91-100717CITY OF
FEDERAL WAY
BUILDING PERMIT
C/ /-1007/7
BUILDING INSPECTION
941-1555
91-670 FSS
PACIFIC FIRST BANK 33702 B
21 AVE SW
PERMIT NO. OWNER'S NAME
JOB ADDRESS
BRONZE MECHANICAL
4158 148 AVE NE REDMOND 98052
882-0422
CONTRACTOR
ADDRESS
CONT. PHONE
BRONZMI142LD 5/92
622-1666 33702
21 AVE SW FEDERAL WAY
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 SPRINKLER SYSTEM
TAX ACCOUNT NO. 242103-9099
LEGAL DESCRIPTIO
ISSUED BY ELIZABETH SNDYER
DATE OF ISSUE DATE OF APPLICATION 5/21/91
BUILDING INFORMATION
OCCUPANCY
B-2 TYPE OF CONSTRUCTION_ 5—N SPRINKLERS
BLDG. SQ. FT 650
'RowE
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 _
SAVATORIES 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 $915.00
FIRE DEPT APPROVAL = KEVIN ELLIS/CHRIS INGRAM
PERMIT FEE $25-00
BLDG DEPT APPROVAL = KEVIN ELLIS
PLAN CHECK FEE 16 _ 00
PLUMBING FEE
ECHANICAL FEE
AL BLDG. FEES $41-00
T P/C FEE
SE REVIEW
J /�
WA R SERVICE
WATER MAIN CHG.
DATE PD (' AMT $66.00
REC'T,_3_44
S.B.C.C. FEE 4.50
OTHER FEES F. DEPT 20.50
AMOUNT DUE $ 66.00
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 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:
' S, C
L y L C, '�
OWNER OR AGENT C .'
DATE
I is
#
RECEIVED � �
MAY 21 1991
CITY OF FEDERAL WAY
I
MY OF FEDERAL WAY BUILDING PERMIT APPLICATION
BUILDING DEPT — Please Print —
BOX 1 TENANT NAME: f:�(eJ A4 e j e r ( Fo d e -a I uk) PCkL'-'P)L F; r's+ Rek, k
OWNER 1 -req IV 144' V a SITE LOCATION :2 `5 f; ,A I !•\Ve-
OWNER'SADDRESS 37Cl Avg CITY PHONE
DESCRIBE JOB 1c c_q 6r k l e4,ecta ' 4'^ r '�vi' i- v kec-fion
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME 3 O nzz Me4)a % Cc0 CONTRACTOR'S REG. # Brcv)z,APL4 2LD
ii Card MUST be presented
CONTRACTOR'S ADDRESS q r S 1 ci 1 Ave NE. CITY Red Mu hU PHONE_ 35P -0q 22
EXPIRATION DATE S - _�2 1 - 1
1'
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 T:)(✓v\ Wo, ( le%ct PHONE ",�1 ':� -U Y'2 2
BOX 4 SEWER DISTRICT WATER DISTRICT �—
,-BOX 5 ESTIMATED PROJECT COST
BOX 6 PROPERTY TAX ACCOUNT NUMB
R=# i�
EXISTING BUILDING VALUATION
- 9v 99
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 0 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
COMMERCIAL/INDUSTRIAL
( ) EXISTING STRUCTURE
( )
TOTAL AREA OF PROPERTY"
SQ
FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —
BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
N0. FURNACE, ELEC. GAS
$
SHOWERS
GAS HOT WATER HEATER
$
LAVATORIES
CONVERSION BURNER
$
SINKS
BOILER, SIZE BTU
$
DISHWASHERS
AIR HANDLING UNITS
$
ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER
$
DRAINS
$
OTHER
$
C/2 TOTAL FIXTURES
$
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: ►��Ii+'L DATE: `
ANP -008 3/90
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFICA ONLY (PLEASE DO NOT WRITE BELOW THIS LINE
SIDE REAR HEIGHT LIMIT
BUILDING DEPARTMENT REMARKS:
ASSIGNED ADDRESS: ``-
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
PERMIT FEE ZS
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES �L
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES r h T_
AMOUNT DUE
BUILDING DEPARTMENT APPROVAL L`� C�
DATE (9 I
ACCEPTED FOR FILING
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL r
REMARKS:_
r
DATE s ``��� Z- 7
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 i'"(� - I �4"—#S St-�
OCCUPANCY 15 2, TYPE OF CONSTRUCTION UAJ S ORES
BUILDING SQ. FT.
b C @ �� 6 D
BUILDING SQ. FT.
@ _
BUILDING SQ. FT.
@ _
BUILDING SQ. FT.
@ _
BUILDING SQ. FT.
BUILDING SQ. FT.
@ _
@
C)
TOTALSQ. FT.
TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
ASSIGNED ADDRESS: ``-
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
PERMIT FEE ZS
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES �L
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES r h T_
AMOUNT DUE
BUILDING DEPARTMENT APPROVAL L`� C�
DATE (9 I
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
BUILDING PERMIT BUILDING
941!N 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
"T t
'
VALUATION
"'7 EX��
�?� DEPT APPTt('! � = KIN
BLDG DEPT "PROVAL = XEWN
T
L�:sISiLHRIS INtRRAM
ELLIS
PERMIT FEE
PLAN CHECK FEE
`
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
_
'
WATER SERVICE
LAMT
WATER MAIN CHG.
V iT!''. pf)
$66. Cl o
REC�T_----_-�M�
S.B.C.C. FEE
—
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
SET BACKS AND FOOTINGS
OX TO POUR FOUNDATION WALLS
PLUMBING GROUNDWORK
DATE__ __ - _-BY
DATE __ _BY
DATE BY
PLUMBING ROUGH IN
WATER LINE O.K.
MECHANICAL INSPECTION
DATE __ ___. - BY
GAS PIPING O.K.
DATE _BY
OX� TO ENCLOSE FRAMING
INSULATION
WALL BOARD AND FIRE WALL
DATE -_ __.. ________.BY
DATE BY ------
DATE BY
FINAL O.K. TO OCCUPY
DATE BY
DCD
FID