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90-100305CITY OF FEDERAL WAY BUILDING PERMIT L 16 c BUILDING INSPECTION 941-1555 90-416 WHITTALL MANAGEMENT 720 S 333 ST PERMIT NO. OWNER'S NAME JOB ADDRESS CONTRACTOR SUPERIOR BUILDERS ADDRESS 1750 S 327 ST UNIT C-1 FEDERAL WAY CONT. PHONE 874-3647** CONT. REG. NO. SUPERBILL2D2 3/91 JJOWNER'S PHONE 682-0666 OWNER'S ADDRESS 999 3 AVE SEATTLE 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 "TENANT IMPROVEMENT" TAX ACCOUNT NO. 926500-0170-05 LEGAL DESCRIPTION LOT 1 OF PROPOSED SHORT PLAT #884049, WHICH IS A PORTION OF LOT 17 WEST CAMPUS OFFICE PARK DIVISION 1, AS RECORDED IN VOL 97 OF PLATS PAGES 55-58 INCLUSIVE RECORDED IN ICING CO. _ ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 4/23/90 BUILDING INFORMATION NE NA OCCUPANCY_ B-2 TYPE OF CONSTRUCTION 5-N BLDG. SO. FT._ 1123 OFFICE T BACKS: FRONT NA -_ SIDE NA REAR__ __NA_ _ STORIES NA HEIGHT LIMIT NA 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 FIXTURESO� NE UNIT HEATER TOTAL MECHANICAL -6--5-0- AMOUNT NONE CHANGING DUCTWORK = 6.50 VALUATION $11,364 -EHANG+NG-B9EAT+9N-9F-B+FFHSBRS---6-58 PERMIT FEE $135_00 PLANNINGDEPT APPROVAL = KEVIN ELLIS ON 4/30/90 (NO CHANGE IN OCCUPANCY PLAN CHECK FEE 88-00 OR USE, PLUMBING FEE CHANICAL FEE _ 6-50 _ FIRE DEPT APPROVAL = KEVIN ELLIS ON 4/30/90 TALBLDG. FEES _ $229.5 -0 ---PUBLIC WORKS DEPT APPROVAL = NOT NECESSARY PER KEVIN ELLIS ON 4/30/90 TP/C FEE BUILDING DEPT APPROVAL = KEVIN ELLIS ON 4/30/90 SEPA REVIEW DATE PAID 5 21-U2 WATER SERVICE WATER MAIN CHG. AMOUNT PAID S.B.C.C. FEE 4.50 # OTHER FEES RECEIPT AMOUNT DUE $234.00 ALL PERMITS EXPIRE 180 DAYS AFTER ISS NCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMIT -S EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFORMATION FURNI H D BY REQUIREMENTS WILL�T: ` S 1 I E IS' TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLIC BLE CITY OF FEDERAL WAY r OWNER OR AGENT DATE" , `J CITY OF FEDERAL WAY BUILDING PERMIT BU"°'94 �N55ECTION 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 ONE OCCUPANCY__ _ TYPE OF CONSTRUCTION BLDG. SQ. FT. =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 RETURNED SINKS MISC. _ CONVERSION BURNER BASIC FEE DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL D * J AMOUNT VALUATION • PERMIT FEE .t.s9- PtANNIMMEPt APPROVAL - XS9 X ELLIS ON 4/30/90 (NO, CH&M-GE IN CUP ANC PLAN CHECK FEE """"'" """ ""!""' OR USB PLUMBING FEE MECHANICAL FEE r P=RE DEPT APPROVAL = KMN ELLIS 'f R +4/30) 90 OTAL BLDG. FEES PUBLIC WOO KS DkPT "PROVAL s Oft Ri.ECEWA.RY PEa REVIV4 &LLIS Ode 4/3C°/90 RT P/C FEE� LUNG DEPT APPWVAL - MaN ELLIS ON 4/30/90 SEPA REVIEW TH PAID WATER SERVICE * WATER MAIN CHG. _ "u PIAID ,; S.B.C.C. FEE 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_.. PLUMBING ROUGH IN DATE -, __ BY - ... O.K. TO/ENCLOSE FRAMING DATE (2-��BY GJ FINAL O.K. T OCCUPY DATE _ ot BY a 0 O.K TO POUR FOUNDATION WALLS DATE ......-- ._.__...._.BY WATER LINE O.K. GAS PIPING O.K.___ INSULATION DATE - .... _ _ BY DCD PSD • PLUMBING GROUNDWORK DATE - - - - BY MECHANICAL INSPECTION DATE BY WALL BOARD AND FIRE WALL DATE �/ BY FD CITY OF FEDERAL WAY REVISION BUILDING PBUILDING INSPECTION ERM IT 941-1555 TENANT: WHITTALL PERMIT NO. 90-416 CA OWNER'S NAME WHITTALL MGMT/CllgHMAN & WAIXEkUELD 720 S. 333RD ST CONTRACTOR SUPERIOR BUILDERS INC ADDRESS 1750 S. 327TH FEDERAL WAY - CONT. PHONE 874-3647 CONT. REG. NO. SUPERBILL2D2 OWNER'S PHONE 682-0666 OWNER'S ADDRESS 999 THIRD AVE SEATTLE 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. 926500-0170-05 LEGAL DESCRIPTION LOT 1 OF PROPOSED SHORT PLAT #884049 WHICH IS A PORTION OF LOT 17 WEST CAMPUS OFFICE PARK DIVISION I AS RECORDED IN VOL 87 OF PLATS; PGS 55-58. ISSUED BY JOANNE JOHNSON DATE OF ISSUEDATE OF APPLICATION 5-14-90 BUILDING INFORMATION NE OCCUPANCY B2 TYPE OF CONSTRUCTION VN BLDG. SQ. FT. 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) SHOWER -,i URINALS _ FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _ LAVATORILS DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE _ DISHWASHERS TOTAL FIXTURES UNIT HEATER _._._._. TOTAL MECHANICAL AMOUNT VALUATION 9,600 APPROVAL TO EXISTING TENANT IMPROVEMENT PERMIT #90-416 CA PERMIT FEE _ PLAN CHECK FEE iri _ n(i_ PLUMBING FEE MECHANICAL FEE TAL BLDG. FEES _ T P/C FEE SEPA REVIEW WATER SERVICE DATE: I �' WATER MAIN CHG. S.B.C.C. FEE i AMOUNT: OTHER FEES AMOUNT DUE 35_0_0__ RECEIPT: CC: FD 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 INFORMATIOPJ FURNISffD ,BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WI L MET-- OWNER OR AGENT DATE –:.�,,,�f.�,•.,+�r++r .��..�..:... �5'+�" n.-�.tgsvarev–" �-� . :m,::.�,?®�4pr•s+�::.wA. ..y� ,s•t.�... _�... �...-. •-,..�--.-----�-—�':---..� FCITY OF EDERAL WAY BUILDING PERMIT BUILDING 941!N SSECTION PERMIT NO. OWNER'S NAME JOB AvDRESS 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 ONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT. 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 RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT VALUATION APNOVAL TO MXISTENG TXXAIVT IMPANEMENT PI3R1UT #99-416 CA PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE OTAL BLDG. FEES RT P/C FEE �j SEPA REVIEW f WATER SERVICE DATE1 WATER MAIN CHG. —� . S.B.C.C. FEE — 40i=: ^'�4 r OTHER FEES t AMOUNT DUE ,"I ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMIT -S 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 DCD PSD PLUMBING GROUNDWORK DATE BY MECHANICAL INSPECTION DATE BY WALL BOARD AND FIRE WALL M BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. # ' Card MUST be presented CONTRACTOR'S ADDRES '7 SO � , 3 27 t�Sf CtN' I -<<=Z CITY � ' � �•� PHONE 06 EXPIRATION DATE 3 L/ I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SF CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. CONTRACTORS AND BOX 3 CONTACT PERSON �I cAtO M, S l� �r �` � �` PHONE S` BOX 4 SEWER DISTRICT r7edCPP-n-( (X3/4v WATER DISTRICT h BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER I - U S LEGAL DESCRIPTION 1,04 1 Cq I re ccQ iN V�P_7 (If necessary, please submit a separate page with the legal d scription.)sS-SS ;A_jks%fir. KcorJrj BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOORIZN SIG tjSND FLOOR 3RD FLOOR BASEMENT --- / - DECK / GARAGE /cam. BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) (`x) EXISTING STRUCTURE a� ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough -ins) N0. WATERCLOSETS BATHTUBS SHOWERS Ni 0--DISHWASHERS LAVATORIES SINKS 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 $ AV l RECEIVED 10 ~ $ 5 CONVERSION BURNER l APR 2 19�ss, $ AIR HANDLING UNITS CITY OF FEDEPIAL WAY HEAT PUMPS, SIZE CITY OF FEDERAL WAY BUILDINtW; DEPT. UNIT HEATERS $ BUILDING PERMIT APPLICATION AIR COOLING UNITS, SIZE $ —Please Print $ BOX 1 OWNER L fO JOB LOCATION LO 'S S +�ee OWNER'S ADDRESS i.irtA A CITY eh e PHONE DESCRIBE JOB r-UQA12 $ THE PROPERTY IS OWNED BY: SINGLE/ ARRIED PARTNERSHIP CORPORATION X BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. # ' Card MUST be presented CONTRACTOR'S ADDRES '7 SO � , 3 27 t�Sf CtN' I -<<=Z CITY � ' � �•� PHONE 06 EXPIRATION DATE 3 L/ I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SF CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. CONTRACTORS AND BOX 3 CONTACT PERSON �I cAtO M, S l� �r �` � �` PHONE S` BOX 4 SEWER DISTRICT r7edCPP-n-( (X3/4v WATER DISTRICT h BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER I - U S LEGAL DESCRIPTION 1,04 1 Cq I re ccQ iN V�P_7 (If necessary, please submit a separate page with the legal d scription.)sS-SS ;A_jks%fir. KcorJrj BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOORIZN SIG tjSND FLOOR 3RD FLOOR BASEMENT --- / - DECK / GARAGE /cam. BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) (`x) EXISTING STRUCTURE a� ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough -ins) N0. WATERCLOSETS BATHTUBS SHOWERS Ni 0--DISHWASHERS LAVATORIES SINKS ELECTRIC HOT WATER HEATER LAUNDRY WASHER OUTLET URINALS DRINKING FOUNTAINS SUMPS, SPRINKLER VACUUM BREAKERS DRAINS OTHER TOTAL FIXTURES ERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE ST OF MY KNOWLEDGE AND FU.PTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER - RM THE WORK FPR WHICP4 PEOMITAPR4-ICATION IS MADE. /NER/AGENT: �r!® ANP -008 2/90 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 $ -% $ 4 -- $ TOTAL MECHANICAL FEE $ ERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE ST OF MY KNOWLEDGE AND FU.PTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER - RM THE WORK FPR WHICP4 PEOMITAPR4-ICATION IS MADE. /NER/AGENT: �r!® ANP -008 2/90 N OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZONE SETBACKS,. FHOW) SIZE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL REMARKS: _ SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DATE REMARKS: ASSIGNED ADDRESS: RECEIVED ACCEPTED FOR FILING 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. - ROOF OTHEfi OCCUPANCY YS TYPE OF CONSTRUCTION t ! STORES D Er— Cf BUILDING SQ. FT. (/ Z 3 @ S O . e; 3. G BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ r BUILDING SQ. FT. 0w @ TOTAL SQ. FT. 7.6 TOTAL VALUATION f ( 3 K272,6 EBUILDING PERMIT N0. PLAN CHECK FE RECD RECEIPT N0. PERMIT FEE t 3 S� o PLAN CHECK FEE - 82. --- PLUMBING FEE - - - - - - - MECH. FEE to SO TOTAL FEES Z - v SBCC SURCHARGE Y - 5' ENERGY SURCHARGE AMOUNT DE 'Z3 Y oa BUILDING DEPARTMENT APPROVAL -------=--------------------- D- +- 3o - 9� REMARKS: ASSIGNED ADDRESS: RECEIVED ACCEPTED FOR FILING 0 aermit # CITY OF FEDERAL WAY A cFsI0N v BUILDING PERM IT APPLICATION .4/* 1 "F° — Please Print — PERMTj"�✓tl BOX 1 TENANT NAME: C,, N j +-` A_ j j li ti c, I r 6-- OWNER r OWNER SITE LOCATION OWNER'SADDRESS 99ci `I`UtA 14,t- CITY_ DESCRIBE JOB Ti .I THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP '7 Ze cJ+ PHONE BOX 2 CONTRACTOR'S NAME CORPORATION S t r C t r1-1 t c( c e- r -S - I w C, CONTRACTOR'S REG. # CONTRACTOR'S ADDRESS 7 �0 S 3 2 7 f� CITY_ �''? 7 PHON EXPIRATION DATE_�ylq 1 —OR— I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIA CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. T k'r(i(!Z_B-Z_ Card MUST be presented 79-1 9-7 CONTRACTORS AND BOX 3 CONTACT PERSON �H� 113 Z-' e PHONE S 7 `1' 'SC- Y 7 BOX 4 SEWER DISTRICTWATER DISTRICT BOX 5 ESTIMATED PROJECT COST(3, Obc EXISTING BUILDING VALUATION ' 0, C1V0 , 0 0 BOX 6 PROPERTY TAX ACCOUNT NUMBER 'IZ(- LEGAL DESCRIPTION LL !e 1L ca(A- -W 128 e) i`s A O- t0A] C (1b 1 7 .�I Cgr�a�S D IFi cc (��r� to �� si.:�� 1- 14s AIS syg�$e< Ss=SB (If necessary, please submit a separate page with the legal description.) j#J.J ts..'o<,I e -e C_ -c(e o t 4" �.j K.C. Plat Recording # 5'6'!c`1 `I BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR Z S'C.r /'SS?-' f 2ND FLOOR 3RD FLOORS=_BASEMENT - DEeK=7:=jGARAGE,==�-- BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY %0 ComSQ FT BOX 9 PLUMBING FIXTURES (including rough -ins) NO. _ WATERCLOSETS +_--�BATHTUBS LAVATORIES ---------SINKS __.____—DISHWASHERS ELECTRIC HOT WATER HEATER LAUNDRY WASHER OUTLET / URINALS " DRINKING FOUNTTW SUMPS SPRINKLER VACUUM BREAKERS [1RAW OTHER -____-- TOTAL FIXTURES MECHANICAL APPLIANCES — BASIC FEE $ GAS PIPING, FEET $ N0. FURNACE, ELEC. GAS $ GAS HOT WATER HEATER --' " $ CONVERSION�NEf� $ B0 L€R; "SIZE BTU $ AIR HANDLING UNITS $ HEAT PUMPS, SIZE _ $ IT HEATERS $ AIR UNITS, SIZE $ COMMERCIAL $ _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 EMkLOYjFES, UPON T E ACCRACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: I DATE: f `1 ANP -008 3/90 • 6 OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZONE -1 SETBACKS:FRONT_ PLANNING DEPARTMENT APPROVAL REMARKS: SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL REMARKS: PUBLIC WORKS DEPARTMENT APPROVA REMARKS: SIDE _,!REAR HEIGHT LIMIT DA DATE 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 26 o 0 BUILDING DEPARTMENT REMARKS: ASSIGNED ADDRESS: Amount K(s PARTIAL PLAN CHECK FEE RECEIVED Date Receipt # BUILDING DEPARTMENT APPROVAL BY DA PERMIT FEE PLAN CHECK FEE <' PLUMBING FEE 6 MECHANICAL FEE U TOTAL BLDG. FEES PART P/C FEE SEPA REVIEW S.B.C.C. FEE OTHER FEES AMOUNT DUE ACCEPTED FOR FILING