90-100601CITY OF
FEDERAL WAY
BUILDING
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BUILDING INSPECTION
941-1555
PERMIT NO. 90-837 RA OWNER'S NAME REV H.
CLAUDE SIMMONS JOB ADDRESS 2101 S 324TH ST SPACE #46
CONTRACTOR CARL E COOPER ADDRESS
7312 202ND ST EAST PUYALLUP CONT. PHONE 848-6212
CONT. REG. NO. #CCBW CCLANLC209 OWNER'S
PHONE 874-5362 OWNER'S ADDRESS 2101 S 324TH ST SP #46 FED 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 DC— <_
TAXACCOUNT NO. 382277-08 LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE_ DATE OF APPLICATION 6-7-90
BUILDING INFORMATION
NE OCCUPANCY__ M2 -
TYPE OF CONSTRUCTION VN _ BLDG. SQ. FT. 5600
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 _
V
DISHWASHERS TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION 4, 928
SEE NOTATIONS
ON PLANS
PERMIT FEE 72-0-0--
2_nn_PLAN
PLANCHECK FEE 47-00
PLUMBING FEE
MECHANICAL FEE
AL BLDG. FEES _
T P/C FEE
DATE:
-13
SEPA REVIEW
WATER SERVICE
AMOUNT:
♦ C_�
WATER MAIN CHG.
S.B.C.C. FEE 4-50
RECEIPT:
I
I L--�
OTHER FEES
AMOUNT DUE 193 5-0—
0ALL
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 c - -
DATE 11
CITY OF BUILDING
FEDERAL WAY41
PERMITBUILDING IN SSECTION
PERMIT NO. V
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
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
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
'3FF "MATIONS (W PIJOS
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG, FEES
PART P/C FEE
SEPA REVIEW
WATER SERVICEr
AP@DtW i
WATER MAIN CHG.
S.B.C.C. FEE
%
RECEIPT:
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
SET BACKS AND FOOTINGS
DATE _. _ _------BY
— -
OX TO POUR FOUNDATION WALLS
DATE ._.__.... . BY —_. -
PLUMBING GROUNDWORK
DATE ——....._— ...---.. BY
PLUMBING ROUGH IN
DATE -__ ...__ BY
_....-----....
WATERLINE 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 OCCU
DATE _ �__BY
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CITY OF FEI, 0ERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
' BOX 1 TENANT NAME:
OWNER' QIA & f 5...,�.0 a .vS SITE LOCATION_ /,2/ 4. �2� "` 17`:. Sa . �O`V 4.
OWNER'S ADDRESS 2 O C TY PHONE 7� s'-34 1r
DESCRIBE JOB ,er' - si' / G.
THE PROPERTY IS OWNf D BY: ARRIED PAR ERSHIP CORPORATION
/BOX 2 CONTRACTOR'S NAME rAxt ,e. 6,goot — �• ,t ,.,., CONTRACTOR'S REG. # CCt3 i✓/cc.c,9�/AC�o9'
/ Car MUST be presented/
CONTRACTOR'S ADDRESS �/-/ -/VA '� .iT. Ems% CITY PHONE �y� • G,2/,e_U�jj
EXPIRATION DATE l /� ��� My 7:5
—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 WI 2,. o PHONE Y
VK'4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST / EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT N a 2 2
✓ LEGAL DESCRIPTION ba &Lt /-4.0c i QC x f D y.'0 92,E
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
(7 BUILDING SQUARE FOOTAGE: (Existing/ 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / / DECK fGe / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
:0 •
PLUMBING FIXTURES (including rough -ins)
NO. WATERCLOSETS//
BATHTUBS
HOWERS
L�VATO R I ES
SINKS
—DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
_URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
—OTHER
TOTAL FIXTURES
---1 MECHANICAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEfs,T
$
N0._ FUR �CE, ELEC. i GAS
$
GAS HRT WATER HEATER
$
CONVERSION BURN R
$
BOILER, SP4E /` BTU
$
AIR HANDLI NITS
$
HEAT PUMP , IZE
$
UNIT HEA RS
$
AIR CODLING UNITS, SIZE
$
COMMERCIAL HOOD
$
OTHER
$
$
S
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 OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT
DATE: Co
ANP -008 3/90
ZONE SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
i to
OFFICE USE ONLY (rLEASE'DO NOT WRITE BELOW THIS LINE)
SIDE REAR HEIGHT LIMIT
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL 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
PART P/C FEE
OCCUPANCY
TYPE OF CONSTRUCTION t//y
STORES
�, ct
BUILDING SQ. FT.
S ( O @
AMOUNT DUE
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
4A an
BUILDING SQ. FT.
@
_
��
TOTAL SQ. FT.
TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
RECEIVED
JUN 0 7 1990
Y OF FEDERAL WAY
BUILDING DEPT.
RECEIVED
ASSIGNED ADDRESS: SPS e K I
PERMIT FEE
72' o G
PLAN CHECK FEE
PLUMBING FEE
v
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
O
OTHER FEES
AMOUNT DUE
2-3 " S
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE—
ACCEPTED FOR FILING
r-lw*l
L-A
Al
RECEIVED
J U s'V 0 7 1990
CITY OF FEDERAL WAY
BUILDING DEPT.
fo —
PER`.
PLANS FOR_._
OWNER-
DATE SUBMITI v; � 'Z
{-�-�v
APPROVED By
X37 MH
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