92-100177CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
9.�-/06177
BUILDING INSPECTION
661-4140
PERMIT NO. 92-119 CA OWNER'S NAME FAMILY PRACTICE DENTAL CTR SITE ADDRESS 31003 PACIFIC HWY S
CONTRACTOR COMM CONSTRUCTION ADDRESS 9834 16 AVE SW SEATTLE CONT. PHONE 763-0733
CONT. REG. NO. COMMUCC126JM EXP.4 92 OWNER'S PHONE 839-6544 OWNER'S ADDRESS SAME AS SITE
TYPEJOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER TENANT IMPROVEMENT ONLY
342000-1506 PARCEL A OF SP # 677167 RECORDED UNDER 771013-0850
TAX ACCOUNT NO. LEGAL DESCRIPTION
r.
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 1/27/92
BUILDING INFORMATION
ZONE BC SET BACKS: FRONT NA SIDE NA REAR NA HEIGHT LIMIT -NA- 35 FT
OCCUPANCY B-2 TYPE OF CONSTRUCTION 5—N CENSUS NO. 437 TYPE OF HEAT EXISTING BLDG. SQ. FT. NA STORIES NA
PLUMBING NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER
GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS
FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS
GAS HOT WATER HTR. AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
CONVERSION BURNER MISC.
RETURNED
SINKS MISC.
NONE
BBQ BASIC FEE
NONE
NONE
DISHWASHERS TOTAL FIXTURES
DRYER TOTAL MECHANICAL
AMOUNT
$6,500
VALUATION
PLANNING DEPT APPROVAL = BILL KINGMAN
$180.00
PERMIT FEE
PLAN CHECK FEE 59.00
"NO NON-CONFORMANCE PER CH 165, ZONING CODE IDENTIFIED. PROPOSAL
LUMBING FEE
IS EXEMPT FROM SITE PLAN REVIEW PER CH 175.10.2.6, ZONING CODE AS
ECHANICAL FEE
NORMAL MAINTENANCE"
PART P/C FEE
SEPA REVIEW
FIRE DEPT APPROVAL = KEVIN ELLIS/CHRIS INGRAM
PUBLIC WORKS
4.50
S.B.C.C. FEE
9.00
BLDG DEPT APPROVAL = KEVIN ELLIS
FIRE FEE
DATE:
$252.50 "DOUBLE FEE ASSESSED BECAUSE WORK WAS STARTED
OTHER FEES
$252-50
AMOUNT:
WITHOUT BUILDING PERMIT"
AMOUNT DUE
RECEIPT:
4tcl
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 INFORM,FURNISHED , BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE €uIET.
OWNER OR AGE AtT - - - - DATE c
L w TY OF FEDERAL WAY
BUILDING DEPARTMENT
ALL PERSONS ARE HEREBY ORDERED TO AT ONCE
STOP WORK
PERTAINING TO CONSTRUCTION, ALTERATIONS, REPAIRS
GRADING OR REGULATED EQUIPMENT
On these Premises at --3% 00 , &I"x–IG /f y Soyli/
This order is issued because .� r>sr� L ,� 50 /) A 7'
4 v /)z/ L) 9 y/LI)>/\,G ,Psi/-M/T` 4110
—�1 -�;a'e . 3v/ 400V/1-04/7 ti/ t®/mac- c-C'!Y
sec. 202(e) U.B.C. Office of Building Official
A.M.
Posted f S'y — % S 1992— By AJ Z 130b4 X1&4
WARNIThe failure to stop work, the resuming of work without permission from the
NG Building Official, or the removal, mutilation, destruction or concealment of
ANP -005 2/90 this Notice is punishable by fine and imprisonment.
0 40
Per # 0'� __ I 19
C IVSD CITY OF FEDERAL WAY Y`(
N'.
.JAN 211992 BUILDING PERMIT APPLICATION
01TY OF FEDERAL WAY — Please Print —
BOX 1 TENANT NAME: q r ajA
��t fi it
OWNER SITE LOCATION
OWNER'S ADDRESS - CITY&Iter—_/its✓_ PHONE ' 2Y -
DESCRIBE
y�r
DESCRIBE JOB
THE PROPERTY IS OWNED 11Y: SINGLE/MARRIED PA TNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME �/r� d't. ��sC� fj ti`°:fa'f7w®'ee, CONTRACTOR'S REG. # .
Card MUST be prese'14.,,g
CONTRACTOR'S ADDRESS VE:741'= Ale C CITY > PHONE 2 C� 1 6'7:4? c�¢
EXPIRATION DATE�yy�
OR
HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENETRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON PHONE 261 ---6;?_Yj
BOX 4 SEWER DISTRICT "— WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER S l)> --
LEGAL DESCRIPTION LzL
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # 2 7.10 1^ cid' 0
BOX 7 BUILDING SQUARE FOOTAGE: &Existin roposed) 1STOOR�U.3r,�/ %` 2ND FLOOR /
3RD FLOOR / EMENT / --DECK "� / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY // 0!? SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins) MECHANICAL APPLIANCES — BASIC FEE
N WATERCLOSETS GAS PIPI FEET $
BATHTUBS N0. RNACE, ELEC. GAS $
SHOWERS GA T WATER HEATER $
LAVATORIE CONVE N BURNER $
SINKS BOILER, SIZ BTU $
HW HERS AIR HANDLING S $
EL IC HOT WATER HEATER HEAT PUMPS, SIZE $
LAU Y WASHER OUTLET UNIT HEATERS $
U AL AIR COOLING TS, SIZE $
KINKING OUNTAINS COMMERC HOOD $
SUMPS, SPR KLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
1 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 e - DATE: / `r -
ANP -008 3/90
0 •
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONEbL2 SETBACKS: FRONT N(04 SIDE 04 REAR N(4, HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL I- ZS _72-.. Bic -
REMARKS: No P5V-Cc>Nf'0tL0 &xA4 PEt1 CVA lam_ 'l-awLNu co09 ""JS Q4
E)ep-mA-t FIL-V�k si-CE �PLA,%3 0LEu1E,A3 &F VL_ x.k 1-7 q. /D. 2 .b.
SFPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
35
DA
PUBLIC WORKS DEPARTMENT APPROVAL DATE
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
OCCUPANCYZ TYPE OF CONSTRUCTION STORES
ov
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @
TOTAL SQ. FT. TOTAL VALUATION .2 5 U G
BUILDING DEPARTMENT REMARKS:
RECEIVED
ASSIGNED ADDRESS:
( vl_
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE L-� Sd
OTHER FEESI=p -Fe-e- 17, 0C
AMOUNT DUE
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY - DATE '-S
ACCEPTED FOR FILING
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