91-100142CITY OF
FEDERAL WAY
BUILDING PERMIT
[00 I y
BUILDING INSPECTION
941-1555
91-0119 P BOB
POLUS 30229
FIRST PL S
PERMIT NO. OWNER'S NAME
JOB ADDRESS
INTERURBAN PLUMBING
36056 MILITARY ROAD S AUBURN
938-1463
CONTRACTOR ADDRESS
CONT. PHONE
INTERI*204CL
839-2230 30229
FIRST PL S FEDERAL WAY
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 PLUMBING ONLY
339180-0082
TAX ACCOUNT NO. LEGAL
DESCRIPTION
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE DATE OF APPLICATION 2-4-91
BUILDING INFORMAT
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
BIw,HTUBS LAUNDRY DRAINS
COMPRESSOR - _ TANK(S)
RECEIVED
SHOWERS URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
_
NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS HOT WATER HTR. MISC
SINXS 1 MIsc.PERMIT FEE 20.00
CONVERSION BURNER BASIC FEE
RETURNED
DISHWASHERS 1 TOTAL FIXTURES 2X5 10._0
UNIT HEATER TOTAL MECHANICAL
_
AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE -$-3o-no
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE __
•1 !�
SEPA REVIEW -
ATE:
f/
WATER SERVICE
WATER MAIN CHG.
OUNT:
$-10-no
S.B.C.C. FEE
_
OTHER FEES
CEIPT:
AMOUNT DUE 30.00
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 Li �����
_ DATE 2
CITY OF
FEDERAL WAY
BUILDING PERMIT
BUILDING INSP�cTION
941-1555
PERMIT NO.
OWNER'S NAME
JOB ADDRESS-
DDRESS
CONTRACTOR
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.SQ.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
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES _
PART P/C FEE
If
SEPA REVIEW.
_
WATER SERVICE
f
WATER MAIN CHG.
UNT:
isin_gar _M_
---_ _._ .,...,......
S.B.C.C. FEE
R
OTHER FEES
".SI'IPi`!
w^
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
SET BACKS AND FOOTINGS
DATE -______ _13Y
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 --BY
O.K. TO ENCLOSE FRAMING
DATE BY
INSULATION
DATE BY
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TO OCCUPY
DATE c7? BY
DCD
PSD
FD
Permit # q1-0 11/y L
RECEIVED
CITY OF FEDERAL WAY
FEB U 1� 1991 BUILDING PERMIT APPLICATION
CITY OF FL-O)ERAL WAY — Please Print —
( nawc n --PT
BOX 1 TENANT NAME:
OWNER 16, SITE LOCATION
OWNER'S ADDRESS CITY PHONE839- .2.7 30
DESCRIBE JOB Add d,sh (AX-'Sne_r �u ef"h/h=ry cap/ rnov / ham,,, S ry r,uer A37
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #lnv>*cr! ii- 2ogcG
Card MUST be presen
CONTRACTOR'S ADDRESS hr,- kry 170 CITY fiv h, h� PHONE
EXPIRATION DATEv/
—OR—
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 Rob P/�M
c!'us PHONE Zvi! IgE- �, U.
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
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 (k) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
:1
PLUMBING FIXTURES (including rough -ins)
N0. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES
1 SINKS
1 _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 IAM 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.
ANP -008 3/90
ZONE SETBACKS:FRONT
PLANNING DEPARTMENT APPROVAL
REMARKS:
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
SIDE REAR HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL
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
OCCUPANCY TYPE OF CONSTRUCTION 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:
RECEIVE
FEB Q 4 1991
CITY OF F."_
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
4mount Date Receipt #
BUILDING DEPARTMENT APPROVAL
3Y DATE_
DA'
DAT
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ACCEPTED FOR FILING