90-100179 CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
96 - >a01-i9
PERMIT NO. 90-0240 OWNER'S NAME PAYLESS DRUGS JOB ADDRESS 2131 SW 336 ST
CONTRACTOR KAREL PELTRAM ADDRESS 30950 325 LANE FEDERAL WAY CONT. PHONE 941-5010
CONT. REG. NO. PELTRP*152RT 12/90 OWNER'S PHONE _ 941-5010 OWNER'S ADDRESS SAME AS SITE
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 PLUMBING
TAX ACCOUNT NO. NA LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 4/2/90
BUILDING INFORMATION
•NE NA OCCUPANCY NA TYPE OF CONSTRUCTION NA BLDG. SQ. FT. NA
SET BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS 1 ELEC. HOT WATER HEATER GAS PIPING FT. BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVI'ORIES DRINKING FOUNTAINS GAS HOT WATER HTR. MISC.
)SINKS 1 MISC. CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS TOTAL FIXTURES 3 x 5 UNIT HEATER TOTAL MECHANICAL NONE AMOUNT NONE
4.
VALUATION NONE $20.00 BASIC FEE
PERMIT FEE Post-Ir brand fax transmittal memo 7671 I#of pages ►
PLAN CHECK FEE To C�']' pkwF r' 1....4 .—, From
PLUMBING FEE 15_00 Co. V 1 o.
OCHANICAL FEE , iI I Co.
TAL BLDG. FEES Dept. I Phone# j
PART P/C FEE Fax#
Fax# n "�
SEPA REVIEW �3`1'� (n
WATER SERVICE PAID IN FULL ON: __41219g__
WATER MAIN CHG. -
S.B.C.C. FEE AMOUNT PAID: -imorAill
OTHER FEES
AMOUNT DUE $35-00 RECEIPT: or „ -_ / 33(((9
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: �� ,� f� �j
OWNER OR AGENT (i��-IC4' -L- �4i�li4 DATE ' 79 l a
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
leNE _ OCCUPANCYTYPE OF CONSTRUCTION _ BLDG. SO. 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
PLAN CHECK FEE
PLUMBING FEE
illiCHANICAL FEE
TAL BLDG. FEES
PART P/C FEE
SEPA REVIEW Ai i
i f "'
WATER SERVICE SAID I! FULL ON: j
WATER MAIN CHG.
S.B.C.C. FEE �.�, ,.-
�'�� s'� PAID:OTHER FEES "! ' - -,-),--, /1
AMOUNT DUE
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_
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CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 OWNER P , JOB LOCATION a/3/ Scv 33G " 4,4,e;
OWNER'S ADDRESS dr 3/ Ski 3'36 .<i ' CITY Fioea.oc.. (A/Ai PHONE VG ( $Z /o
DESCRIBE JOB "%'-e 4-c<- 7347-i/ oaoi
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME /<-4Kc<.. CONTRACTOR'S REG. # PeLT/''t /5.7 RT
Card MUST be presented ?)\
CONTRACTOR'S ADDRESS gCf $O 3�S F `�'�c CITY ":&47E-4-41- 6-14` PHONE �3& 4�H''/
,v
EXPIRATION DATE /2/, ,f S�Uo3
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR
3RD FLOOR / BASEMENT / DECK J GARAGE
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) Zi<ocl, 15a IC- 77‘e--e—MECHANI CAL APPLIANCES — BASIC FEE$
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 $
•_- (5- vZ' 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 PER-
FORM THE WORK FOR WHICH PERMIT APPLICATION IS MADE.
OWNER/AGENT: V 7 DATE: ' /2.. 97
ANP-006 2/90
� u ��.yv
• • '
•
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIZE 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. ROOF 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
EBUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NO.
PERMIT FEE 20 .OQ PLAN CHECK FEE -�--_-- PLUMBING FEE ---t- -0-6,\-- MECH. FEE -er-
TOTAL FEES 3 S- O o SBCC SURCHARGE -- ENERGY SURCHARGE -h AMOUNT DUE 3S. o 0
BUILDING DEPARTMENT APPROVAL DATE sf 90
REMARKS:
ASSIGNED ADDRESS: S e- - - IS F(`
7
1
RECEIVED
APR - 2 1990
CITY OF FEDERAL WAY
BUILDING DEPT.
RECEIVED ACCEPTED FOR FILING