIGHT LIMIT NA
LUMBING NO. NO.
MECHANICAL APPLIANCES
AMT. AMT.
BOND
WATER CLOSETS 3 ELEC. HOT WATER HEATER 1
GAS PIPING __ FT,
BOILER
BATHTUBS 2 LAUNDRY DRAINS
COMPRESSOR
TANK(S)
RECEIVED _
SHOWERS URINALS
FORCED AIR FURNACE
_ AIR HANDLING UNIT
NUMBER _
LAVATORIES 3 DRINKING FOUNTAINS _
GAS HOT WATER HTR.
MISC _
SINKS _1 misc. BASIC FEE 20.00
CONVERSION BURNER
BASIC FEE
RETURNED
DISHWASHERS 1 TOTAL FIXTURES 11 X $5.00
UNIT HEATER
TOTAL MECHANICAL NONE
AMOUNT NONE
VALUAJION NONE
PERMIT cEE
PLAN CF'ECK FEE
PLUMBING FEE $ 75-00
MECHANICAL FEE
TOTAL BLDG. FEES $ 75-00
RT P/C FEE
'EPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
DATE PAID AMOUNT
$75.00 RECEIPT /
OTHER FEES
AMOUNT DUE $ 75.00
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 INFORMAT ON FURNISHF,D BY ME TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET%
OWNER OR AGENT
0 `
DATE
. Permit #
CITY OF FEDERAL WAY RECEIVED
BUILDING PERMIT APPLICATION iOCT 121990
— Please Print —
BOX 1 TENANT NAME:
OWNER 4, d 2- SITE LOCATION Old.
OWNER'S ADDRESS CITY64-61
PHONE -
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME C%/ z4iazi„ r 1 cw) >i�, s CONTRACTOR'S REG. #r )fir t',r' /qlr
Card MUST be presented
CONTRACTOR'S ADDRESS 1e V 12Z CITY d)(k"244 PHONE �- J
EXPIRATION DATE —1 - .11 - `f /
—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 Z>12 1)/) PHONE U 1- Z. -S -'
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 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 # /7 l t
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK______J_ GARAGE /
BOX 8 (t,') SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
:1 M.
PLUMBING FIXTURES (including rough -ins)
NO. `� 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: > J _G`'?'m-V'4 6"( DATE:
ANP -008 3/90
CITY OF
FEDERAL WAY
BUILDING PERMIT BUILDI41
NG INSPECTION
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 NEWINDUSTRIAL 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
PART P/C FEE
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
°{
S.B.0 C. FEE
*- wvwvs r;u D
$75.00 R==PT
OTHER FEES
_AMOUNIT
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
. ...... ....
OX TO POUR FOUNDATION WALLS
DATE _BY . ... ...
PLUMBING GROUNDWORK
DATE . . .... .... . _.. BY. 4ff .. .. . . . . ...........
PLUMBING ROUGH IN
DATE_ 4W BY
WATER LINE O.K.
GAS PIPING 0. K. .... .
. . ..... __ . .....
.... ....
MECHANICAL INSPECTION
DATE _ - . ... ... . --BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE
WALL BOARD AND FIRE WALL
DATE
FINAL O.K. TO OCCUPY
DATE BY
DCD
PSID
FD
Z
7-1i