90-100486 9b -/ab Y8�
CITY OFBUILDING INSPECTION
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FEDERAL WAY uI L D I N G PERMIT 941-1555
3S-3 5-
PERMIT NO. 90-669 P OWNER'S NAME __ WM SHERMAN JOB ADDRESS__ 1236 SW 4.54T14 ST
CONTRACTOR PERKINS & SON PLUMBING ADDRESS 8524 NE 147TH PL BOTHEL488-3535
CONT. REG. NO. PERKI I*20 OBI CONT. PHONE
OWNER'S PHONE 641-3939 OWNER'S ADDRESS 150 - 140TH AVE N.E.
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
TAX ACCOUNT NO. LEGAL DESCRIPTION STREET SIGNS ARE UP MADRONA MEADOWS
0 ISSUED BY JOANNE JOHNSON DATE OF ISSUE _ DATE OF APPLICATION 5-22-90
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 3 _ ELEC. HOT WATER HEATER 1 GAS PIPING FT. BOILER
RECEIVED _
BA-HTUBS LAUNDRY DRAINS ____1_ COMPRESSOR TANK(S)
SHOWERS ___1____ URINALS FORCED AIR FURNACE AIR HANDLING UNIT _ NUMBER
LA\'TORIES 4 DRINKING FOUNTAINS GAS HOT WATER HTR. _ MISC
SINKS MISC. BASIC FEE 20_00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS 1 TOTAL FIXTURES 13X5= 65-00 UNIT HEATER TOTAL MECHANICAL _._ AMOUNT
75.00 -
VALUATION
PERMIT FEE
PLAN CHECK FEE
,PLUMBING FEE
MECHANICAL FEE 75-00
TOTAL BLDG. FEES J --- j)0
PART P/C FEE DATE
REVIEW ^/
WATERSEP
SERVICE AMOUNT:
/ �
SERVICE
WATER MAIN CHG. ,/S.B.C.C. FEE RECEIPT: 1c (
OTHER FEES _
AMOUNT DUE 75.00
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 WILLMET:
OWNER OR AGENT Al
/61..eyth:L y E/11(1-, 2/1(2
DAT
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
.3,- 5 .
PERMIT NO. OWNER'S NAME JOB ADDRESS . . /
CONTRACTOR ADDRESS CONT. PHONE
CONT. REG. NO. OWNER'S PHONE OWNER'S ADDRESS
i 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 _ I AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
OCHANICAL FEE
TAL BLDG. FEES _ _ ^
PART P/C FEE DATE: ...s..�3.._rr_.i....
SEPA REVIEW - 1r
WATER SERVICE MOUNT` _M��'_ ,..,..'_/Y.,
WATER MAIN CHG. -, (M
S.B.C.C. FEE PEI
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 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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CITY OF FEDERAL WAY /q�C
BUILDING PERMIT APPLICATION MqrFO
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Please Print— Cy )
BOX 1 TENANT NAME:64,411 6 4 pthi pzi z90
OWNER liter-1n SITE LOCATION (� S (� o►.04 ,i• •
OWNER'S ADDRESS /So - /4-(o '" C'-v-. 1t9 E _ CITY 7 GPHONE 64/—3 3 y
DESCRIBE JOB d
THE PROPERTY IS OWNED BY: SINGL /MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME L. : "A, P��.�_. ' ONTRACTOR'S REG. #f L/z �� 4 go 03 /
Card MUST be presented
CONTRACTOR'S ADDRESS F5-9 yi(1 6' /V7 �� CITY /3 U`- -,/ PHONE flc.—3 6-3
EXPIRATION DATE 6 la 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 DaY1 PHONE 'VS/r— 3 6-3.5—
BOX
3.5BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COS, 3;-a-o0 •`° EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTIONM 1lrerA. _.a
(If necessary, please submit a separate page with the legal description.) �n I opik
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR J—_ 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK _J 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
r $
BATHTUBS NO. FURNACE, ELEC. GAS $
I SHOWERS GAS HOT WATER HEATER $
II LAVATORIES CONVERSION BURNER $
I SINKS _ BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS
1 ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE __ $
I LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
l3 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 K OWLEDGE
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.
OWNER/AGENT: /, °i.L - 1 /' L. DATE: l/// , . �O
ANP-008 3/90
• I
OFFICE USE ONLY (PLEASE JO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
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 TYPE OF CONSTRUCTION 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
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
11ea) ASSIGNED ADDRESS:
VO
t'c / PARTIAL PLAN CHECK FEE RECEIVED
YO 24 9
+ "1iJ Amount Date Receipt#
14_17 BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING