91-100349CITY OF
FEDERAL WAY
(4341
BUILDING
"RF.NF.WAT. nF 9(1-17"
PERMIT
9) - /003 ?9
BUILDING INSPECTION
941-1555
PERMIT NO. 91-310 RE
OWNER'S NAME DORENBUSH HOMES JOB ADDRESS 4914 SW 329
WAY
CONTRACTOR OWNER
ADDRESS 18000 72 AVE S X206 KENT
CONT. PHONE 251-9877
CONT. REG. NO. DORENI*21 OM3 6/91 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 RENEWAL OF 90-37 TO CONSTRUCT
NEW RESIDENCE
TAX ACCOUNT NO. 142103-9012 LEGAL DESCRIPTION LOT 7 STONEBROOK IT
SSUED BY ELIZABETH SNYDER
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
ZONE RS 9. 6
OCCUPANCY R-3 TYPE OF CONSTRUCTION 5-N
BLDG. SO. FT. 3310 _
SET BACKS: FRONT 20'
SIDE 5' EACH REAR 5' _ STORIES 2
HEIGHT LIMIT 30' _
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS _ 3
ELEC. HOT WATER HEATER
GAS PIPING FT. 100 + FT BOILER
RECEIVED
BATHTUBS 2
LAUNDRY DRAINS _�
COMPRESSOR TANK(S)
SHOWERS I_
URINALS
FORCED AIR FURNACE 1 AIR HANDLING UNIT
NUMBER _
LAVATORIES 5
DRINKING FOUNTAINS
GAS HOT WATER HTR. 1 MISC _
RETURNED
SIt`iKS —1--
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS 1
TOTAL FIXTURES 14
UNIT HEATER TOTAL MECHANICALBELOW
AMOUNT
VALUATION $189,300
THIS PERMIT WILL EXPIRE ON APRIL 1,
1992
PERMIT FEE $477.50
PLAN CHECK FEE
MBING FEE 35-00
CHANICAL FEE 10
-on
FEES DUE ARE I OF THE ORIGINAL AMOUNT COLLECTED
FOR THIS PROJECT.
TOTAL BLDG. FEES $ S
_ S 0
PART PIC FEE
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
DATE PD AMT $522.50 REC' T
OTHER FEES
AMOUNT DUE $522.50
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:
Seel-,
lLI �
OWNER OR AGENT
DATE
CITY1 FEDERAL WAY
Ormit #
BUILDING P RMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER SITE LOCATION 1161111 Sw 3Zq`-'k i�Ay
OWNER'S ADDRESS 1,k>00 CITYYPHONE 5- - 477�
DESCRIBE JOB nq
THE PROPERTY IS OWNED BY: SINGLE MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME 001,enbV., /7 /A /29e -j
CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS S,4h_Me --CITY PHONE
EXPIRATION DATE
—
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 -77/-r tz PHONE 7 7
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER ! y)L I 3 q6 f2
LEGAL DESCRIPTION LGT
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR '37 U. / 2ND FLOOR IL& S /
3RD FLOOR / BASEMENT / DECK / GARAGE 71-6 /
BOX 8 SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMM ERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
I 1W01
PLUMBING FIXTURES (including rough -ins)
NO. 3 WATERCLOSETS
"l— BATHTUBS
/ SHOWERS
____?P_LAVATORI ES
/ 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 BESTOF 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:
ANP -008 3 �1J
ZONE SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
0 0
OFFICE USE ONLY (PLEASE DO NOTiITE BELOW THIS LINE)
SIDE RE HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL
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 TYPE OF CONSTRUCTION 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:
ASSIGNED ADDRESS:
Amount
[39
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
DAT
DATE
DA
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
BUILDING PERMIT
D6j�
BUILDING�INSPECTION
941®1555
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
SSUED 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 _
Y
LAVATORIES
DRINKING FOUNTAINS
GAS HOT WATER HTR. MISC
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION
THIS WILL F IRE, ON" Al' i%.i
PERMIT FEE
PLAN CHECK FEE
FEE
aUMBING
Q^7�r ME ARE OF THE ORIGINAL AIMOUNT COLLECTED
ISS Pi"''.:)s� �. '•r
POP THIS
CHANICAL FEE _
TOTAL BLDG. FEES _
PART P/C FEE
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
t I
A
S.B.C.C. FEE
. wS. .�! ; i +# , " r �p�,
OTHER FEES
J
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
SfT BACKS AND FOOTINGS /
DATE _ ___.—_ BY _..�..._
O.K TO POUR FOUNDATION WALLS
DATE _....._— ..._.__.__ BY ,.._. —._
PLUMBING GROUNDWORK
DATE _- _ _ - BY
PLUMBING ROUGH IN
DATE _�/ ......BY
✓i'1/Y1 -
WATER LINE O.K.
GAS PIPING O.K. __/ `.� �_�%/ %7� _
MECHANICAL INSPECTION
DATE _ya _BY
O.K. TO ENCLOSE FRAMING
DATE ...��-- BY
INSULATION
DATE BY - ._
WALL BOARDANDFIRE WALL
DATE_ �O._ -YI _ BY
FINAL O.K. TO OCCUPY
>> // U��i
DATE _ V-/4-`L.BY
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