90-100443 CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
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PERMIT NO. 90-613 P OWNER'S NAME DUNCAN W BLANCHARD JOB ADDRESS 31456 7TH PL SW
CONTRACTOR OWNER ADDRESS
CONT. PHONE
CONT. REG. NO. OWNER'S PHONE 941-5138 OWNER'S ADDRESS 31456 7TH PL SW
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 LOT 36 MIRROR LAKE
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 5-17-90
BUILDING INFORMATION
ONE_._ - OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
SET BACKS: FRONT SIDE REAR STORIES_ _ HEIGHT LIMIT
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATEeR CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. BOILER
BATHTUBS 1 LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED _
SHOWERS 2 URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVATORIES 2 DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. _
SINKS 3 MIBASIC FEE 20.00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS 1 TOTAL FIXTURES 9X5= 45.00 UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION 65.00
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE 65_00 5--..,_) ,.7
^CHANICAL FEE
DATE: 3
OFOTAL BLDG. FEES ç PART P/C FEE ( ....--
SEPA REVIEWAMOT:
WATER SERVICE RECEIPT: ' --3 - (2---i--
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE 65-00
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 Co -ECT.TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BEM- '� /'
OWNER OR AGENT ../16-._1i fr. "" _= _.c. DATE 5-,4c— g�
CITY OF BUILDING INSPECTION
BUILDING
FEDERAL WAY 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
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
-i
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. La.. CONVERSION BURNER BASIC FEE _
DISHWASHERS TOTAL FIXTURES 7<-r ' 4 UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE 'rE a 1 jf,/
DATE: ,.,.,.,,1,..,(j _. l_1. �.:
TOTAL BLDG. FEES T
PART P/C FEE �tI (�{ '�
•
SEPA REVIEW t e
WATER SERVICE�G
WATER MAIN CHG. dad: Li .......L.:... .s... r`i �- .F
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
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
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(4,31)
CITY OF FEDERAL' WAY �,�k,�y,
BUILDING PER— eMIase PT APPLICATION e�;rint— o'�o i) o
itiOn gq/ 0
BOX 1 TENANT NAME: 9 � -- �T, �qY
OWNER / 111 _ SITE LOCATION 3/yS f / S Lam.
OWNER'S ADDRESS�, ' /5c. 744' )/ S. c, CITY Z<_) PHONE >5//5/3,:c...),
DESCRIBE JOB /J u_ /✓c>.n
THE PROPERTY IS OWNED BY: SINGL /MARRIED: PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME C' .A�� CONTRACTOR'S REG. #
Card MUST be presented
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 . - 1A..A, C. PHONE f�L4( - S c
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION N 'I LtW«,7IIIMM`I _
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR ///5 / 2ND FLOOR S.C.7 /
3RD FLOOR / l7 / BASEMENT / DECK / GARAGE /
BOX 8 (SINGLE FAMILY (e_.":;)--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 $
2_ SHOWERS GAS HOT WATER HEATER $
2—LAVATORIES CONVERSION BURNER $
3 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 EMPLOY $, UPBJV E ACCURACY OF THE INF SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: ...e.:".4.-..t/"^L-' -zt--- DATE: --/7" %
ANP-008 3/90
`Y` •
•
OFFICE USE ONLY (F.LEASE D0 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
*6' ASSIGNED ADDRESS:
��% PARTIAL PLAN CHECK FEE RECEIVED
,� p� Amount Date Receipt#
°O 6v BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING