91-100847CITY OF
FEDERAL WAY
434
BUILDING PERMIT
9/- o 8-Y7
BUILDING INSPECTION
941-1555
PERMIT NO. 91-797.5
OT OWNER'S NAME CHET/CAROL SABOTKA JOB ADDRESS 28717 PACIFIC HWY S
CONTRACTOR OWNER
ADDRESS 2436 SW 355 ST FEDERAL WAY CONT. PHONE 838-1569
CONT. REG. NO. NA
OWNER'S PHONE SAME OWNER'S ADDRESS SAME
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 INSTALL STAIRS FROM HYW 99 TO PARKING
LOT
TAX ACCOUNT NO. 332204-9158 LEGAL DESCRIPTION THE NO. 136' OF THAT POR OF THE SO. 236'
OF
THE SW
i OF THE SW !-OF SEC 33 T 22 R 4 EAST IN KING CO WASH
SUED BY ELIZABETH SNYDER DATE OF ISSUE Z DATE OF APPLICATION 6/17/91
BUILDING INFORMATION
ZONE BC
OCCUPANCY M-2 TYPE OF CONSTRUCTION 5—N BLDG. SQ. FT. NA
SET BACKS: FRONT 20'
SIDE 5' EACH REAR_ 5' _ STORIES NA HEIGHT LIMIT NA
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 NONE
UNIT HEATER TOTAL MECHANICAL NONE,
AMOUNT
NONE
VALUATION $1,000
-on
PLANNING DEPT APPROVAL = LORI SCHILL
PERMIT FEE $25-00
C HE
PLAN CK FEE 16-00
FIRE/BLDG DEPT APPROVAL = KEVIN ELLIS
uMBINGHE FEE
CHANICAL FEE
PUBLIC WKS DEPT APPROVAL = TOM COLLINS
TOTAL BLDG. FEES $41.00
PART P/C FEE
_
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
4.50
OTHER FEES PUB. WKS.
35. 00
DATE PD - / 2- -?I AMT $80. 50 RE' CT
AMOUNT DUE $80.50
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 FrNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
i"
// C—
f
OWNER OR AGENT
_/ DATE
RECEIVED
JUN 17 1991
r.pDEWypu1lAN EPL AY
BOX 1 TENANT NAME:
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
lav 7-7-a^4 a/=
/N P�OS� Gj LO
OWNER UlYeT V- C.' a G t- Q bt SITE LOCATION
OWNER'S ADDRESS X5_34 __3 CITY -!'- 7
DESCRIBE JOB '/ iti �o
THE PROPERTY IS OWNED BY: SINGLE/MARRI PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S ADDRESS
EXPIRATION DATE
CITY
off MW
CONTRACTOR'S REG. #
Card MUST be presented
PHON
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 M_a L IIL44 r.w-(fl PHONE S3 0 %-1 t1 f
BOX 4 SEWER DISTRICT - WATER DISTRICT �--=
BOX 5 ESTIMATED PROJECT COST'Zr-VT .- EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LFGAL.,DESCRIPTION
(If necessary, please submit a separate page with the legal description.
K.C. Plat Recording #
id r df zj
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK------/— GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
PLUMBING FIXTURES (including rough -ins)
N0. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES,
SINKS 1
DISHWASHER
ELECTRIC HOT WATER HEATER
LAUNDRY WAS R OUTLET
URINALS
DRINKING FOUNTA NS
SUMPS, SPRINKLE 'VACUUM BREAKERS
DRAINS
OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEET
$
N0. FURNACIr, ELEC. GAS
$
GAS HOt, WATER HEATER
$
CONVERION BURNER
$
BOILER, ZE BTU
$
AIR HAND ING UNITS
$
HEAT PU S, SIZE
$
UNIT HEA ERS
$
AIR CO )LI G UNITS, SIZE
$
COMMERCI L 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 EMPLOYEW, UPON THE AWRACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE: i l
ANP -008 3/90
ZONE SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFI USE ONLY (PLEASE DO NOT WRITE BELOW TH LINE)
�SIDE REAR SHEIGHT LIMIT
SEPA: EXEMPT Y NOT EXEMPT
FIRE DEPARTMENT APPROVAL r� DATE 7- ` !r4
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE ? zTL
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. OTHER
OCCUPANCY M -_� TYPE OF CONSTRUCTION V"t) STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
RECEIVED
ASSIGNED ADDRESS:
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
BY K DATE
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE f ��
OTHER FEES
AMOUNT DUE
ACCEPTED FOR FILING
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 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
iUED BY
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
ZONE
OCCUPANCY_ TYPE OF CONSTRUCTION
BLDG. SO. 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
#Z
Mon no
VALUATION
PI MING DII.F' XPPROVA.L - LORI SCHI"
PERMIT FEE
PLAN CHECK FEE
_
FlR /P1., v DEPT At PROV IL FIN ELLIS
OJMBING FEE
MECHANICAL FEE _
PUBLIC W -AS DEPT APPROVAL = TONA CO"INS
TOTAL BLDG. FEES _
PART P/C FEE
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
a,..._ °A#IT 80. 50
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
0 0
SET BACKS AND FOOTINGS
DATE . ...... . . BY
OX TO POUR FOUNDATION WALLS
DATE . ...... . .... ... -, _13Y ____
PLUMBING GROUNDWORK
DATE ___ . . . ...... _.___._BY
PLUMBING ROUGH IN
DATE,_____ __BY . ........
WATER LINE O.K.. ..... .. . ... ... __
GAS PIPING O.K._ ____ . . .... ..... . .... ..
MECHANICAL INSPECTION
DATE . .... .. . .... .. . ___BY
O.K. TO ENCLOSY FRAMING
!�_ BY
DATE ,_4/� VI_
INSULATION
DATE . . .... .... . ..... ...
WALL BOARD AND FIRE WALL
DATE . .. . BY -_ , __ - . ...
FINAL O.K. TO OCCUPY
DATE _7/5* BY
DCD
PSD
FD
_)Z Z