91-101027 9 J-!a/ti1 7
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 91-973 PA OWNER'S NAME ILLAHEE JR HIGH JOB ADDRESS 36001 1ST AVE S fl �1
'
CONTRACTOR JOHN KORSMO CONST ADDRESS POB 99846 TACOMA 98499 CONT. PHONEc '--(� Y
CONT. REG. NO. JOHNKCI126BE 1/92 OWNER'S PHONE 941-0100 OWNER'S ADDRESS 31409 18TH AVE S FEDEML 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. 302104-9013 LEGAL DESCRIPTION NE QTR OF THE SE QTR LESS THE SWWR LESS THE E 30 FT
FOR CTY RD OF SEC 30, TWP 21 N, RANGE 4 E.W.M. , IN
KING CO. WA.
ISSUED BY JOANNE JOHNSON DATE OF ISSUE Y�X91 DATE OF APPLICATION 7-22-91
BUILDING INFORMATION
�E
NE RS 15 OCCUPANCY E1/B2 TYPE OF CONSTRUCTION VN BLDG. SQ. FT.
T BACKS: FRONT SIDE _ REAR STORIES HEIGHT LIMIT
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
R CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. BOILER
RECEIVED
LAUNDRY DRAINS COMPRESSOR TANK(S)
URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
DRINKING FOUNTAINS GAS HOT WATER HTR. MIDUCT WORK 6.50
RETURNED
MISC. CONVERSION BURNER BASIC FEE
DI ERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 6.50 AMOUNT
VALUATION
15,000 PLANNING DEPT APPROVAL: CS 7-25-91
FIRE/BUILDING DEPT APPROVAL: KC 7-26-91
PERMIT FEE 162.00
PLAN CHECK FEE 105.00
PLUMBING FEE —___-
MECHANICAL FEE _ _6_.50
AL BLDG. FEES
HT RFEE ii.,1- i
SEPA REVIEW ___ DATE'
WATER SERVICE
WATER MAIN CHG. AMOUNT: $286.00
S.B.C.C. FEE 4.50
OTHER
OTHER FEES F.D. 8.00 RECEIPT:
_______Alii../.
AMOUNT DUE 286.00
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 FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET: 5)\/ - --72 //y
OWNER OR AGENT �{:77 • ._ , ra DATE / ( ! /
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
ONE 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
`..L 4.•.IY`;t 13x:ktie'L'a aWA : \'.w: i_ ,13.
VALUATION /BUILDING DEPT APPROVAL: KC 7-26-91
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
SCHANICAL FEE —
TAL BLDG. FEES
PART P/C FEE
SEPA REVIEW DAT: : L J
WATER SERVICE
WATER MAIN CHG. AM°' 'T» -- $286.00 --
S.B.C.C. FEE .. J r I(
OTHER FEES RECEIPT., r l-.-, �..
I
AMOUNT DUE
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.'RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT DATE
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Reten ermit # I'91-3"
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Cnv �21991CITY OF WAYfi it'\
811r141.war BUILDING PERM APPLICATION
pt
—Please Print—
TENAN
BOX 1 OWNERT NAMfc4E z�L A- }-i's� J R.., 4 ivl�10 . SITE LOCATION 3 •D• 513 ' .0 .
OWNER'S ADDRESS 3114 OS if,+h V. S. CITY Fier?. 14P _ PHONE ' 2010
DESCRIBE JOB Mop'f ICA 'tons 6o L.ovNGle znci L12ss_KookA
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #
0Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
,p - OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON Q-A-L L/I k) G1,1t5A-til Rrj PHONE '48- 1193 7
BOX 4 SEWER DISTRICTe,r 43 ITMd-SeAN_e WATER DISTRICT fedex_z_11,64TUII}1 JZ d- Sei r
BOX 5 ESTIMATED PROJECT COST -15,o00' ' EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER _r . a — ' 0 _
LEGAL DESCRIPTION Set Jr 1 C. II i-. 1
(If necessary, please submit page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK I GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) N_EW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) XISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY 9.0 11CR 55 SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
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 ! .c `1 $
DRAINS $ /
HER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
I CERTIFY NDER 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, UT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOY ES, . PON TH. 'CCU Y OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: �� DATE: _
7 ANP-008 3/90
COV t.
1k r
OFFICE USE ONLY ( 1•
COV
,TEBELOW THIS LINE) 010
ZONE
ZONE /15/ SETBACKS: FRONT /N// EAR %//A HEIGHT LIMIT /L%/41 .tom
PLANNING DEPARTMENT APPROVAL 7 s Y/
REMARKS:
•
•
SEPA: EXEMPT \ NOT EXEMPT car:Cc mi""" d K
.'�{ sC
FIRE DEPARTMENT APPROVAL DATE 7__ 2
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS: 411/�
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 / /i TYPE OF CONSTRUCTION tV • STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS: PERMIT FEE (6 7--
PLAN CHECK FEE (b S
PLUMBING FEE
MECHANICAL FEE 6 -1—
TOTAL
sTOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE LI-
OTHER FEES Q r
AMOUNT DUE
�► ASSIGNED ADDRESS: Se-Q e K( S
Q
�C/
N tU4 PARTIAL PLAN CHECK FEE RECEIVED
14/ v 42 Amount Date Receipt#
�� BUILDING DEPARTMENT APPROVAL
RECEIOD BY DATE _ 1
1 ACCEPTED FOR FILING