91-100964CITY OF
FEDERAL WAY
BUILDING
PERMIT
9)-/oD9&y
BUILDING INSPECTION
941-1555
PERMIT NO. 91-908 RA OWNER'S NAME FRANK & BETTY NOMIYAMA
JOB ADDRESS 32020
40TH PL SW
CONTRACTOR DOUGLAS GEN CONTRACTOR$IDDREss 4804 CENTER ST
TACOMA
CONT. PHONE 564-6808
CONT. REG. NO. DOUGLGC164BP OWNER'S PHONE 838-0580
OWNER'S ADDRESS 32020 40TH PL 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
TAX ACCOUNT NO. 873190-2630-04 LEGAL DESCRIPTION LOT
263 DIV 2 TWIN LAKES
ISSUED BY JOANNE JOHNSON DATE OF ISSUE
DATE OF APPLICATION 7-9-91
BUILDING INFORMATION
ONE RS 7 . 2 OCCUPANCY R3_ TYPE OF CONSTRUCTION
I
VN
BLDG. SQ. FT. 60
ET BACKS: FRONT 20 SIDE 5 REAR
5 STORIES
HEIGHT LIMIT 30LUMBING
NO. NO.
MECHANICAL APPLIANCES
AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER
GAS PIPING FT.
BOILER
BATHTUBS LAUNDRY DRAINS _
COMPRESSOR
_ EXH FARNK(S) 4-9;
0
RECEIVED _
SHOWERS URINALS __.
FORCED AIR FURNACE
AIR HANDLING UNIT
NUMBER _
LAVATORIES DRINKING FOUNTAINS _
GAS HOT WATER HTR.
MIscRANGE
RETURNED
SINKS MISC.
CONVERSION BURNER
BASIC FEE
USHERS TOTAL FIXTURES 2X5= 10-0
UNIT HEATER
TOTAL MECHANICAL 11 _ 0
AMOUNT
ATION 3,849_12
PLANNING DEPT APPROVAL:
PUBLIC WORKS DEPT APPROVAL:
DB 7-15-91
TC 7-19-91
PERMIT FEE 63.00
PLAN CHECK FEE 41-00
UMBING FEE _ 00 .—
BUILDING DEPT APPROVAL:
KC 7-22-91
0L"CAL
CHANICAL FEE �l 00
BLDG. FEES
PART P/C FEE
DATE:
SEPA REVIEW
WATER SERVICE
AMOUNT.$174.50
WATER MAIN CHG.
4.50
S.B.C.C. FEE
RECEIPT: E•
_
OTHER FEES P WORK45.00
174, 6
AMOUNT DUE
ALL PERMITS EXPIRE 180 DAYS AFT R ISS N E IF NO WORK IS STARTED. RESIDENTIAL AND GRADING
PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
r
I CERTIFY THAT THE INFORMATIO FURNI$HE BY ME IS TRUE AND CORRECT TO THE BEST OF
MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
c
OWNER OR AGENT �'V1l��_
DATE ,
RECEIVED • 4rit #
JUL 0 9 1991 CITYO FEDERAL WAY
Cifl'YOfFF.PERALWAY BUILDING PERMIT APPLICATION
SUILDWQ DEPT. — Please Print —
BOX 1 TENANT NAME:
OWNER SITE LOCATION Z�kl
OWNER'SADDRESSil�� L#iJ ! �1.. SW CITY t=tr�f PHONE J9 1`3 - O
DESCRIBE JOB '10 G p"' c
THE PROPERTY IS OWNED BY: SINGLE ARRIED 3 PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME DOS Xj --Vi- (_-E % CONTRACTOR'S REG. 420 _ L6r._ 1�4 (_21,0
Card MUST be presented
CONTRACTOR'S ADDRESS, C St . CITY �i ir: C�,�,� PHONE
EXPIRATION DATE ' i 1 s -L
—OR—
I HAVE READ CHAPTER 18.27.010 R kTTNG TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
PROPERTY TAX ACCOUNT NUMBE
LEGAL DESCRIPTION IN ,,r—
(It necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) T FLOOR'+' 2ND FLOOR /
3RD FLOOR / BASEMENT DECK / GARAGE /
BOX 8 (SINGLE FAMILY ( ) NEWCONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS=—) (t— ISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL 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
1 $
LAVATORIES
CONVERSION BURNER
�$
SINKS
BOILER, SIZE BTU pe $
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
—�QT� R
$
DRAINS
(Jr /�t—t.
$
OTHER
$
7 TOTAL FIXTURES
i�
$
rp , vv
TOTAL MECHANICAL FEE
$
1c� e�
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 HARM LESS 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 T E CIT"F FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPL YEE PON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: %1 ✓iU/ / ;i;
DATE:
ANP -008 3/90
ZONE fS TZ SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFIGOSE ONLY (PLEASE DO
.A/ ' SIDE
-••yam ---w, .:,..�,,.-�....,�-w�•�aw.--�.ya;a�a �.-.v.. •-ro^-.'- 7
BELOW THINE) QIV1303A
HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL 14) DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE V, Of/
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES.
ADD/ALT A_ NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL
COMM. ADD/ALT
NEW MULTIFAMILY
(UNITS )
MULTIFAMILY ADD/ALT
TENANT IMP.
OTHER
OCCUPANCY
3 TYPE OF CONSTRUCTION j) /
STORES
BUILDING SQ. FT.
f @
S.B.C.C. FEE
5
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
-tk
BUILDING SQ. FT.
@
TOTAL SQ. FT.
TOTAL VALUATION �`} �- Za
BUILDING DEPARTMENT REMARKS:
`46
ASSIGNED ADDRESS: C[' P e -Y ( Is
PERMIT FEE
63
PLAN CHECK FEE
PLUMBING FEE
C) C',
MECHANICAL FEE
• 0p
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
Pw
- 4s-a�
S.B.C.C. FEE
5
OTHER FEES
AMOUNT DUE
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE q
ACCEPTED FOR FILING
CITY OF
FEDERAL WAY
BUILDING PERMIT BUILDING
941 �N 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
ZO NE
OCCUPANCY Y_ 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
.aAPI -JIN s TARP' APPROVAL:
DO 7--15-91
VALUATION
Qi LIC h'ORFS LDITTT "PROVAL:
TC 7-19--91
PERMIT FEE
PLAN CHECK FEE
UMBING FEE
9V17ZT'_qEw DEPT APPROVAL:
KC 7-22-91
CHANICAL FEE
TOTAL BLDG. FEES
!�
PART P/C FEE
t
SEPA REVIEW
� s
WATER SERVICE
_x
WATER MAIN CHG.
<, J
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
0 •
SET BACKS AND FOOTINGS
DATE_ BY .._--
��
OX TO POURIFOUNDATION WALLS
DATEW, �'� �L�
PLUMBING GROUNDWORK
DATE _ _ BY / '' �"� • `
PLUMBING ROUGH IN
DATE — - BY
_ _. -
WATER LINE O.K.
GAS PIPING Q.K.-......--—.....-
MECHANICAL INSPECTION
DATE — _- __BY
O.K. TO ENCLOSE FRSMIN
DATE __ ,.-G},BY � —
INSULATION
DATE 3 - .. - BY d -.._
WALL BOARD AND FIRE WALL
DATE _ 3G� BY
FINAL O.K. TO OCCUPY
DATE _A_'`/K_ --- BY
_ _
DCD
PSD
FD
-
- 3 0 - y/ 6
;2 _'Gu
Yf L ! `SU/9i2
/t�iP/e,Bjt> It, 14