91-101266CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
BUILDING INSPECTION
661-4140
PERMIT NO. 91-1216
MH OWNER'S NAME KATEIERTNIF HELMER SITE ADDRESS 2101 S 324 ST #205
OWNER
_
POB 346 BLACK DIAMOND 886-1124
CONTRACTOR
ADDRESS CONT. PHONE
NA
NA 'SAMA' SAME
CONT. REG. NO..
EXP. OWNER'S PHONE OWNER'S ADDRESS
TYPEJOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL___ COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY
(UNITS ) MULTI. ADD. SIGN GRADING OTHER INSTALL MOBILE HOME
TAX ACCOUNT NO. 162104-9037
LEGAL DESCRIPTION LOT 205 BELMORE MOBILE HOME PARK
ISSUED BY ELIZABETH
SNYDER DATE OF ISSUE DATE OF APPLICATION 9/5/91
Jr
BUILDING INFORMATION
ZONE RM3600
SET BACKS: FRONT 16 SIDE 211/5' REAR 741 HEIGHT LIMIT NA
OCCUPANCY ___ R-3
TYPE OF CONSTRUCTION 5—N CENSUS NO. O/S TYPE OF HEAT NA - _- BLDG. SQ. FT. 924 STORIES ONE
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 NONE
DRYER TOTAL MECHANICAL NONE
AMOUNT _ NONE
$4,065.00
VALUATION
PLANNING DEPT APPROVAL = DEB BARKER
-�
$63.00
PERMIT FEE
PLAN CHECK FEE
41.00
FIRE/BLDG DEPT APPROVAL = MIKE MONEN
PLUMBING FEE
MECHANICAL FEE
PART P/C FEE
SEPA REVIEW
PUBLIC WORKS
4.50
S.BIC.C. FEE
_ r
FIRE FEE
DATE:
OTHER FEES
- 50
AMOUNT: 108-50
$108.50
^�708
!T C-1
AMOUNT DUE
RECEIPT: 7
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 FURNISH DB 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__ -/'2-
__
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
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.
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
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
t4 f1cC OV
VALUATION
,
PERMIT FEE
PLAN CHECK FEE
F�1�I �T3�.:Ofa Ok7Fm' APPROVAL
M.TKE 2401dFN
PLUMBING FEE
MECHANICAL FEE
iRT P/C FEE
IRE;
SEPA REVIEW
jyt?
PUBLIC WORKS
S.B.C.C. FEE
iZ.
FIRE FEE
OTHER FEES
DATE:
AMOUNT:
D
AMOUNT DUE
RECEIPT:
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 REQUIREMEOTS'LL
BE MET.
OWNER OR AGENT
___ _
DATE
7—,,,,- , 4 % j/.__ ,-I /Z //1 —/ 4'— c:;Pj
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 -BY
O.K. TO ENCLOSE FRAMING
DATE _ BY ... ... . .... ..... .
INSULATION
DATE
WALL BOARD AND FIREWALL
DATE BY
FINAL O.K. TO OCCUPY
DATE -,...,-
DCD
PSD
FD
0 0
Permit
ECtIVED
SEP 5 1991 CITY OF FEDERAL WAY
CtTVc F UEAALWAY BUILDING PERMIT APPLICATION
BUILD 1�{I DEPT —Please Print —
BOX 1 TENANT NAME:
OWNER 2 e c SITE LOCATION/O/ o • 3o7�/T F e��L w,+�/ Sp��•e,;
OWNER'S ADDRESS O oy35/G CITY ,C?.<Ac," D/4.0•o1-tc) PHONE` -
DESCRIBE JOB _/lam/ olod S.Tue
THE PROPERTY IS OWNED BY: SINGLE/MARRIEDSrcTe PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME 64-olA/ c4- CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
—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 PHONE //v7'51
BOX 4 SEWER DISTRICT ���c��9 L Why WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST /6_'0eJ EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER D -2 0 3
LEGAL DESCRIPTION
i
(If necessary, please submit a separate page with the legal escription.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 8` 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 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
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 KNOOLYDGE
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 THVACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
(W� DATE:
ANP -008 3/90
0
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE lA— SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
SIDE REAR `f HEIGHT LIMIT
FIRE DEPARTMENT APPROVAL DATE ��jlYf
REMARKS:
PUBLIC WORKS DEPARTMENT APPR
REMARKS:
DA
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 N STORES O�
-�:»>di*°f:c:� t BUILDING SQ. FT. @ -S ``e
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ p _
BUILDING SQ. FT. @'/
TOTAL SQ. FT. "` TOTAL VALUATION q0
BUILDING DEPARTMENT REMARKS:
ED
ASSIGNED ADDRESS: Ste– E' K
Amount
PARTIAL PLAN CHECK FEE RECEIVED
Date
PERMIT FEE
/1,13
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
Receipt #
BUILDING DEPARTMENT APPROVAL
BY —DATE l
ACCEPTED FOR FILING
4Y
FILE
•
CITY OF FEDERAL WAY
DEPT. OF COMM ITY DEVELOPMENT
PERMIT NUMBER M--
ADDRESS
PLANS FOR RNM'1142— VFn'A1� zpq
OWNER LkCJ�Lf
41-r\eg, 4etrer.
SUBMITTED- �—f-qf DATE APPROVED '�/'///1Z
APPROVED BY
i. flis molails ho v "I dWay a Permanently
afted Dept of 1.41, or H.U.D. inspection label.
2. Installation of the mobile home shall be per
manufacturers recommendations.
3. Provide a)ob she oDpy of the manufacWWs
set-up buoWt
RECEIVED
SEP 5 1991
CITY OF FEDERAL WAY
BUILDING DEPT
SEA TAC MALL PARK & RIDE
Q 'AlAth ct
tF
Awn P 7-^' .
4
it
0
)-6
,q� -1 - L
1. The n�ntjl� hams
nfiix�Mail display I POma,.* 1
DO d Ul or inspection Imel. j
InglAftakg, of ft mobile
manufacturors bon* 311911 be per
foommenciguou
3. Plolda a pb 09 GapyW atie m1m
at"* uf"NW4
� a (U Lb.),4 X
C: --4 --1
FILE
I P h L'.. F "� kOf VE L M D 19A Dk n f� /,,,, D14,10 4 1 L L-- 2LUD.
RECEFFI/el)
SEP 5 1991
'e OF FE, -
'J'11,11L VVAV