90-100541 c)b -00 SY/
CITY OF BUILDING INSPECTION
BUILDINGFEDERAL WAY PERMIT 941-1555
PERMIT NO90- 736 P OWNER'S NAME EVERGREEN QUALITY_ CONSTRUCTION ADDRESS 1205 S.W. 346TH ST
CONTRACTOR LEES PLUMBING ADDRESS 22110 133 ST E SUMNER CONT. PHONE 897-8444
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 55 MADRONA MEADOWS
ISSUED BY JOANNE JOHNSON __ DATE OF ISSUE DATE OF APPLICATION 5-29-90
imh BUILDING INFORMATION
ONE _ 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 _2_ ELEC. HOT WATER HEATER _ 1 GAS PIPING .__ FT. BOILER _
BATHTUBS 3 LAUNDRY DRAINS __L_ COMPRESSOR TANK(S) RECEIVED _
SHOWERS URINALS _._._ FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVATORIES 3 DRINKING FOUNTAINS _ GAS HOT WATER HTR. MISC.
SINKS 1 MISBASIC FEE 70-00 CONVERSION BURNER BASIC FEE RETURNED
C.
DISHWASHERS -1_ TOTAL FIXTURES11X5= 55-00 UNIT HEATER TOTAL MECHANICAL AMOUNT
75.00
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE 7-5-.-0-0_-_
CHANICAL FEE
OTAL BLDG. FEES
DATE: 4:. - - 7 v
PART P/C FEE
SEPA REVIEW �� J
AMOUNT:
WATER SERVICE
WATER MAIN CHG. RECEIPT: ( U O 7 ( c/
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE 7 5-0 0
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 INTQRMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL B(E MET:
OWNER OR AGENT i. / ),:' Ili � DATE (2 5 CIO
Permit # 91 - 7ii' P
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
—Please Print-
BOX 1 TENANT NAME: ,dor
OWNER �i'F (_',/PP.c./ 19,,h4_,7-7, Lv0rs 7 SITE LOCATION .jos ��_cv. L•Vi, 47-:OWNER'S ADDRESS /?// >w p
e . vs /z3 CITY/J 14J.4 '- PHONE 875/ 3 -z- I
DESCRIBE JOB Y?/4.-/o /4/C .-
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ,/ e<,S /Y,-,.-04•A/t,_---- CONTRACTOR'S REG. ft 4t-e-*p i a3 K L)
Card MUST be presented
CONTRACTOR'S ADDRESS Z Z-11 O 13 3 s•r t- CITY 5 ditYil)eie PHONE F45-7 e-vii i/
EXPIRATION DATE 5'- i c> - g
— 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.
S BOX 3 CONTACT PERSONL `(� .) /(_. . PHONE,69T--e i
BOX 4 SEWER DISTRICT WATER DISTRICT P6.3—8$Z--Z__
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
t-LEGAL DESCRIPTION Zo'r- 6-.5- /13 4(.0,eD?L,9 ,i1�/f ecti,S
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( `4 SINGLE FAMILY ( )1 NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$ '-0 c
NO. ' WATERCLOSETS GAS PIPING, FEET $ /v
-q BATHTUBS NO. FURNACE, ELEC. GAS $ ,D
SHOWERS -GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $ AS-
/
5/ SINKS BOILER, SIZE BTU $
/ DISHWASHERS AIR HANDLING UNITS $ S
Ei40RRlC HOT WATER HEATER HEAT PUMPS, SIZE $ 3
/ LAUNDRY WASHER OUTLET UNIT HEATERS $ 5
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
// TOTAL FIXTURES $
TOTAL MECHANICAL FEE $ '7C.
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 C Y 0. DERAL WAY, BUT OJ l RE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLO ' 'I THE -• U''CY 0' H. FORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
4 /
OWNER/AGENT:+ 0/ _ ,/ DATE:
/ ANP-008 3/90
CITY OFBUILDING
BUILDING INSPECTION
FEDERAL WAY 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
*NE 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. CONVERSION BURNER BASIC FEE
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION _
PERMIT FEE
I PLAN CHECK FEE
PLUMBING FEE
iitCHANICAL FEL
TAL BLDG. FEES
DATE
v
PART P/C FEE
SEPA REVIEW 4.I of r:
WATER SERVICE .......
WATER MAIN CHG. RECEIPT: -
S.B.C.0 FEE �� ���'���
OTHER FEES
AMOUNT DUE
I
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE If i:0 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 O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE BY ._.—_.... DATE --.. BY —_. DATE __..___— _ ___BY
PLUMBING ROUGH IN �r WATER LINE O.K. MECHANICAL INSPECTION
DATE 7/l `9G BY /113 ______ GAS PIPING O.K. ______...... DATE BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE BY —... DATE BY — DATE BY
FINAL O.K. TO OCCUPY
DCD PSD FD
DATE BY
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