92-102047 CITY OF FEDERAL WAY BUILDING PERMIT PERMIT NO.: BLD92-2448
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/04/92
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 28717 PACIFIC 13W S
PARCEL NO.: 332204-9158
PROJECT DESCRIPTION: T.I. — BLUE MOON ESPRESSO AND BOOK BAR
OWNER — CONTRACTOR — LENDER
MERRY HEBERT *OWNER IS CONTRACTOR*
28717 PACIFIC HWY S
FEDERAL WAY WA 98003
946-0389
*OWNER*
ill
BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •B FEES:
TYPE OF WORK:TEN USE:COM 1ST.: 2000: 0:sf STORIES • 3 REQUIRED PARKING..: 3 SPRINKLERS? •. FINAL PLAN CHECK...* $ 58.50
CENSUS CATEGORY •437 2ND.: 2000: 900:sf HEIGHT • 0.00 ft HAZARD CLASS •? BUILDING PERMIT....* $ 90.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm SBCC SURCHARGE * $ 4.50
:B2 :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 20.00 ft PLCK-FIR commt only* $ 4.50
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...S: 6678 SIDE • 0.00 ft WATER SERVICE..:FED
:5N -:? :? :7 DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:FED
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:11/17/92
28: 0: 0: 0: TOTL: 4000: 900:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
1
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 157.50
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE... ,.: 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS.. : 0 > 10,000 CFM: 0 UNDERGROUND.: 0
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 6'/`,? t (K � L DATE f • / c 4
bld_prmt 10/23/92 Tf /
371/ -77a8�
CITY ;`F FEDERAL WAY BUILDING PERIIIIT PERMIT NO.: BLD92-2448
335301 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/04/92
Federal Way, NAA 98003 BY: JJ
66':-4000. �:),.0_ /4. i 4 / f)
4
SITE ADDRESS: 28717 PACIFIC HW S -i
PARCEL NO.: 332204-9158 r' ��' t—'
PROJECT DESCRIPTION: T v I o — BLUE MOON ESPRESSO AND BOOK BAR
/Ott
OWNER — CONTRACTOR
1- •- LENDER
MERRY HEBERT *OWNER IS CONTRACTOR*
28717 PACIFIC HWY S
FEDERAL WAY WA 98003
0389
*OWNER*
i
BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 1 COMP PLAN •B FEES:
TYPE OF WORK:TEN USE:COM 1ST.: 2000: 0:sf STORIES • 3 REQUIRED PARKING..: 3 SPRINKLERS? .9 FINAL PLAN CHECK...* $ 58.50
CENSUS CATEGORY •437 2ND.: 2000: 900:sf HEIGHT • 0.00 ft HAZARD CLASS •' BUILDING PERMIT....* $ 90.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm SBCC SURCHARGE * $ 4.50
:62 :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 20.00 ft PLCK-FIR comm only* $ 4.50
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 6678 SIDE • 0.00 ft WATER SERVICE..:FED
:5N :? :? :? DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:FED
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:11/17/92
. 28: 0: 0: 0: TOTL: 4000: 900:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 157.50
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
G�OGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
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 �2'(� F., ) � �' DATE
bld_prmt 10/23/92 \\ Ll
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RECEWED BY
NW DEVELOPMENT DEPARTMENT CITY OF FEDERAL WAY
NOV 17- 1192 BUILDING PERMIT APPLICATION
-PleaseeaPrint— r-'{
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BOX 1 TENANT NAME: e - L\ f-I e',be r t' p
OWNER CO ro I mac\ bci'6- a_ cv' . So `''�`
� SITE LOCATION .�� 7 /7 ►�o . � y 43
OWNER'S ADDRESS -(='y CITY !ma(( W e, PHONE' 9 4 c. G -3 7
DESCRIBE JOB C,ok 1-ci r. , Ci c-f`� € c-5p:-• S`%c) - .4- ,
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME _ .4 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 ili Q r ✓'1 H t'c, c'�^1-- /I'" PHONE (c / .39 &-' 7
BOX'4 SEWER DISTRICT WATER DISTRICT
BOX 5'ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER . 3j-,-bl-! 'c/5
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # yj y cccjc.-��
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / cf % 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / c GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (,C) EXISTING STRUCTURE
(n) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET' $
_BATHTUBS NO. FURNA , ELEC. GAS $
SHOWERS GAS HOT ATER HEATER $
LAVATORIES CONVERSIO BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS fii" AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
\19) 6-Q
WASHER OUTLET C ,,,c,' UNIT HEATERS $
r. URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
C SUMPS. SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
TOTAL FIXTURES FIXTURES S
TOTAL MECHANICAL FEE S
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 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.
--731 • /
OWNER/AGENT: ' 2-C. i► ' I DATE: 1/
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