92-100763CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
ct D --1 is - V73
BUILDING INSPECTION
661-4140
PERMIT NO.
OWNER'S NAME _ _ SITE ADDRESS
CONTRACTOR_ _
ADDRESS CONT. PHONE
CONT. REG. NO.
EXP. OWNER'S PHONE_ _____. _ OWNER'S ADDRESS _
TYPEJOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. ___ INDUSTRIAL ADD.__ _NEWPUBLIC _ 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
ONE
SET BACKS: FRONT SIDE REAR HEIGHT LIMIT
OCCUPANCY
TYPE OF CONSTRUCTION CENSUS NO. 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
VALUATION
P ANNING/RILDG APPROVAL z RICN"M COTTAGE
PERMIT FEE
PLAN CHECK FEE
f
"CALL 661—A 140 OP SIGNAGE, INSPECTION/ INSPECTION'
PLUMBING FEE
MECHANICAL FEE
PART P/C FEE
4+
SEPA REVIEW
PUBLIC WORKS
S.B.C.C. FEE
?'
FIRE FEE
DATE:
OTHER FEES
AMOUNT:
AMOUNT DUE
RECEIPT: D T
H G
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-_._-........-_
OX TO POUR FOUNDATION WALLS
DATE ____ .BY
PLUMBING GROUNDWORK
DATE _ - ___BY
PLUMBING ROUGH IN
DATE--.......BY _
WATER LINE O.K.
GAS PIPING O.K.-__ ..._......._
_... ........ .. ..... .__._
MECHANICAL INSPECTION
DATE
O.K. TO ENCLOSE FRAMING
DATE .....--......._....... .BY
INSULATION
DATE ...... BY
WALL BOARD AND FIRE WALL
DATE _. __BY
FINAL O.K. TO OCCUPY
DATE ....._._-.BY _......._
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