91-101127 CITY OF FEDERAL WAY 91/b1/27
33530 First Way South
Federal Way, WA 8003 BUILDING PERMIT BUILDING INSPECTION661-4140
PERMIT NO.__91-1073 RA OWNER'S NAME KEN BERTRAM SITE ADDRESS 35828 8 AVE SW
CONTRACTOR ADAMS GROUP ADDRESS 1001 S PEARL #A-10 TACOMA 98465 CONT.PHONE 565-7494
CONT.REG.NO. ADAMSG*100LJ EXP. OWNER'S PHONE 874-5883 OWNER'S ADDRESS SAME AS SITE
TYPE JOB: NEW RESIDENCE ADDITION XXX NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING_ OTHER INTERIOR REMODEL/SKYLIGHT REPLACEMENT
TAX ACCOUNT NO. 302104-9159 LEGAL DESCRIPTION LOT 2 THE W i OF THE N i OF THE S 2/3 OF THE S i
OF THE SW 1 OF THE SW } OF THE NE } OF SEC 30 T 21 NO.RANGE 4 EAST
KING CO WASH /��J
'3SUED BY ELIZABETH SNYDER DATE OF ISSUE '��5, 1 I DATE OF APPLICATION E1114/91
- BUILDING INFORMATION
ZONE RS 9.6 SET BACKS:FRONT 20, SIDE 5' /5' REAR 51 HEIGHT LIMIT 30'
OCCUPANCY R-3 TYPE OF CONSTRUCTION 5-NCENSUS NO. 434 TYPE OF HEAT ELECTRIC BLDG.SQ.FT.119 STORIES EXISTING
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 NONE DRYER TOTAL MECHANICAL NONE AMOUNT NONE
VALUATION $7,634.00
PLANNING DEPT APPROVAL = DEB BARKER
PERMIT FEE $9.9_.00
LAN CHECK FEE 6_4.00 PUBLIC WKS DEPT APPROVAL = TOM COLLINS
UMBING FEE
MECHANICAL FEE BLDG DEPT APPROVAL = KEVIN ELLIS
PART P/C FEE
SEPA REVIEW
PUBLIC WORKS $35.00
S.B.C.C.FEE 4.50
FIRE FEE DATE:
OTHER FEES AMOUNT: $202.50
AMOUNT DUE $202.50 RECEIPT:
4r-o -9
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.
. (C - (0�1
OWNER OR AGENT k AL. - _ ___ DATE___
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 8003 BUILDING PERMIT BUILDING INSPECTION661-4140
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
ZONE 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 AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEEt. 1 k?‘1‘I3
,
PART P/C FEE
SEPA REVIEW
PUBLIC WORKS
S.B.C.C.FEE �)
FIRE FEE DATE: ,a
OTHER FEES AMOUNT: Q��e
- "
AMOUNT DUE - RECEIPT:
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMIT X IRE 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 _
1
SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE -_ _ BY DATE BY -___.__.. DATE . BY
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE -._ BY GAS PIPING O.K. _ DATE .BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE...t 't..k BY ..-M DATE _wl �6 Qr BY /., --...._ DATE - joZik/'/ BY /441-in
FINAL O.K. TO OCCUPY
DCD PSD FD
DATE _ BY -......._-
2-9/ _a 9V o ,; c ciz i S 6 02 .. NG/'4 Z/sf/N- G3
RECEIVED ' • . Perm. q I-- \D1- - (P4r
Ails 1 4 iggi CITY OF FEDERAL WAY
� Y BUILDING PEI�eMIPTtAPPLiCATION `__-
emorBOX 1 TENANT NAME: r
OWNER {C • ' -- ="= ITE LOCATION e 2 g:-AT ; 5- la ,
OWNER'S ADDRESS �'' • do Al) , SITE
CITYM149- PHONE j 7`>�- 5ee.3
DESCRIBE JOB /ic-frfk.icf . int 22g/11029g-4 4•)' e - Al1eX.)(
THE PROPERTY IS OWNED BY: `.�..ierEE 1ARRIEDifeC/, 42 PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #
Card MUST be presented
-
0 `�/ CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
+ — 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 1,41-GF J, L�v/U// A I A PHONE gi i-I--4�
BOX 4 SEWER DISTRICT - --> WATER DISTRICT -1---
BOX
'BOX 5 ESTIMATED PROJECT COST VVI COO 41c — EXISTING BUILDING VALUATION (1-0) L�C�
BOX 6 PROPERTY TAX ACCOUNT NUMBER ( --30c)-104- q1 .5-4) )
LEGAL DESCRIPTION 6e. .3t/Ee7 '20 F 2. a% _
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # jc�.
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 2 & 2ND FLOOR /2/ /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 (SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (X) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY .i= 3z_ ‘--_-,q L., 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 S $
LAVATORIES CONVERSION BURNER
SINKS BOILER, SIZE :T
DISHWASHERS AIR HANDLING UNITS ,,C 0_,,,
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE ;.
LAUNDRY WASHER OUTLET UNIT HEATERS Q
URINALS AIR COOLING UNITS, SIZE ,\)(r` $
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 KN WLEDGE
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.
i ^C
AWNER/AGENT: .\ - -— �---- DATE: e- t 4 I I
ANP-008 3/90
•
OFFICE USE ONLY (PLEASE D^ NC.T ),PATE BE 1I THIS LINE)
ZONE RS 9't&' SETBACKS: FRONT A( SIDE �r EAR S( HEIGHT LIMIT ?J0 i
/ l —
PLANNING DEPARTMENT APPROVAL lOq� 7 N. L
REMARKS: a.i'`'
710...i.; -/l
SEPA: EXEMPT I- NOT EXEMPT
FIRE DEPARTMENT APPROVAL /V r/� DATE
REMARKS: / UT
PUBLIC WORKS DEPARTMENT APPROVAL l� DATE g/-9.(a
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 3 TYPE OF CONSTRUCTION V N STORES
LI V i / BUILDING SQ. FT. i @ 7 Z - c-f0 = g `7S
J BUILDING SQ. FT. @
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ =
BUILDING SQ. FT. _ @ _
BUILDING SQ. FT. _ @ d( ( Fc cAO ` 6 ' 8
TOTAL SQ. FT. TOTAL VALUATION 76 3 `I t'0 9
BUILDING DEPARTMENT REMARKS: PERMIT FEE q g
<- IC -eJ _ ..9f Arr/4-3 L PLAN CHECK FEE 6 q
(--)06‘.--
�-'� �` PLUMBING FEE
C-3 06.-- •-iz) j?n.t.t..e. k.A"` 11 \- --- MECHANICAL FEE
Oh k �Q TOTAL BLDG. FEES
S-1.4-41. PART P/C FEE
SEPA REVIEW
35---
S.B.C.C. FEE £1,-SC)
OTHER FEES
AMOUNT DUE a.5-\`
ASSIGNED ADDRESS: St-1?--- Q1( (tS 1`(`
PARTIAL PLAN CHECK FEE RECEIVED
ITv�j Amount Date Receipt#
a
Q
v ^ ;2 '—i BUILDING DEPARTMENT APPROVAL ! p
CEI D "9 BY f� DATE LI 1 / ACCEPTED FOR FILING
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