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91-100437 9)-/00y4 -7 CITY OFBUILDING INSPECTION BUILDING FEDERAL WAY PERMIT 941-1555 (434) "RENEWAL OF 90-160" PERMIT NO. 91-409 RE OWNER'S NAME PARKWOOD HOMES JOB ADDRESS 32846 7 CT SW CONTRACTOR PARKWOOD HOMES ADDRESS 8920 152 AVE NE REDMOND CONT. PHONE 881-6600 CONT. REG. NO. PARKWHI131BK 1[17-92 OWNER'S PHONE SAME OWNER'S ADDRESS SAME TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD NEW PUBLIC PUBLIC ADD. NEW MULTI-FAMILY ) MULTI. ADD. SIGN GRADING OTHER RENEWAL OF 90-160 TO CONSTRUCT NEW RESIDENCE TAX ACCOUNT NO. 82104-9065 LEGAL DESCRIPTION LOT 42 THE POINTE AT WEST CAMPUS UISSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 4/5/91 BUILDING INFORMATION ZONE RS 7.2 OCCUPANCY R-3 TYPE OF CONSTRUCTION 5-N BLDG. SQ. FT 3601 SET BACKS: FRONT 20' SIDE 5' EACH REAR_ 5' STORIES 2 HEIGHT LIMIT 30' MAX PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS 3 ELEC. HOT WATER HEATER GAS PIPING - FT. XXX _ BOILER BATHTUBS 2 LAUNDRY DRAINS _ 1 COMPRESSOR _ TANK(S) RECEIVED SHOWERS 1 URINALS FORCED AIR FURNACE (1) AIR HANDLING UNIT _ NUMBER LAVA-i)RIES 5 DRINKING FOUNTAINS GAS HOT WATER HTR. (1) MISC. SINKS 1 MISC. CONVERSION BURNER BASIC FEE RETURNED DISHWASHERS 1 TOTAL FIXTURES 14 UNIT HEATER TOTAL MECHANICAL BELOW AMOUNT NONE VALUATION $187,260.00 PERMIT FEE $474.00 PLAN CHECK FEE THIS PERMIT WILL EXPIRE ON APRIL 5, 1992 AND CANNOT BE •LUMBING FEE 35.00 RENEWED AGAIN. CHANICAL FEE 10.00 TOTAL BLDG. FEES $519.00 FEES DUE ARE 1 OF THE AMOUNT COLLECTED FOR THE FIRST PERMIT PART P/C FEE ISSUED FOR THIS PROJECT. SEPA REVIEW WATER SERVICE WATER MAIN CHG. _ / • S.B.C.C. FEE DATE PD �� AMT $519.00 RE ' i l ' OTHER FEES $ C T ' J AMOUNT DUE $519.00 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 ET: � , �OWNER OR AGENT w .)--4� / � DATE ,� 3140 1N3OV HO U3NMO :13W 38 11IM SIN3013HIf103E1 AVM 1V1A303d AO 1110 3l8VOIlddV 3HI 0NV 30031MON)1 AIN A01538 3H1 O1 1031d1:100 0NV 3f11:11 SI 3IN 18 03HSINFif13 N011VWHOJNI 3H1 IVHI A311H30 I '3ONVfSSI AO 311/0 Ii31AV I:11/3A 3NO 3HIdX3 SIMEI3d DNIOVHO ONV 1VIIN30IS3H 'O31HVIS SI )IHOM ON 3I 3ONVf1SSI H31AV SAVO OSI 31:1IdX3 SIIW1:13d 1101 3f10 1Nf10WV S33d 83H10 33d '0'0'8'S OHO NIVW 831VM 3OIAIJ3S 831VM M31A38 Vd3S 33J Old 18Vd S33J '0019 1VIO1 33J 1VOINVHOilb 33d ONI8Wf1 33d>103H0 NVId 33d 1IW83d NOIIVl1VA 1Nf10WV 1VOINVHO31N 1V101 831V3H llNfl S38f11X1d 1VIO1 S83HSVMHSIO 33d OISV8 H3N8f19 NOIS83ANOO 'OSIW S)INIS O3N8f1138 OSIW '81H 831VM 10H SVO SNIV1Nf1Od ONI)INI8O S31801VAV1 83801f1N ltNfl ONI10NVH 81V 3OVN8fId 81V 03O80d SIVNIHfI S83MOHS (S)NNV1 8OSS38d01OO SNIVEO A80Nf1V1 S8f11HIV8 O3A13O38 831108 '1J ONIdId SVO 831V3H 831VM 101-1 '0313 S13SO1O H31VM MOS '1WV '1WV S30NVIlddV IVOINVH33V 'ON 'ON 9N18INflld 1101111H013 S318OIS 8V38 301S 1NO8d S)IOV813S ld 'OS '0018 NOIIOl81SNOO JO 3dAl AONVdf1000 3NOZ NOIIVWHOJNI ONIO1IfB NOI1VOIlddV JO 31V0 3flSSI JO 31V0 18 03f1S NOI1dI8OS3O 1V031 ON INl000V XVI 83H10 ONIJV80 NOIS '00V 'I1lf1W ( SIINfl) A11WVd-111111N M3N 00V OI18ld 011811d M3N OOV 1VI81SfONI 00V 1VIO83WWOO 1VI083WW0O M3N 1VI81Sf10N1 M3N NOI1100V 30N301538 M3N 90f 3dAl SS3800V S,83NMO 3NOHd S,83NMO ON '038 '1NOO 3NOHd '1NOO SS380OV 801OV81NOO SS3800V 80f 3WVN S,83NMO ON 1114183d SSSL-1 N 1I W �13d omaiine AVM 110A1 O NO1103dSNI JIaline 1 §N r\10\ J J Y >-: z m m • O 0 • ¢ \I 0 U \! A L.L. W LL • Z ">. 0 I U` / ' < 1I p z " z 0 • m a m D w 0 I- J iW- W a a o 2 o o c Q a z I , \.5 O m IN i �m a z \ • I O Fr l o `\N, = h w OO O ` Z d M' J d F= \:. w n- O Iw- H cA - F 0 000 0 � o '3 I A . zk Z >- 2e r > m z m Q; EL 03 U Z\ Y ` M z wN O Q m• w 2 W ~ice w Q w �. H i I- Y\ F- Z I- W 0 w 0 OL!\ 0 W 0 ' • 'Permit # 91- 4Y? <7 CITY OF FEDERAL WAY +, ., tom,�: .__. ._ -- BUILDING _BUILDING PERMIT APPLICATIO MAR 2 7 VA — Please Pri GK -1 BOX 1 TENANT NAME: OWNER -dill r 1iM1111 _$c-. SITE LOCATION � 1 ' Is r. E_ OWNER'S ADDRESS �� i52 — U 1• CITY � PHONE I. ► .6 DESCRIBE JOB '�F— THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION x BOX 2 CONTRACTOR'S NAME -'---- T-'-'_ `.. CONTRACTOR'S REG. #_P \"(2 =U. x \3txy, Card MUST be presentee CONTRACTOR'S ADDRESS CITY PHONE EXPIRATION DATE dt-'QI- — 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 11 i�� V )L_ PHONE H_ P1DU. IIMPE BOX 4 SEWER DISTRICT at __ �� WATER DISTRICT sa__ . irk BOX 5 ESTIMATED PROJECT COST 1 -mil& EXISTING BUILDING VALUATION n a BOX 6 PROPERTY TAX ACCOUNT NUMBE• ��10 LEGAL DESCRIPTION Iiis ai t iagiN/tiitiI.0 (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording # BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 1 / 2ND FLOOR \ off/ 3RD FLOOR / BASEMENT / DECK / GARAGE HiQ/ BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAUINDUSTRIAL 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. GASi $ SHOWERS t GAS HOT WATER HEATER $ LAVATORIES CONVERSION BURNER $ i SINKS • BOILER, SIZE BTU $ I 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. MPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGEN _A . . .A ► \I 1 MIL tA 'ATE: 'C' ANP-0041 3.P3 1110 OFFICE USE ONLY (PLEASE GO 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 ASSIGNED ADDRESS: Ca a LU ' tat in Q t PARTIAL PLAN CHECK FEE RECEIVED w ou ) -C3 . Amount Date Receipt# m BUILDING DEPARTMENT APPROVAL RECEIVED O BY DATE ACCEPTED FOR FILING q),/do X3'7 CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 REVISION PERMIT NO. 91-0409 NR OWNER'S NAME PARKWOOD HOMES INC JOB ADDRESS 32846 7TH CT SW CONTRACTOR PARKWOOD HOMES INC ADDRESS 8920 152ND AVE NE REDMOND CONT. PHONE 881-6600 CONT. REG. NO. PARKWHI131BK OWNER'S PHONE 881-6600 OWNER'S ADDRESS 8920 152ND AVE NE REDMOND WA 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 REVISION TO NSF PERMIT TAX ACCOUNT NO. 182104-9065-04 LEGAL DESCRIPTION T.OT 42 THE P IT..AT WEST CAMPUS ,JED BY JOANNE. JOHNSON DATE OF ISSUE it— (b Ci'/ DATE OF APPLICATION 11-8-91 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 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 AMOUNT VALUATION PERMIT FEE PLAN CHECK FEE $30_00 - ONE-HOUR PLAN REVIEW FEE @ $30. 00/HR UMBING FEE MECHANICAL FEE TOTAL BLDG. FEES _ PART P/C FEE SEPA REVIEW WATER SERVICE DATE : / i - (S -- WATER MAIN CHG. S.B.C.C. FEE AMOUNT: $30. 00 OTHER FEES AMOUNT DUE $30.00 RECEIPT: '4,2- ( / 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 BF MET: / OWNER O AGENT. / --- c' - DATE �` - / - 7/ 44.)10.,, CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 PERMIT NO. OWNER'S NAME JOB ADDRESS CONTRACTOR ADDRESS CONT. PHONE 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__ TAX ACCOUNT NO. LEGAL DESCRIPTION ISSUED BY _ DATE OF ISSUE DATE OF APPLICATION 0 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 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 AMOUNT VALUATION PERMIT FEE - tHIS PERMIT WILL EXPIRE f.}f-; APX%.lj, `11 1.1.94 ANO Ui 'tkol PLAN CHECK FEE RFNE I) Ar TN. AlliUMBING FEE ' w.ECHANICAL FEE — TOTAL BLDG. FEESr)'rS !)t ARE i O!' THE AMOUNT COT:LEL =---- -. - - ---- _ _ -'- - • PART P/C FEE ISSUED FOR 13 PROJECT. SEPA REVIEW WATER SERVICE WATER MAIN CHG. yg4pp- r//f I S.B.C.C. FEE As„r+,- C PD l' 1 4M? $519.00 R `ea y, ,'1 x . _------ 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 PtlliVlSION • • , • it # S I-4U3 RECEIVED ,,/,5 , .., NOV 8 egg) CITY OF FEDERAL WAY '� pERuircLk3 BUILDING PERMIT APPLICATION — Please Print- ^ BOX 1 TENANT NAME: OWNER Ae{&viOT'P 1 OctW x . ITE LOCATIONgY 7 CT $ictf„ OWNER'S ADDRESS 2411, _ CITY h/3Q PHON Ti DESCRIBE JOB kE� S, COALS i A 'E�,�`i'SZA ,.- 4 6. 'i THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME PAg J& b t\C ME .=..i__ CONTRACTOR'S REG. # Aawlif- /.3/PK n, Card MUST be presented CONTRACTOR'S ADDRESS #2O I5 i Al r6. CITY �C6D ,D PHONE gel - ft.).0 EXPIRATION DATE ) -' -4 Z, r/ - OR - I HAVE READ CHAPTER 18.27.010 RELATIN e a DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON 31)i-.ZE- Renliti PC)L &, PHONE ee I `(cam) BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST -- EXISTING BUILDING VALUATION --- BOX 6 PROPERTY TAX ACCOUNT NUMBER I8_/Qf - Yafc,----04( LEGAL DESCRIPTION 6-01 '12- , [ (4t P'0zt-T6 ti 4tf 1- C 1i'4f ) (If necessary, please sutsit4 seprate page wit the legal description.) K.C. Plat Recording # rr p_•._w-zy BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR / 3RD FLOOR / BASEMENT / DECK / GARAGE / BOX 8 (yi SINGLE FAMILY (j NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES - BASIC FEE$ 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 $ SUMP ,SPRINKLER VACUUM BREAKERS OTHER $ D NS $ HER $ 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 MYV: 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 EMPL S, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE/ CITY ASrAA PART OF THIS APPLICATION. OWN �c � L�1`'4— DATE: /! - 8- 7/ ANP-008 3/90 O"r9CE USE ONLY (PLEASE DO NOT WRITE BELOW T IS 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 r.1 (aci G' t V(f LJ �'--`�_ �C7 c)27/44 �^ 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 ASSIGNED ADDRESS: ) ( PARTIAL PLAN CHECK FEE RECEIVED Amount Date Receipt# BUILDING DEPARTMENT APPROVAL RECEIVED BY . DATE ( � Y — Y� ACCEPTED FOR FILING