90-100537 CITY• OFBUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
t go t o 0 537
PERMIT NO80- 732 P OWNER'S NAME EVERGREEN QUALITY CONSTRUCTIOIB ADDRESS 1211 S.W. 346th ST
CONTRACTOR LEES PLUMBING ADDRESS 22110 133 ST E SUMNER CONT. PHONE897-8444
CONT. REG. NO. LEESP123KU OWNER'S PHONE 874-3221 OWNER'S ADDRESS 1911 SW CAMPUS #123 FEDERAL 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__
TAX ACCOUNT NO._ LEGAL DESCRIPTION LOT 54 MADRONA MEADOWS
ISSUED BY JOANNE JOHNSON DATE OF ISSUE _ DATE OF APPLICATION 5-29-90
BUILDING INFORMATION
OZONE 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 3 ELEC. HOT WATER HEATER __ 1 GAS PIPING FT. BOILER
BATHTUBS 2 LAUNDRY DRAINS _ 1 COMPRESSOR TANK(S) RECEIVED _
SHOWERS URINALS - FORCED AIR FURNACE AIR HANDLING UNIT _ NUMBER
LAVATORIES 4 _ DRINKING FOUNTAINS GAS HOT WATER HTR. MISC.
SINKS MISC.BASIC FEE 20.00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS 1 TOTAL FIXTURES 65.00 UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION 85.00
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE 85-00 _
iiiMECHANICAL FEE
morTOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW DATE: 4 -s---- 6
WATER SERVICE
WATER MAIN CHG. AMOUNT: 0✓
S.B.C.C. FEE
OTHER FEES RECEIPT: / 6 U IC)- 5
AMOUNT DUE 85.00
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 B T:
OWNER OR AGENT (.\:.1..\..,: --c- DATE L' ` S - 9 0
Permit # $v - 73 2
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER t^v E`� 4" C ✓�14Z,,i—y /� >, SITE LOCATION / // ` 1,14). i'Y�� r' "'t:—�
OWNER'S ADDRESS /f// �S�i, C4-44 c,5 L 2 - `,2-3 CITY ON,
`' q2�3 13 PHONE 87&/ 3 e--2- I
DESCRIBE JOB r
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #[_tet-:;ys , Z. 3 is
t Carl MUST be presented V Q
CONTRACTOR'S ADDRESS Z Z Ito t 3 cr,_ CITY`SS'..,.7e.c' PHONE p S.7 e'"/'S/'S/
EXPIRATION DATE c- 9 t
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON _ / Et. PHONE c'97 ?'(7''./' '
BOX 4 SEWER DISTRICT WATER DISTRICT 2c, 3 S - 2_
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER f�
LEGAL DESCRIPTION �r f' 5c-( /LGNta, t'e/ 'F!41_)-
(If
1i(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 (,X) SINGLE FAMILY (X) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ •�o
NO. WATERCLOSETS GAS PIPING, FEET $ .SES
,c' BATHTUBS NO. FURNACE, ELEC. GAS $ /0
SHOWERS GAS HOT WATER HEATER $
gy LAVATORIES CONVERSION BURNER $ 2t-)
/ SINKS BOILER, SIZE BTU $ \7
/ DISHWASHERS AIR HANDLING UNITS $
ttferiTC HOT WATER HEATER HEAT PUMPS, SIZE $ 't
/ LAUNDRY WASHER OUTLET UNIT HEATERS $ t5'
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKE•. OTHER — $
DRAINS $
OTHER $
3 TOTAL FIXTURES $
TOTAL MECHANICAL FEE $ • cr,
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 FED 'AL WAY, BUT ONLY WHE•E SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
'OFFICERS AND EMPLOYEES, I •►N - ACCU•£CY OF T'E I 'IR ATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
•
OWNER/AGENT: : i" � DATE: --5—
ANP-008 3/90
V/
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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
WINE 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,,_ x.''--- 4.0•°" ' CONVERSION BURNER BASIC FEE
DISHWASHERS TOTAL FIXTURES UNIT HEATER _ TOTAL MECHANICAL AMOUNT
+.....:.6;5._
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
CHANICAL FEE
'TAL BLDG. FEES
PART P/C FEE
SEPA REVIEW DI%"
WATER SERVICE
WATER MAIN CHG. MUT:
S.B.C.C. FEE
OTHER FEES ttWEIPT` _,_�
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
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