90-100687 •
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
9i ' /00687
PERMIT NO. 90-984P OWNER'S NAME CASTLEWOOD HOMES JOB ADDRESS 1024 SW 354 ST
CONTRACTOR ACTION PLBG ADDRESS 14714 MANOR WAY LYNNWOOD CONT. PHONE 745-6325
CONT. REG. NO. ACTIOPS145PB 10/90 OWNER'S PHONE_ 486-1700 OWNER'S ADDRESS 14040 NE 181 ST WOODINVILLE
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 ONLY
TAX ACCOUNT NO. NA LEGAL DESCRIPTION LOT 77 MADRONA MEADOWS
SUED BY ELIZABETH SNYDER ,`,C DATE OF ISSUE --2 6 - 9G) DATE OF APPLICATION 6/25/90
BUILDING INFORMATION
ZONE NA OCCUPANCY NA TYPE OF CONSTRUCTION PLUMBING ONLY 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 3 -et!MOT WATER HEATER 1 GAS PIPING FT. BOILER RECEIVED
BATHTUBS 2 LAUNDRY DRAINS 1 COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVATORIES _ DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. _
SINKS 1 MISC. BASIC FEE 20.00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS 1 TOTAL FIXTURES 13X5.00 UNIT HEATER TOTAL MECHANICAL NONE AMOUNT NONE
VALUATION NONE
PERMIT FEE
PLAN CHECK FEE
MBING FEE $8 5-00
HANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE p^J-l 6 .._...2_‘-'F°
SEPA REVIEW ( i} ,�J
WATER SERVICE _c-.)WATER MAIN CHG.
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S.B.C.C. FEE
OTHER FEES _I_�r f-: /Z. Qs 7 77
AMOUNT DUE $85.00
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.'RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION RNISHElI BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE M T:
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CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER rq_511t c74-D J OIfl 5 f AJ G SITE LOCATION I D 9. - l.,°. 3 5'c{ f ter_ '' w`i
OWNER'S ADDRESS a O N f ):t "f/' gITY SVP PHONE .J. - 17 CO
DESCRIBE JOB,S 17
THE PROPERTY IS 0 ED BY: SINGL /MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME A C-T/b cj PuAfik 3Iq cord i'C.P CONTRACTOR'S REG. # etc-i tc Ps j'=E.S P...B
Card MUST be presented
CONTRACTOR'S ADDRESS I 714 MgNsdr CITY / NUWc7U1 tigir PHONE —7 4:5'6,3Z�
EXPIRATION DATE 10 f J 9 O
/ — OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON Al% Cs{'1 ct-e. I P. Z h bex PHONE zct. 7`f -G 3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION f Y -]-7 MA-0rO/VGl tA-Dtu)S
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( SINGLE FAMILY (X) NEW CONSTRUCTION
( MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. 3 WATERCLOSETS GAS PIPING, FEET $
. BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
44- LAVATORIES CONVERSION BURNER $
j SINKS BOILER, SIZE BTU $
/ DISHWASHERS AIR HANDLING UNITS $
/ ?!a5 i HOT WATER HEATER A-7- . HEAT PUMPS, SIZE $
/ LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
1 3 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 FF RAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, UPS I TH ACCURAC OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE:
v
ANP-008 3/90