90-100093 CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 90-1245 P OWNER'S NAME DR BRYAN MAYER JOB ADDRESS 1305 S 312TH ST
CONTRACTOR CORNELL PLUMBING & HTGADDRESS 3210 S TACOMA WAY TACOMA CONT. PHONE 473-7171
CONT. REG. NO. CORNEPH277JF OWNER'S PHONE 839-1141 OWNER'S ADDRESS 1309 S 212TH ST
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. NA LEGAL DESCRIPTION NA
ISSUED BY
JOANNE JOHNSON DATE OF ISSUE �.2 7-?6 DATE OF APPLICATION 7-25-90
BUILDING INFORMATION
NE 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. _
SINKS ____2____ MISC. BASIC FEE 20.00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS TOTAL FIXTURES 2X5= 1 D._O1? UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION 30.00
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE 30-00
ECHANICAL FEE
iiiTAL BLDG. FEES
RT P/C FEE
SEPA REVIEW DATE: 7 - -J
WATER SERVICE
WATER MAIN CHG. AMOUNT: 3 d 0._)
S.B.C.C. FEE
OTHER FEES RECEIPT: /c-r 7Zf 7 /-
AMOUNT DUE 30.00
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.'RESID NTIAL /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: /
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OWNER OR AGENT fr2 7.9e)
--- -i '_�i�I DATE 'moi
• 2
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
NE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT
ET 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
SINKS MISC. , • ' CONVERSION BURNER BASIC FEE _ RETURNED
CU►
DISHWASHERS TOTAL FIXTURES -,5 Y✓•:iii UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE _
MECHANICAL FEE
•TAL BLDG. FEES
PART P/C FEE
SEPA REVIEW DATE;
WATER SERVICE
WATER MAIN CHG. AMOUNT:
!___. T_,_._
S.B.C.C. FEE
OTHER FEES RIPT-
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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CITY OF FEDERAL WAY
RECEIVED
BUILDING PERMIT APPLICATION JUL 2 61990
— Please Print—
BOX 1 TENANT NAME: 1)(, /2jy'j�(Jn !n( 'e(
OWNER /)Ana Q(, Do D,11,0,,k,0� 8 Di,lobedE1/,5.rj SITE LOCATION 13(15 SOLD/) 3/2 fh .
OWNER'S ADDRESS ;54mE CITY Pclita/ 1IJ,2(/ PHONE '39. 1/1//
DESCRIBE JOB Add dei/a! Maw' 5i/7k /
THE PROPERTY IS OWNED BY: SINGLE/MARRIED ___ PARTNERSHIP i� CORPORATION
BOX 2 CONTRACTOR'S NAME n//2.d/ /L11'i b' Ph) /Iv, CONTRACTOR'S REG. # /4/V, y77'c ')' 7
(lard MUST be presented
CONTRACTOR'S ADDRESS VI/0 5o.Tal'c'i�a lila/ CITY '1' /.'?, PHONE L/7i - 7,7/
EXPIRATION DATE /0,3i• 9O
— 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 2 l)c2s/ O"/fcl/t(..i_ PHONE 5'3 2 /575
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(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 ( ) 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) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
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.
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OWNER/AGENT: DATE: d
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ANP-008 3/90