90-101152CITY OF
FEDERAL WAY
BUILDING PERMIT
ctO-�DI l5�
BUILDING INSPECTION
941-1555
INSPECTION REQUEST LINE — 946-6794
PERMIT NO. 90-1363 CA OWNER'S NAME JAY
JACOBS JOB ADDRESS 1927 SO SEATAC MALL
CONTRACTOR ALGENE CONSTRUCTION ADDRESS
POB 1353 LYNNWOOD 98046 CONT. PHONE 774-3115
CONT. REG. NO ALGENC*306BE ( t/ / y )OWNER'S PHONE 622-5400 OWNER'S ADDRESS 1530 5 AVE SEATTLE
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 COMMERCIAL ALTERATION (TENANT IMPROVEMENT)
TAX ACCOUNT NO. 762240-0010
LEGAL DESCRIPTION ATTACHED
ISSUED BY ELIZABETH SNYDER
DATE OF ISSUE DATE OF APPLICATION 8/15/90
Ls.
BUILDING INFORMATION
NE NA OCCUPANCY_ B-2
TYPE OF CONSTRUCTION_II-N _ BLDG. SQ. FT. 3,000 SF
T BACKS: FRONT NA SIDE_ NA
REAR __--- . NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER 1
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 DUCTWK 6-50
SINKS MISC. _
CONVERSION BURNER4_50
RETURNED
DISHWASHERS TOTAL FIXTURES 3 X $5_00
UNIT HEATER TOTAL MECHANICAL 11-00
AMOUNT NONE
VALUATION $
BUILDING
DEPT APPROVAL: KEVIN ELLIS ON 9/4/90
PERMIT FEE _ 234 - n n
PLAN CHECK FEE i-,9_n0_
PLANNING
DEPT APPROVAL: NO CHANGE IN USE/OCCUPANCY
PLUMBING FEE 1 ri nn
MECHANICAL FEE�i nn
FIRE DEPT
APPROVAL: KEVIN ELLIS ON 9/4/90
TAL BLDG. FEES
ART P/C FEE
COPY TO
FIRE DEPT
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE $4.50
OTHER FEES F.D. 11.70
DATE PAID _ AMOUNT428 • 20 RECEIPT / - .a
AMOUNT DUE $ 428-20
ALL PERMITS EXPIRE 180 DAYS IF NOWORK IS
ARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATHED BY ME IS TR
D ORRECT TOTHE EST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
ZAFTERANCE
REQUIREMENTS WILL BE MET:
^_T
OWNER OR AGENT L V
�ti, �..
DATE /
FCITY OF EDERAL 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 NEWINDUSTRIAL 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
NE
OCCUPANCY_ - TYPE OF CONSTRUCTION__ _
BLDG. SQ. FT.
T 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
SINKS
MISC
CONVERSION BURNER BASIC FEE
RETURNED
DISHWASHERS
TOTAL FIXTURES S `� • `
UNIT HEATER TOTAL MECHANICAL ► .
AMOUNT
VALUATION
Mi 19�l.i Ei Vtl , w!;'1 WIN ELL IS CW 9 i 4 i 9 o
PERMIT FEE
PLAN CHECK FEE
DEPT "PROVAL : NC CMUME IN USE/OCCUPAP=
PLUMBING FEE
MECHANICAL FEE _
#
FIRC DEM "PRO�rAL: VIN BLL16r ON S/4/ 90
TAL BLDG. FEES
Pp
ART P/C FEE
COPY TO FIRE DEPT__..
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
++* �•a
Plat) �`4INT 20 RM�ZP;'�
AMOUNT DUE
�$42
`
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
DATE — -_--.__—BY —
PLUMBING ROUGH IN
DATE
O.K. TO ENCLOSE FRAMING
DATE ID /[ BY
FINAL O.K. TO OCCUPY
DATE
OX TO POUR FOUNDATION WALLS
_-- DATE _ __ _ __ —_BY
WATER LINE O.K.
GAS PIPING O.K.
INSULATION
DCD PSD
'leL.kdl_
Lj
PLUMBING GROUNDWORK
DATE ---- _.BY
MECHANICAL INSPECTION
DATE _ ___BY
WALL BOARD AND FIRE WALL J
DATE ��� ___BY
FD
c
v/% o O _ a _."�//_ /J g4l< 11
r
Ormit # 9J - / 3 (3 (� /#
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
OWNER ITE LOCATION
OWNER'S ADDRESS IG?U C rOAd-lG - CITY PHONE ;1 _ 5¢�✓U
DESCRIBE JOB I N TIMI M , fu0h.; " S 1 P-V6MVAL, -U&l GN LS71 Aka cif
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION .X!t-
BOX 2 CONTRACTOR'S NAME OC` CONTRACTOR'S REG. #
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
Card MUST be presented
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 is uN4I P -EN (F�J li{ "aA47--K, PHONE 6---Z `5qq/Ci
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST i , � EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBERIUj 7
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 / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
STRUCTURE
( ) COMMERCIAL/INDUSTRIAL
(EXISTING
TOTAL AREA OF PROPERTY ��'� 17`�
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —
BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
N0. FURNACE, ELEC. GAS
$
SHOWERS
—LAVATORIES
GAS HOT WATER HEATER
$
CONVERSION BURNER
$
t 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 A
DRAINS
=Zcl�o��5't` �u ►�
$LI.S 0
OTHER
$
_TOTAL FIXTURES
$
I.1 - C_0
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:
DATE:
ANP -008 3/90
ZONE SETBACKS:FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS: ,.%It{-
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
SIDE REAR HEIGHT LIMIT
O L
vc c .4 nark
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL Y_C DATE
4 _L/
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL L)M 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
MECHANICAL FEE
o
OCCUPANCY
TYPE OF CONSTRUCTION
PART P/C FEE
ZL 4j STORES
iLeFRr 1
BUILDING SQ. FT. 3oc?c>
@
7'
OTHER FEES
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
BUILDING SQ. FT.
@
_
TOTAL SQ. FT.
TOTAL VALUATION Z y 2-6 G
BUILDING DEPARTMENT REMARKS:
RECEIVED
PERMIT FEE
23
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
o
TOTAL BLDG. FEES
PART P/C FEE
d
SEPA REVIEW
0
S.B.C.C. FEE
d
OTHER FEES
((,70
AMOUNT DUE
LlZ
Hzg• zU
ASSIGNED ADDRESS: sS1-(
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE
ACCEPTED FOR FILING