91-100943 9) r/ 9 Lf3
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 91-890 RA OWNER'S NAME LLOYD MENZEL/ESTHER STOLTENBFjRG,IdADDRESS 32820 20 AVE S #17
CONTRACTOR OWNER ADDRESS SAME CONT. PHONE 838-2655
CONT. REG. NO. NA OWNER'S PHONE SAME OWNER'S ADDRESS SAME
TYPE JOB: NEW RESIDENCE ADDITION XXX NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITSMULTI. ADD. SIGN GRADING OTHER ADD SUNRROOM-&r�EelE ONTO MOBILE HOME (DECK UNDER 30"
TAX ACCOUNT No. 144170-0170 LEGAL DESCRIPTION LOT 17 CEDAR CREEK MOBILE HOME PARK FEDERAL WAY
Mr
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 7/3/91
BUILDING INFOR ATION
NE RS 7.2 OCCUPANCY R-3 TYPE OF CONSTRUCTION 5-N BLDG. SQ. FT. 410
SET BACKS: FRONT 20' SIDE 5' EACH REAR 5' _ STORIES NA HEIGHT LIMIT NA
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 NONE UNIT HEATER TOTAL MECHANICALNONF. AMOUNT NONE
VALUATION $16,892.00
PERMIT FEE -1$A-.$9-171.00 PLANNING DEPT APPROVAL = LORI SCHILL
PLAN CHECK FEE -144-,0-0111.00
PLUMBING FEE "EDGE OF PROPOSED SUNROOM WILL BE 6' 5" FROM ADJACENT STRUCTURE
111 MECHANICAL FEE AT SPACE 19"
OTAL BLDG. FEES $29-7,044282.00
PART P/C FEE _ FIRE/BLDG DEPT APPROVAL = KEVIN ELLIS
SEPA REVIEW -_
WATER SERVICE "DECK IS UND R 30', NO PERMIT FEE REQUIRED"
WATER MAIN CHG. 9/qj
S.B.C.C. FEE 4.50 f9/1:
OTHER FEES DATE PD AMT 3-0-1-. 5-0- RE'CT ,367b 4....---
AMOUNT DUE 4111L-541$286.50 $286.50
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 pRRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
0
OWNER OR AGENT /�- �� ® t DATE 7ri .4,-:.1. --- g/r___'
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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
Ai
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 PANNING t)it'T AP'P'ROVAL s 'VRI :.iti.iil L.:.
PLAN CHECK FEE
PLUMBING FEE - 'EDGE OP PROPOSED SU ROOM WILL FE 6'5" FROM ci J0,(7.
CHANICAL FEE AT SPACE 19
alt.TAL BLDG. FEES
PART P/C FEE FIR'! BLDG DEPT APPROVAL a= KEVIN ELMS
SEPA REVIEW
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WATER SERVICE - -
WATER MAIN CHG. -
S.B.C.C. FEE i
/
OTHER FEES AM+r3{ 'C' �,,_RE'CSS'. L s+.._
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. k
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 j L
REQUIREMENTS WILL BE MET: r
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OWNER OR AGENT DATE 1/
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RECEIVED
CITY OF FEDERAL WAY
JUL 03 1991 BUILDING PERMIT APPLICATION
Gm Of FEDERAL WAY — Please Print—
BUILDING DEPT
BOX 1 TENANT NAME:
OWNER /ntin /t1EA/ZEZ Iksrt/ZRSM.rCit28C C SITE LOCATION 3P4S'at)-RD7t/S ,Y .;7 --1c4- ! /,,Ja,y
OWNER'S ADDRESS a rH-e ,f.s 5 t 7 __' CITY --t{ J u/J.,/ PHONE 83g -a 65S
DESCRIBE JOB f4 3c /r,q 5un /oorn Z DEcte___
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME �"ZriA/cYL- CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
— 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 4-1-01-1 ll? i(/Z�L. PHONE 8"-cX36—
BOX 4 SEWER DISTRICT --e rt-ea,otkj/l9a' WATER DISTRICT -_ 2t.- -L y
rtkz
BOX 5 ESTIMATED PROJECT COST -- 5-5-477610,� e_76 EXISTING BUILDING VALUATION .n ' 4z/77,e7/Y/7
BOX 6 PROPERTY TAX ACCOUNT NUMBER /9/4/ 7D --C'/-7 a
LEGAL DESCRIPTION C-'o/3 R C, - 'k /7
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2 Y ao 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK .-.5- / /0 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 $
ATHTUBS NO. FURNACE, ELEC. GAS $
ROWERS GAS HOT WATER HEATER $
LAVATORIES CONVE SION BURNER $
SINKS / BOILER, SIZE BTU $
DISHWASH'R'S AIR HAN LING UNITS $
ELECTRI' HOT WATER HEATER HEAT PU/ S, SIZE $
LAUND°Y,WASHER OUTLET UNIT HEA RS $
URIN.LS \ AIR COOLING UNITS, SIZE $
DRI KING F UNTAINS COMMERCIAI\HOOD $
S PS, SPRINKLER VACUUM BREAKERS %OTHER \ $
BRAINS $
OTHER 7 $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THESEST 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: — ,� �:� ��.�.' � i..' 1 DATE: �' -
AN0-008 3/90
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OFFIC USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) Q3V 1.3
ZONE3P '7Z SETBACKS: FRONT 2e ' SIDE S ' REAR S ( HEIGHT LIMIT +
PLANNING DEPARTMENT APPROVAL 1-/ 7-id 4 f
REMARKS: Ti. , , — Gtc ap 7 G72—f_a,--,( .__ MAW .1AN.iu j.i i( ;r
g-DC.- - of D Ste.v 9.oc+�( �'i1-c- --- " f�-01e1 A-7).TA-e- Air1490 QstllF4
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c-rA-T s PA-c,E /9. 4,/5.--a
SEPA: EXEMPT ,----- NOT EXEMPT
FIRE DEPARTMENT APPROVAL --Cr DATE7` /6- 7/
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE gifE RES. ADD/ALT X- NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY R 3 TYPE OF CONSTRUCTION V/V STORES drre
MI;I SL'o( BUILDING SQ. FT. a 9 0 @ 702io = 11, 9Cf L.
fl e�lAN - BUtLDING SO. FT. /•.70- —_ — @ — - = /7
7 BUILDING SQ. FT.
vildet 3v `' BUILDING SQ. FT. @
b a�ncr i BUILDING SQ. FT. @ yv+u/liert x . $g = 11t lq la
a BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION 1 (o i l'9 a• t/$
(3d/0 i Si 3.7&,V r
BUILDING DEPARTMENT REMARKS: PERMIT FEE - I 71 �l
PLAN CHECK FEE ___1747._. I i i
PLUMBING FEE -a-
MECHANICAL
MECHANICAL FEE -0-
TOTAL
TOTAL BLDG. FEES -_ -ii-r"' -ITg
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE '1
OTHER FEES
AMOUNT DUE 7, 1,4_T. ?
ASSIGNED ADDRESS: Se-_ cikl.ai Sidc- !
GG���Vso PARTIAL PLAN CHECK FEE RECEIVED
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3 V'SIA �y Amount Date Receipt#
OF "pE0�. BUILDING DEPARTMENT APPROVAL p
G 1 �D BY r- ------- DATE 7— (7 — 1 / ACCEPTED FOR FILING
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