90-100768 CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
9a--16676. 8
PERMIT NO. 90-1142 P OWNER'S NAME WEST CAMPUS PRO BLDG JOB ADDRESS 34709 9TH AVENUE S (#A)
CONTRACTOR DELTA PLUMBING ADDRESS 13122 8TH ST E #1 SUMNER CONT. PHONE 927-7620
CONT. REG. NO. DELTAPH176QP OWNER'S PHONE OWNER'S ADDRESS 2000 - 124TH AVE N.E. #3100 BELLEVUE
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. NA LEGAL DESCRIPTION NA
ISSUED BY JOANNE JOHNSON DATE OF ISSUE I DATE OF APPLICATION 7-16-90
BUILDING INFORMATION
NE. OCCUPANCY TYPE OF CONSTRUCTION BLDG. SO. FT.
SET BACKS: FRONT SIDE__ REAR STORIES HEIGHT LIMIT
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS 4 ELEC. HOT WATER HEATER 3 GAS PIPING FT. BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS _ - FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVATORIES 4 DRINKING FOUNTAINS _ GAS HOT WATER HTR. MISC. _
SINKS 3 MISC. BASIC FEE 20_00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS TOTAL FIXTURES 14 UNIT HEATER TOTAL MECHANICAL AMOUNT
s.
14X5=70.00
VALUATION
90.00
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE 90_00
ECHANICAL FEE
..)TAL BLDG. FEES
PART P/C FEE
SEPA REVIEW '' l`. -O
WATER SERVICE I �(j
WATER MAIN CHG. (.,,c ✓ 3.4
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE 90-00
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 B ) .
ET: (J-_ /
OWNER OR AGENT
QG� ',A-- ✓ CLr ,.t4 c DATE /P-)7e7
i t # ib , 11 --a ?
RECEIVED "
JUL 16 1990 CITY OF FEDERAL WAY
CITY OPFEDERALWAY BUILDING PERMIT APPLICATION
BUILDING DEPT- —Please Print-
Ha:I 1u1 -to jex_I t,_" 1 (a_.
BOX 1 TENANT NAME:VIC (111-tpUD 4- u , vIC -„5-0.
OWNER I I MCV SITE LOCATION 'i S ( i t1 • -11=
OWNER'S ADDRES4-a :a.., I-.�`I1_ ' t\l �.(' k L . *111IL.`. CITY IV)t 1I(`v'�( PHONE
DESCRIBE JOB I . II 1 NI )II \' I �.
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME i _11O i--)IUtl \LA r' CONTRACTOR'S REG. #_rot I )e,1t (-W
A scar MUS eresented
CONTRACTOR'S ADDRESS �I r�c7-► ._ I CITY/ )l irn r r PHONEC- ,'4-11 4 C)
EXPIRATION DATE I+ 1–I —OCA (*:
— 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 _ -1.1 d M'lL i--(..1.1 ,._,' PHONE
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(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 ( 4 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. ''i 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 $
`
I I TOTAL FIXTURES $ N
TOTAL MECHANICAL FEE T-"
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.
OWNER/AGENT` � ) �� DATE: ' I L=
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