91-101170CITY OF
FEDERAL WAY
BUILDING
PERMIT
BUILDING INSPECTION
941-1555
9) ,i0/f70
PERMIT NO. 91-1119 FSS OWNER'S NAME LORIMAR HOMES JOB ADDRESS 30951 36 AVE
SW
CONTRACTOR NORTHWEST
RESIDENTIAL ADDRESS 1625 ETHRIDGE OLYMPIA
CONT. PHONE 754-6475
CONT. REG. NO. NWRSF136MI 6/92 OWNER'S PHONE 847-9081 OWNER'S ADDRESS
8423 191
ST E PuyALLUP
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 FIRE SPRINKLER
SYSTEM (RESIDENTIAL)
TAX ACCOUNT NO. 058755-0050 LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH
SNYDER DATE OF ISSUE t
DATE OF APPLICATION 8190/91
BUILDING INFORMATION
ZONE NA
OCCUPANCY TYPE OF CONSTRUCTION_ -$-N-
S -N _
BLDG. SO. FT. 5776
SET BACKS: FRONT NA
SIDE NA REAR NA
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 $8.1
--42-00
FIRE/BLDG DEPT APPROVAL = REVIN
ELLIS
RMIT FEE $110.8_._00
_--
AN CHECK FEE 70-00---
n_nn__PLUMBING
PLUMBINGFEE
MECHANICAL FEE
TOTAL BLDG. FEES
Il
PART P/C FEE
lUX/
SEPA REVIEW
DATE:
WATER SERVICE
WATER MAIN CHG.
-
AMOUNT: 271.50
S.B.C.C. FEE 4-50
OTHER FEES FIRE D_ R9_00
RECEIPT:
AMOUNT DUE $271
_ 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- -`���
DATE
`\
A�CENEt)
AUG Z 0 1991
%0,
I'rEUEflAL WAY
�AI►MC W..
BOX 1 TENANT NAME:
0
CITY OF FEDERAL WAY
Per 1) 9
CJ's
BUILDING PERMIT APPLICATION
— Please Print —
OWNER r i rigw/ 140'- Cs SITE LOCATION 3) ( 3 L'(a ✓c 5,0, Fe A. V),.v 100.
OWNER'S ADDRESS �'�/Z 3 I j S CITY P0 V ', ✓e PHONE - 10 k'
DESCRIBE JOB Fr)n Cr
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION x
BOX 2 CONTRACTOR'S NAME fIX5, 'Jdyu f 154-f ONTRACTOR'S REG. #WOO 13 6 ►'h
Card MUST be presented
CONTRACTOR'S ADDRESS � �C CITY Q IV &f- PHONE 75% -�o'q7!5r
EXPIRATION DATE -�2 -
—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 Se rr
y L., rC
$
PHONE _74y- 6417S
BOX 4 SEWER DISTRICT j
�"µt° o ''~�.
WATER DISTRICT D
71 e al- --
BOX 5
ESTIMATED PROJECT COST
fo
EXISTING BUILDING VALUATION"
-
BOX 6
PROPERTY TAX ACCOUNT NUMBER_____F
UNIT HEATERS
- D
AIR COOLING UNITS, SIZE
$
LEGAL D SCRIPTION L15
$
OTHER
$
5t ('"SS
- z - a 3
")
(If necessary, please submit a separate page with the legal description.) `1 A- j
K.C. Plat Recording #
BOX 7
BUILDING SQUARE FOOTAGE:
(Existing/Proposed) 1ST
FLOOR / 2ND
FLOOR /
3RD FLOOR /
BASEMENT /
DECK /
GARAGE /
BOX 8
( ) SINGLE FAMILY
(
Z
NEW CONSTRUCTION
(�4 MULTIFAMILY (NO. OF UNITS =
) )
EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL
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 UNpER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KLEDGE
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:
ANP -008 3/90
BUILDING DEPARTMENT REMARKS:
ll c;T c-
ASSIGNED ADDRESS: ` �-
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
BY 4—L- DA'
PERMIT FEE n
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES e%
AMOUNT DUE
ACCEPTED FOR FILING
OFFICE USE ONLY (PLEASE'DO NOT -WRITE BELOW THIS LINE)
ZONE SETBACKS:
FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT
NOT EXEMPT
FIRE DEPARTMENT APPROVAL
DATE S ' 1 E
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL
DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL
MULTIFAMILY ADD/ALT
COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
TENANT IMP. OTHER /la
yl
OCCUPANCY
TYPE OF CONSTRUCTION STOR14
S ;- Xm,
BUILDING SQ. FT. 7
Cc
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @
TOTAL SQ. FT. TOTAL VALUATION
6
BUILDING DEPARTMENT REMARKS:
ll c;T c-
ASSIGNED ADDRESS: ` �-
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
BY 4—L- DA'
PERMIT FEE n
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES e%
AMOUNT DUE
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
BUILDING PERMIT BUILDI41
NG IN SSECTION
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
PIRA:/ b."Ar'u ii -c -1 A2PROVAL KliXat —t
PERMIT FEE
PLAN CHECK FEE
LUMBING FEE
CHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
itl:
WATER SERVICE
WATER MAIN CHG.
_
P �ir� :
.B.C.C. FEE
__271.50
/
OTHER FEES
O
:+..:^..<b.: "" J1
.
���.4
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
9
a
SET BACKS AND FOOTINGS
DATE _..- .. - _BY __._ --
OX TO POUR FOUNDATION WALLS
DATE ____ BY ..
PLUMBING GROUNDWORK
DATE - __ ____ BY
PLUMBING ROUGH IN
DATE_BY
WATER LINE O.K. ___
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE ___BY
O.K. TO ENCLOSE FRAMING
DATE_____ --_. BY - _
INSULATION
DATE - BY - - -
WALL BOARD AND FIRE WALL
DATE --.. _ BY
FINAL O.K. TO OCCUPY
DATE 3�ry I ,j BY C�
DCD
PSD
FD