91-100319 9/.Jo031y
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
434 RENEWAL OF 90-83
PERMIT NO. 91-353 RE OWNER'S NAME GEORGE ACOSTA JOB ADDRESS 30305 9 AVE S
CONTRACTOR OWNER ADDRESS SAME CONT. PHONE 941-3898
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 RENEWAL OF 90-83 TO CONSTRUCT AN ADDITION TO
TAX ACCOUNT NO. 515365-0120 LEGAL DESCRIPTION LOT 12 MARINE VIEW PARK RESIDENCE
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE ir ' DATE OF APPLICATION 3/15/9L
qi
BUILDING IN ORMATION
ZONE _ OCCUPANCY_ R-3 __- TYPE OF CONSTRUCTION 5-N (ADWN) BLDG. SQ. FT. 288 SF
SET BACKS: FRONT 2O' SIDE 5 EACH REAR 5' STORIES EXISTING HEIGHT LIMIT 30' MAX
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 NON UNIT HEATER TOTAL MECHANICAL ______NONE AMOUNT NONE
VALUATION $17,487-00
THIS PERMIT WILL EXPIRE ON 4/1/92
PERMIT FEE $94.50
PLAN CHECK FEE FEES DUE ARE 1 OF THE ORIGINAL FEES FOR THIS PROJECT
UMBING FEE
CHANICAL FEE
TOTAL BLDG. FEES $94.50
PART P/C FEE
SEPA REVIEW liA
WATER SERVICE )J2
WATER MAIN CHG. DATE PD / AMT $94.50 REC'T ,p-
1.2)
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE $94.50
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.'RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
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Permit #.a.,c1. '
CITY of FEDERAL WAY �- u►roc.-1. car
BUILDING PERMIT APPLICATION
—rYleete Print T -
BOX 1 TENANT NAME: •
OWNER i► . . " SITE LOCATICCt
DINNER'S ADORE ' ate el , _S-- __CITY h + . PHONE —14.{1 1 -t1v--
DESCRIBE JOB ._—Stt}�Jx ..: 1t. cs*,=,,
THE PROPERTY IS OWNED BY: SINGLE/MARRIED ', _ PARTNERSHIP_ CCRPORATION_
BOX 2 CONTRACTOR'S NAME
AWxt,ACONTRACTOR'S REG. #
Card MUST beDresenttl.
CONTRACTOR'S ADDRESS CITY__ PHONE._ _�
EXPIRATION DATE —
OR—
I HAVE REAL CHAPTER 18,27.010 RELATING TO CEFINITIONE OF GENERAL CONTRACTORS AND SPECIALTY CONTRAC TORS AND
CHAPTER 18:27,110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.•
BOX 3 CONTACT PERSON c' ty,.i,,• _ --.:1144&—s4,PHONE 1 tt_'-i-4
BOX 4 SEWER DISTRICT .),1_(- sR- WATER DISTRICT C� •tt_g
BOX 5 ESTIMATED PROJECT COST L ) __ EXISTING BUILDING VALUATION _--
BOX 6 PROPERTY TAX ACCOUNT NIM=ER I O ;,,
11 A .—LEaAL DESCRIPTION r �—
(If necessary, please submit a separate page with tl,e legal Cescription.)
K.C. Plat Recording#
BOX 7 BUILDING' SQUARE FOOTAGE: (Existin4/Proposed) 1ST FLOOR liU0_/ Soto. 2ND FLOOR /`
3RD FLOOR___,/ BASEMENT L DECK /, GARAGE__ j
BOX 8 (`-''SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO, OF UNITS - —._ ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDU3TRIAL _ TOTAL AREA OF PROPERTY SO FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES-- BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET
BATHTUBS NO. FURNACE, ELEC. GAS S _,
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 ..__UWiT HEATERS $
_.URINALS AIR COOLING UNITS,SIZE_, S
. DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS.SPRINKLER VACUUM BREAKERS t ff OTHER 3
DRAINS
OTHER $
V 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 PERM IT APPLICATION IS
MADE.I FURTHER AGREE TOSAVE 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 CIT OF OF FEDERAL WAY,BUT ONLY WHERE SUCH CLAIM ARISES OUT CF THE RELIANCE OF THE CITY,INCLUDING ITS
OFFICERS AND£IIPLOYEE r PON TH ACCU`•CY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: PA,_ lit.-:',.,1-'d'
DATE:
?@'d SZZb199 0i d3.LNs.J OS SWI 31) 03W d i4O d 00:30 1651-ti?-d 3N