91-101253 CITY OF FEDERAL WAY
33530 First Way South BUILDING P E R Ill I TRENEWAL OF BUILDING90-645 INSPECTION
Federal Way, WA 98003 661-4140
PERMIT NO. 91-1212 RE OWNER'S NAME CHAFFEY CORP SITE ADDRESS 34324 30 AVE SW
CONTRACTOR CHAFFEY CORP ADDRESS POB 560 KIRKLAND CONT.PHONE _ 822-5981
CONT.REG.NO. CHAFFC*15ONG EXP.7/92 OWNER'S PHONE SAME OWNER'S ADDRESS SAME
TYPE JOB: NEWRESIDENCF ADDITION NEW INDUSTRIAL NEWCOMMERCIAI COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC _ PUBLIC ADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER RENEWAL OF EXISTING PERMIT TO CONSTRUCT HOUSE
TAX ACCOUNT NO. 294450-0390 LEGAL DESCRIPTION LOT 39 GROUSEPOINTE
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE q15 ? i _ _ _ DATE OF APPLICATION _ 9/4/91
BUILDING INFORMATION
SNE RS 7.2 SET BACKS:FRONT 20 ', SIDE 5EACH REAR 5, HEIGHT LIMIT 3O MAX
OCCUPANCY R-3 TYPE OF CONSTRUCTION 5—N CENSUS NO. 434 TYPE OF HEAT GAS _ BLDG.SQ.FT. 2907 STORIES 2
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. _ BOND
WATER CLOSETS 3 ELEC.HOT WATER HEATER GAS PIPING FT. XXX GAS LOGS
BATHTUBS 2 LAUNDRY DRAINS 1 FORCED AIR FURNACE XXX DUCT WORK RECEIVED
SHOWERS 1 URINALS _ GAS HOT WATER HTR. XXX AIR HANDLING UNIT NUMBER
LAVATORIES 5 DRINKING FOUNTAINS CONVERSION BURNER MISC.
SIIKS 2 MISC. _ BBQ BASIC FEE RETURNED
DI HWASHERS 1 TOTAL FIXTURES 15 DRYER TOTAL MECHANICAL BELOW AMOUNT NONE
VALUATION $150,384.00
PERMIT FEE $407.50 - THIS PERMIT EXPIRES 6/20/92 AND CANNOT BE RENEWED AGAIN! !
PLAN CHECK FEE -
PLUMBING FEE 37.50
MECHANICAL FEE 10.00 _
SAT P/C FEE
SEPA REVIEW
Q
I /�PUBLIC WORKSI SS.B.C.C.FEE
FIRE FEE DATE: `
OTHER FEES — AMOUNT: $455.00
AMOUNT DUE $455-00 RECEIPT:
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 INF ATION FURNISSD BY ME TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
rsi \
fI� 1 'OWNER OR AGENTl DATE 7
CITY OF FEDERAL WAY
33530 First Way South BUILDING PERMIT BUILDING INSPECTION
Federal Way, WA 98003 661-4140
PERMIT NO. _ OWNER'S NAME SITE ADDRESS
CONTRACTOR ADDRESS CONT.PHONE
CONT.REG.NO. _EXP. 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
1.0NE_ SET BACKS:FRONT SIDE REAR _ HEIGHT LIMIT _
OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG.SQ.FT._ STORIES
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC.HOT WATER HEATER GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER _ - MISC.
RETURNED
SINKS MISC. BBQ -- BASIC FEE _
DISHWASHERS _ TOTAL FIXTURES DRYER TOTAL MECHANICAL h AMOUNT
VALUATION
PERMIT FEE THIS PERMIT EXPIRES 6/20/92 AND CANNOT bE RENEWED AGAIN! !
PLAN CHECK FEE
PLUMBING FEE _
MECHANICAL FEE
*ART P/C FEE
SEPA REVIEW
PUBLIC WORKS - y� t
f
S.B.C.C.FEE ) 'fff / I
FIRE FEE DATE:
OTHER FEES AMOUNT:
AMOUNT DUE - RECEIPT:
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
RECEIVED 0 . emit
# - ,f
SEP 4 i99i CITY OF FEDERAL WAY
�ITY�� ,� BUILDING PERMIT APPLICATION ��
BUILDING DEPT - Please Print— ,/ `c
BOX 1 TENANT NAME: GI
OWNER . „AridCe J SITE LOCATION = 3-= `t - S ti/
OWNER'S ADDRESS AeIr`Waririir CITY Ai 1Zr../ PHONE .se
DESCRIBE JOB • 'E3 _ — B' ."` Mir'
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION l�
BOX 2 CONTRACTOR'S NAME /� CONTRACTOR'S REG. #___________________z-_
Card MUST be presented
O
CONTRACTOR'S ADDRESS AV,i%)( //��6 .0 CITY /'�-i D PHONE 822-5/8/
EXPIRATION DATE 7?//. 7
— 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 I _ :� 'rt►._,diG PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER Z-14_>- - 3q 0
LEGAL DESCRIPTION Z(.-7- 3 y -6-/r%i') '/UT.
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / 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 $
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), 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 EMPLI : S, UPON T A URACY OF THE FORM I SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
� de"OWNER/AGENT: / DATE: /2VL�j.
ANP-008 3/90