91-100317CITY OF
FEDERAL WAY
BUILDING PERMIT
c) l -10031�-
BUILDING INSPECTION
941-1555
91-296 MH VOELK
LEWIS R
2101 S 324TH ST SPACE #177
PERMIT NO. OWNER'S NAME
JOB ADDRESS
CONTRACTOR PMH CONSTRUCTION ADDRESS
1203 MERIDIAN E
PUYALLUP WA CONT. PHONE 952-7255
PUYALMH132MM
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. 162104-9037 LEGAL
DESCRIPTION SPACE #177 OF SE 3 OF NW I AND PINS OF
SW i OF NE} AND PTNS OF NW i
OF SE I LYING WET
OF INTERSTATE 5
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE
_ DATE OF APPLICATION 3-15-91
BUILDING INFORMATION
NE RM 3600 OCCUPANCY__ R3
TYPE OF CONSTRUCTION
VN BLDG. SO. FT. 1440
SET BACKS: FRONT 5 SIDE 5
REAR 7
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 6,336.00
PLANNING
BUILDING
DEPT APPROVAL:
DEPT APPROVAL:
DB 3-15-91
KC 3-18-91
PERMIT FEE 90.00
PLAN CHECK FEE 59.00
PLUMBING FEE _
HANICAL FEE
WAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
DATE:
-3 - �C
WATER SERVICE
WATER MAIN CHG.
AMOUNT:
$153.50
4.50
S.B.C.C. FEE
OTHER FEES _
RECEIPT:
0
AMOUNT DUE 153.50
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-7ED BY 1015' RUE AND CORRECT TO THE BEST OF
MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGE
DATE
CITY OF
FEDERAL WAY
n
BUILDING IN 55ECTION
BUILDING PERMIT
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 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
JOIW
PERMIT FEE
PLAN CHECK FEE
FEE
16UMBING
CHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
yt�:
WATER SERVICE
_
�A
WATER MAIN CHG.
$ 3.53.50
S.B.C.C. FEE
^ F
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
9 0
SET BACKS AND FOOTINGS +c-dcwv
DATE _f_a' '1_BY ,Cf7�-IiL _dK
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 OCCUPY
DATE ...... ............ BY
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ermit #�v
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME, LS Y�, Sk, — PJ J j I v
OWNER — LD 01 SITE LOCATION 101 S L4- ST' 1-7
OWNER'S AD NESS CITY FEMA L PHONE
DESCRIBE JOB NOLLF 40MC-
THE PROPERTY IS OWNED BY: SINGLENWARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME r�H ' EDI OC -2701 1 CONTRACTOR'S REG. # PCYALY_Y M 13� M rVI
Card MUST be presented
CONTRACTOR'S ADDRESS 1 2p �, GM ERIDIAL) CITY J PHO05Q ,_? TJ S 5 -
EXPIRATION DATE b-9 l
ZIICiO
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 W� S QR 0A E PHONES -
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUN NUMBER I l0 0 -
LEGAL DESCRIPTION`S Xao Sid �ZCt�E
hl) \lF_ (n_0Pv F� Ur% (.Milk _ 9�
e
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR /`�`K' / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 rj
SINGLE FAMILY ( ) NEW CONSTRUCTION
MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
:n •
PLUMBING FIXTURES (including rough -ins)
N0. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES
SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
NOTAL 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 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 EMPLOYE %, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE:
ANP -008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS CENE)
ZONE�Y�SETBACKS: FRONT �� SIDE ✓�-r REAR �� HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT Q
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL 4 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
OCCUPANCY TYPE OF CONSTRUCTION-'(, STORES
BUILDING SQ. FT. I I-fy
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @6�
TOTAL SQ. FT. TOTAL VALUATION Co 336'' n
BUILDING DEPARTMENT REMARKS:
RECEIVE
MAR 15 1991
011Y OF FEDERAL 4
BUILDING DEPT.
RECEIVED
ASSIGNED ADDRESS:
kt
PERMIT FEE
O, do
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
S- 3, S` C'
PARTIAL PLAN CHECK FEE RECEIVED
%mount Date Receipt #
BUILDING DEPARTMENT APPROVAL p
3Y DATE ` -1
0 •
ACCEPTED FOR FILING
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CITY OF FEDERAL WAY
BUILDING DEPARTMENT
PERMI NUMBER C
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