91-101225 c,), JO/LIS
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 91-1187 MH OWNER'S NAME RALPH JACKSON JOB ADDRESS 32820 20TH AVE S. #44
CONTRACTOR OVERSON CONSTRUCTION ADDRESS 1908 S 341ST PL #7 FEDERAL WAY _ CONT. PHONE 874-3400
CONT. REG. NO. OVERSCC141DU OWNER'S PHONE 874-7842 OWNER'S ADDRESS 31326 12TH AVE SW 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. 797880-0500-01/0525-02/005QMSCRIPTION (SEE ATTACHED TO PLANS)
9
ISSUED BY JOANNE JOHNSON DATE OF ISSUE9A l / DATE OF APPLICATION 8-29-91
BUILDING IN ORMATION
ZONE RS 7.2 OCCUPANCY R3 TYPE OF CONSTRUCTION VN_ BLDG. SQ. FT. 1440 SF
SET BACKS: FRONT 10' SIDE 12' REAR 18' 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 8,388_86 PLANNING DEPT APPROVAL: DB 9-4-91
108.00
PERMIT r;EE FIRE/BUILDING DEPT APPROVAL: MM 9-6-91
PLAN CHECK FEE 70-00
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES 4( ...--c? i
PART P/C FEE
SEPA REVIEW DATE
WATER SERVICE
WATER MAIN CHG. AMOUNT: $182.50
S.B.C.C. FEE 4.50 (j
OTHER FEES RECEIPT: aCi2r
AMOUNT DUE 182- 90
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 INFORMATIO FURNIS ED Ba TRW AND ORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL :E MET: // kr.
T
4 /OWNER OR AGEN �_ /„. �� .a. DATE � /�� l
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
ZONE 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 .... s) ';PiAPPROVA`"'.
PERMIT FEE .."-•� L s ,i1 ORM APP VAT+• :
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
/ r
TOTAL BLDG. FEES _. f t r
PART P/C FEE j
SEPA REVIEW
WATER SERVICE y d s
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
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 TF,UL 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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Permit # qi,-- liyr ty\
RECEIVED
AUG 2 9 1991 CITY OF FEDERAL WAY
crr1OFFED RADEWAY BUILDING PEReMIPT rint APPLICATION
BUILDINBOX 1 TENANT NAME:
OWNER -RAL ? H -1 ft-cK sQ r3 SITE LOCATION 3,21 0 g-0/:4-' Ove• S S . # `f�
OWNER'S ADDRESS 312,P..6 vas~ Ave. 5 WCITY F-(ADPHONE 5n 4 -7 S'4 a,
DESCRIBE JOB 11kve 1 o4v me_ Se-}-- p ' & -(A(' _-
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME (DUES-56 &) CoTITS i. Co . CONTRACTOR'S REG. #
Card MUST be res teen d
g7 4 Ov,ERsmc i4vEt.i
CONTRACTOR'S ADDRESS 1 el O% 5 31 -- r i• CITY r'‹ d • W M PHONE 1.7 -34t0 0
EXPIRATION DATE c3 ii a 19 a q),
I y
— 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 Ke n Ai C 1<t 1 PHONE $-'-F-34.00
BOX 4 SEWER DISTRICT FLL WATER DISTRICT f (1,..)
BOX 5 ESTIMATED PROJECT COST !D. 00 O _ EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER Mil`6g 0- 050 b - O 1 17 91 ' ' o- OSa.S-D / -71-7 -66 6-0 %
LEGAL DESCRIPTION See ATTi4c t* D
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # ,,..---- `
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / / I S-- 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE / .2.115.
BOX 8pSINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ /
NO. WATERCLOSETS GAS PIP ' ., 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 I ICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY,BUT ONLY - ,E SUC CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, UP N THE CCU C/OF E INFORM, 'ON SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE: g
_ 9 / ` /
ANP-008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONESIZ SETBACKS: FRONT SIDE 17-- R AR I ) HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL q V q/ O'
REMARKS:
SEPA: EXEMPT v/ NOT EXEMPT
FIRE DEPARTMENT APPROVAL 47,4/17 DATE 9A/9./
REMARKS'
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS: WA/
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. OTHER
OCCUPANCY R3//,-,'/ TYPE OF CONSTRUCTION STORES �!�J'2_
),..,d -4;, BUILDING SQ. FT. //39. @ 1� = 5764,(ip
^,rr /Jef-,/--- BUILDING SQ. FT. ,)QF' @ !3 4' = '3 77d •8b
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ = /S3 2. 'FO
BUILDING SQ. FT. @ � / =
BUILDING SQ. FT. @ /i)Cr//d-ie.2 )( ,g$ =
TOTAL SQ. FT. yqO SQ TOTAL VALUATION ,,,.1,,,,_,
> 3.c• ' �
BUILDING DEPARTMENT REMARKS: PERMIT FEE /0
PLAN CHECK FEE •7G
PLUMBING FEE -61--
MECHANICAL FEE
TOTAL BLDG. FEES ,, —
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE y se
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS:
r 4' PARTIAL PLAN CHECK FEE RECEIVED
! 314/4. Amount Date Receipt#
aA BUILDING DEPARTMENT APPROVAL
R41BY 74, ,mai "Yf():a: k DATE 7/6/9/ ACCEPTED FOR FILING
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