92-101007CITY OF FEDERAL WAY
9 a-tolao7
33530 First Way South BUILDING PERMIT BUILDING INSPECTION
Federal Way, WA 98003 661-4140
92-1036
CA DR SIDNEY GALLEGOS 118 SW 330TH SUITE #103
PERMITNO.
OWNER'SNAME SITEADDRESS
CONTRACTOR RICHRDS ®NST ADDRESS 34016 9TH AVE D-9 FEDERAL WAY CONT. PHONE 838-1844
CONT. REG. NO. RICEARC1092DB Exp -3/93 OWNER'S PHONE 643-8400 OWNER'S ADDRESS 14645 BEL RED RD BELLEVUE
TYPEJOB: NEWRESIDENCE
ADDITION NEW INDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. XX INDUSTRIALADD.EWPUBLIC PUBLIC ADD.
NEW MULTI -FAMILY
(UNITS MULTI. ADD. SIGN GRADING OTHER INSTALL NITRIOUS & O ROOM
TAX ACCOUNT NO.
fin)
82104-M45-09 LEGAL DESCRIPTION SEE ATTACHED
ISSUED BY JOANNE
JOHNSON DATE OF ISSUE DATE OF APPLICATION 7-13-92
BUILDING INFORMATION
NE
SET BACKS: FRONT SIDE REAR HEIGHT LIMIT
CCUPANCY $2
TYPE OF CONSTRUCTION VN CENSUS NO. 437 TYPE OF HEAT BLDG. SQ. FT. STORIES
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS
LAUNDRY DRAINS
FORCED AIR FURNACE DUCT WORK
SHOWERS
URINALS
GAS HOT WATER HTR. AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
CONVERSION BURNER MISC.
RETURNED
SINKS
MISC.
BBQ BASIC FEE
DISHWASHERS
TOTAL FIXTURES
DRYER TOTAL MECHANICAL
AMOUNT
500.00
VALUATION
FIRE/BUILDING DEPT APPROVAL: 7-13-92
15.00
PERMIT FEE
10.00
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
RT P/C FEE
PA REVIEW
r
PUBLIC WORKS
4.50
S.B.C.C. FEE
75
FIRE FEE
DATE:
OTHER FEES
AMOUNT: $30-25
30.25
AMOUNT DUE
RECEIPT:
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
AWEIVED10 jjVImit # �?_/0362?�7
JUL 13 1992 CITY OF FEDERAL WAY C4
`'y".v BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME: 1J,e & rc%cz, �hx4L�e 5 ._ , -1
OWNER SITE LOCATION '
OWNER'S ADDRESS Ne!��CITY PHONE eg�/z.-C
DESCRIBE JOB 0
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PA NERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME kn4draS L CONTRACTOR'S REG. #2L4o5�oqr
Card MUST be presented
CONTRACTOR'S ADDRESS 3y�J�6 y ° /1 �I CITY 40S PHONE �'3� /'F`K/
EXPIRATION DATE �✓ S— 2' 3
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SP
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON
AND
BOX 4 SEWER DISTRICT J�-Z ' l/ WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST
BOX 6 PROPERTY TAX ACCOUNT
LEGAL DESCRIPTION
(If necessary, please submit a separ pv with the
K.C. Plat Recording # - ? G® `//
EXISTING BUILDING VALUATION
-c>9
description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / ND FLOOR /�
3RD FLOOR / BASEMENT / DEC GARAGE----/—
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
fx) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY Q FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPL1AMIDES--®-B
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
/(( 2 ®z SN,S
$
OTHER
$
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 OFTHE 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 OFrTHE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE: 7 / 3 —f�z
ANP4009 3/90
OFFIRSE ONLY (PLEASE DO NOT WRITE BELOW TH L NE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS: A
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE % - I3 - fZ
PUBLIC WORKS DEPARTMENT APPROVAL f DATE
REMARKS: 411 1�
( V / It
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 I �- TYPE OF CONSTRUCTION 111V 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:
J U L 13 1992
FEDERAL WAV
SURDOG DEPT
RECEIVED
ASSIGNED ADDRESS: �V�L-
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
PERMIT FEE
15'
PLAN CHECK FEE
to
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
5- O
OTHER FEESF b Fee
AMOUNT DUE
Receipt #
BUILDING DEPARTMENT APPROVAL u
BY (--, C--, DATE 7- ( 3
ACCEPTED FOR FILING