90-100414 CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 90-569 P OWNER'S NAME HELMER PACIFIC JOB ADDRESS 452 SW 347TH
CONTRACTOR LANNING PLUMBING INC ADDRESS 18132 SE PETROVISKY RENTON _ CONT PHONE 228-7562
CONT. REG. NO. LANNIP*234PR OWNER'S PHONE 432-5055 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 GRADINGOTHER
TAX ACCOUNT NO._ LEGAL DESCRIPTION LOT 18 DIVISION 3 CAMPUS HIGHLANDS
ISSUED BY JOANNE JOHNSON DATE OF ISSUE S--D. 1--C�O DATE OF APPLICATION 5-10-90
BUILDING INFORMATION
NEOCCUPANCY TYPE OF CONSTRUCTIONBLDG. SQ. FT.
SET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT
PLUMBING Na Na MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS 4 ELEC. HOT WATER HEATER 1 _ GAS PIPING FT. BOILER
BATHTUBS 2 LAUNDRY DRAINS 1 COMPRESSOR TANK(S) RECEIVED
SHOWERS 2 URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVATORIES 6 DRINKING FOUNTAINS _ GAS HOT WATER HTR. MISC
SINKS 2 MIsc. LAUNDRY TRAY CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS I TOTAL FIXTURES 2OX5=100-00 UNIT HEATER TOTAL MECHANICAL —_ AMOUNT _
BASIC FEE2U.O0
VALUATION 120.00
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE 120_00
CHANICAL FEE
JTAL BLDG. FEES _
PART P/C FEE
SEPA REVIEW DATE: 47 ( / 5' C)
WATER SERVICE
WATER MAIN CHG. _ C2)S.B.C.C. FEE _ AMOUNT: I 0
OTHER FEES
AMOUNT DUE 120.00 RECEIPT: 5 `73
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 c4. '-: - 1 ,��"' DATE ' s.
• emit # ib - 5 t !
B I CITY OF FEDERAL WAY � CE�v
U LDING PERMIT APPLICATION Ep
—Please Print— MAY 0199#
Clj�rCJI t.El. J U
BOX 1 TENANT NAME: 8U1i?DlRRAL WA
y
OWNER \het�£�- --4a.� LA..� c__. SITE LOCATION `-\ -S - . S : - 3 1 `k 1� T
OWNER'S ADDRESS CITY PHONE`-1 S2- S S S
DESCRIBE JOB 'Pl k- ...-.
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION ---
BOX 2 CONTRACTOR'S NAME t--R1-'s'\+-J"N.. "‘V•b- � 1%b-C.-. . CONTRACTOR'S REG. #�'�‘ �‘ •2-3-1 P�
\ Card MUST be present
CONTRACTOR'S ADDRES� r%k 3Z-5t v?e-"-c �`-�CITY Y Z -2---F PHONE - Z S •'L_�
EXPIRATION DATE I q l D )
1 — 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 &26' \^A.',-' C *-A Vh.N. P H 0 e a:2-24g '-1 S z
• BOX 4 SEWER DISTRICT WATER DISTRICT
- BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION --e1)--
•
BOX 6 PROPERTY TAX ACCOUNT NUMBER Ai.
LEGAL DESCRIPTION r t�11I1 1UMIWZ=I ��r
(If necessary, please submi a separate page with the legal description.) J 5
K.C. Plat Recording#
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR / _
3RD FLOOR l BASEMENT / DECK / GARAGE /
- BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. 4 WATERCLOSETS GAS PIPING, FEET $
2 BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
L' LAVATORIES CONVERSION BURNER $
2- SINKS BOILER, SIZE BTU $
k DISHWASHERS AIR HANDLING UNITS $
1 ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
k LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
k OTHER L.., Av r-�•-r' ..\ . LA`y $
2_ TOTAL FIXTURES $
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 EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: � _s.---== (----- .Z.a- —___' DATE: 5 -- 1 - c)
ANP-008 3/90
• •
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
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
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: 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
'16, ASSIGNED ADDRESS:
•
s>? 41/.4 PARTIAL PLAN CHECK FEE RECEIVED
\>p' >Amount Date Receipt#
,,[ ) BUILDING DEPARTMENT APPROVAL
RECEIVV'W BY DATE ACCEPTED FOR FILING
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
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. 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. *:4"►c1A#ik++Y`:i 4.4h r.a + CONVERSION BURNER BASIC FEE
DISHWASHERS TOTAL FIXTURES ^4,- UNIT HEATER TOTAL MECHANICAL _ AMOUNT _
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW '°.5 t ,.:..r+' -I ll
J.. W
WATER SERVICE
WATER MAIN CHG. _
S.B.C.C. FEE . ' S I ,j (J _ : _
OTHER FEES
*x
AMOUNT DUE } rrrrrtor-, 91- i /
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 __ _
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