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90-101700CITY OF FEDERAL WAY BUILDING PERMIT 9 n . 101700 BUILDING INSPECTION 941-1555 PERMIT NO. 90-1920 OT OWNER'S NAME SERVANTS OF CHRIST CHURCH JOB ADDRESS 35448 11TH AVE SW CONTRACTOR KEN GOHRICK CONST ADDRESS BOX 3496 FEDERAL WAY CONT. PHONE 941-7186 CONT. REG. NO. KENGOC*198CJ OWNER'S PHONE 838-6721 OWNER'S ADDRESS 35448 11TH AVE SW FEDERAL WAY 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 PORTABLES TAX ACCOUNT NO. 222406-9001-42 LEGAL DESCRIPTION ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 12-26-90 BUILDING INFORMATION ZONE OCCUPANCY A3 TYPE OF CONSTRUCTION___ VN BLDG. SO. FT. 36X56=2016SF SET BACKS: FRONT SIDE REAR _ STORIES HEIGHT LIMIT _ PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLQSETS 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 8,870 4n PLANNING DEPT APPROVAL: (NO SITE PLAN APPROVAL REQUIRED) KM 12-28-90 PERMIT FEE i nR _ nn BUILDING DEPT APPROVAL: KC 12-31-90 PLAN CHECK FEE 70-00 MBING FEE CHANICAL FEE Is TOTAL BLDG. FEES PART P/C FEE - DATE: j SEPA REVIEW LOT 22-24-06 BLOCK 9001 CODE 6825 SEC 22; TWT 24; RG 06. WATER SERVICE AMOUNT: A 187.90 PP ACT 39929518 MOBILE HOME WATER MAIN CHG. THAT TOR OF W 1/2 OF NE 1/4 OF NE 1/4 LY W OF E 200 FEET S.B.C.C.FEE 4 _ 5 0 � � AND LY S OF IN DAF - BEG SE COR OF N 5 AC OF ABOVE DECS. RECEIPT: OTHER FEES 5 _ 40 AMOUNT DUE J R 7_ 9 n 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 Rf�mit CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 TENANT NAME: OWNER=-�,��' E LOCATION S OWNER'S ADDRESS y CITY f= tti " PHONE DESCRIBE JOB THE PROPERTY IS OWNED ARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME �� l �� ,YL� c �L (0 1-, �" CONTRACTOR'S REG. #�fWG-�'c-,�I�l�r� Card MUST be presented CONTRACTOR'S ADDRESS CITY PHONE <<'4i <^ 7/�, EXPIRATION DATE c —OR— I HAVE READ CHAPTER 18.27.010 RELATING TO I FIM IONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON KiLr x'"t LAL PHONED 7 BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION '- - ' 06 OU_N_T NUMBE LEL DESC- (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording # 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 (6MMERCIAL/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 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 EMPLOYEE$, UPON TR ACQU41CY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: DATE: ANP -008 3/90 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 t=_C DATE REMARKS: PUBLIC WORKS DEPARTMENT APPROVAL DATE REMARKS: TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT PLAN CHECK FEE NEW COMMERCIAL COMM. ADD/ALT •-� NEW MULTIFAMILY (UNITS ) MULTIFAMILY ADD/ALT TENANT IMP. OTHER SEPA REVIEW OCCUPANCY— I. TYPE OF CONSTRUCTION V /y STORES OTHER FEES F0 rC6 o lQUILDING SQ. FT. @ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ < <` 0 - $ BUILDING SQ. FT. @ = BUILDING SQ. FT. @ _ �' �� C TOTAL SQ. FT. TOTAL VALUATION BUILDING DEPARTMENT REMARKS: 36 x s -c NO P&44—) Amount :SS: PARTIAL PLAN CHECK FEE RECEIVED Date PERMIT FEE /0$ , 0,0 PLAN CHECK FEE 70 Ga PLUMBING FEE MECHANICAL FEE TOTAL BLDG. FEES 17 9 dp PART P/C FEE SEPA REVIEW S.B.C.C. FEE `/ - S G" OTHER FEES F0 rC6 5--40 AMOUNT DUE " Receipt # V BUILDING DEPARTMENT APPROVAL BY CAk DATE 2-- w - �O ACCEPTED FOR FILING CITY OF FEDERAL WAY BUILDING PERMIT BUILDI41 NG IN 55ECTION 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. 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 VALUATION /► � T)FPT PROML - ()I0 SITF pL l APPROVAL JMQU'x Lj PERMIT FEE 311011IGF,.PT APMOVtiL i XC 1.1-31-90 PLAN CHECK FEE UMBING FEE `CHANICAL FEE TOTAL BLDG. FEES PART P/C FEE LOT 22-24-06 BLACK 9001 CODE 6825 SEC 22; TWT 24; RG 06. SEPA REVIEW WATER SERVICE °��„►�,�": ;�1�i PP ACT 39929518 MOBILE HOME WATER MAIN CHG. n----_.� -_ THAT TOR OF W 1/2 OF NE 1/4 OF NE 1/4 LY W OF E 200 FEET AND LY S OF LN DAF - BEG SE COR OF N 5 AC OF ABOVE DECS. S. B.C.C. FEE •s-r+,rs� _ti OTHER FEES AMOUNT DUE ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITIS 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 iA"L o r_ rL�ir. r.- rr T//Z UL��/I.0 • <&J'v /^ r_ 0 DATE _14 Y�'�� BY h%3 DATE . C�%S '�/�__BY � - -- PLUMBING GROUNDWORK DATE --_ _ --BY PLUMBING ROUGH IN DATE _- - _ BY --____ WATER LINE O.K. GAS PIPING O.K.--- __.-_ — ---. ___ MECHANICAL DATE INSPECTION — __BY O.K. TO ENCLOSE FRAMING DATE BY — INSULATION DATE -- - BY - ._ WALL BOARD AND FIRE WALL DATE _ _ BY FINAL O.K. TO OCCUPY -W DATE _I6 �5 -%BY DCD PSD FD " "� /i/9t'/V 'w_/'fA c'4L Z_ -'va 3 S / �. _711Z L L i L cx: le