91-101097 9J-1O J ti 9 2
CITY OFBUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. 91-1050 OT OWNER'S NAME FEDERAL WAY MISSION CHURCH JOB ADDRESS 31260 4 AVE S
CONTRACTOR FAR CONSTRUCTION ADDRESS 25230 SE 359 ST AUBURN CONT. PHONE 886-1439
CONT. REG. NO. FARCO131OD 9/91 OWNER'S PHONE 839-1613 OWNER'S ADDRESS SAME AS SITE
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 GRADE & FILL
TAX ACCOUNT NO. 082104-9157 LEGAL DESCRIPTION POR OF NE I OF SEC 8 T 21 RANGE 4 EAST WM IN RING CO
cl'
6 ..3)(7/0 .
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE , DATE OF APPLICATION 8/8/91
BUILDING INFORMATION
ZONE RS 7.2 OCCUPANCY NA TYPE OF CONSTRUCTION 5-N BLDG. SO. FT. NA
SET BACKS: FRONT NA SIDE NA REAR_. NA STORIES NA HEIGHT LIMIT NA
PLUMBING Na 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
AVATORIESiii
DRINKING FOUNTAINS GAS HOT WATER HTR. MISC.
_
INKS MISC. CONVERSION BURNER BASIC FEE
RETURNED
)ISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL NONE AMOUNT NONE
VALUATION $1,000.00
PLANNING DEPT APPROVAL = BILL KINGMAN
PERMIT FEE $22.50 --__-- "EXEMPT FROM LAND SURFACE MODIFICATION PERMIT PER CHAPTER 115.75.3.G. ,
PLAN CHECK FEE 15.00
PLUMBING FEE MUNICIPAL CODE"
MECHANICAL FEE
TOTAL BLDG. FEES PUBLIC WKS DEPT APPROVAL = TOM COLLINS
PART P/C FEE BLDG DEPT APPROVAL = KEVIN ELLIS "LESS THAN 100 CUBIC YARDS"
SEPA REVIEW - DATE: F,,3c ; ._9
WATER SERVICE
WATER MAIN CHG. AMOUNT: $87.00
S.B.C.C. FEE 4.50
OTHER FEES P. WKS• 45.00 ?
AMOUNT DUE $87.00 RECEIPT:
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 ET:
OWNER OR AGENT . DATE a-5 o / 9
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. OWNER'S NAME _ JOB ADDRESS 7 :411/
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
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
4NING .:...A APPROVAL za BILL KINGMA1
PERMIT FEE —
FEE 'i7XEMPT FROM IRNA SURFACE MODIFICATION PERMIT PER CHAPT:k 11 r r . 3»eT. .
PLAN CHECK FEE - ,airi4>•.wCIPAL t'F
UMBING FEE
CHANICAL FEE — PUBLIC WKS DEPT APPROVAL -- TOM COLLINS
TOTAL BLDG. FEES
PART P/C FEE BLDG DEPT APPROVAL = E ,,:vlELLIS BLESS THAN 100 CUBIC YARDS"
SEPA REVIEW F.
WATER SERVICE ..._.••...-�._. w.__._1,_.L__..,_ __
WATER MAIN CHG. •
$87.00
S.B.C.C. FEE
OTHER FEES .-_i ,s.,7.(-7-.) (_
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:
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OWNER OR AGENT DATE �'hi\�
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RECEIVED I.
AUG 0 8 1991 CITY OF FEDERAL WAY (}i-
en OF FeDER
}i-enOFFeo*R LvvAYBUILDING PERMIT APPLICATION
BUILDING DEPT: t‘ c_ cct I ") — Please Print— A. tuircH ,,
BOX 1 TENANT NAME: ,i</ ("r-1( LL A 4 AO Ij
OWNER :-/�i4 4�'' C. . iX/ SITE LOCATION Scwn c%�vdi��ss
OWNER'S ADDRESS,�71-3 /e1-, -v7 cp S,1 P . p 'dr rt /4-'4 PHONE Y3?-/ /
DESCRIBE JOB /`/r /i r A,v•' /.v p r7 W .P 22 c LA--
THE PROPERTY IS OWNED BY: SINGLE/MARRIED fp PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME /-4 ie Com'" l 4"4.-.7, ',- CONTRACTOR'S REG. it f, Z 13j-OD
Card MUST be presen
CONTRACTOR'S ADDRESS 2-5-2-7 J Se 3 s 9.14 CITY 4 ? 4 4--- PHONE 8A'� - /y3 2?
EXPIRATION DATE C V410
— 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 ie.e./,_ ti ._.V.--7.,.... c., PHONE 3'-s 9'--.3 z
BOX 4 SEWER DISTRICT .......--
WATER DISTRICT _ er-e-
BOX 5 ESTIMATED PROJECT COST /-- ' — - C- EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER ` D 4 ' 9]'S�
LEGAL DESCRIPTION Nitl_a_e d
(If necessary, please subit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1 T FLOOR Njf 2ND FLOOR A-/,
3RD FLOOR 9�/4 / BASEMENT 4__ DECK N �j GARAGE__774--
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = NI ( ) 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 /1/76-l /- 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 $
7 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 KNOW EDGE
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 WHER . CH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES .'ON THE ACCURACY OF T , 1' ATION SUPPLIED TO THE CITY A A PART OF THIS APPLICATION.
4,
OWNER/AGENT: _ ' I►iS __ --iAllr _ ' DATE: i (r'Z?j
U
ANP-008 3/90
OFFICE USE ONLY (PLEA T WRITE BELOW THIS LINE)
ZONE 1QS1.1. SETBACKS: FRONT /V/A SIDE ^/1A REAR N(A HEIGHT LIMIT N/ff'
PLANNING DEPARTMENT APPROVAL 8 tZ - 00 -6‘F---
REMARKS: ewtirr rite) (.
M .1q NQ S L 12 PH(S.- ?O IJ tPtca4TtuN PerRIA LZ. rt.
Gh4ea"Mg -- It6. 7S. 3. . "wvtctPmt__ c.oae...
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS: n)
(A-
PUBLIC WORKS DEPARTMENT APPROVAL 7Z DATE 6'5./J•7"
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 L9UtQ�'- -F F('(
OCCUPANCY TYPE OF CONSTRUCTION U Al STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION 1000
BUILDING DEPARTMENT REMARKS: PERMIT FEE ZZ.) v
`.I J.( II 1Y-I 6 O kS cktok-ri I ^�A r PLAN CHECK FEE
PLUMBING FEE I S v 0
x.9.VLl 7 1 5 �j}(e-Z tf-�1 -j1 MECHANICAL FEE
1 /�� c_ } TOTAL BLDG. FEES
E SS �" PART P/C FEE
SEPA REVIEW
' S.B.C.C. FEE 4 ) C'
OTHER FEES Gq
AMOUNT DUE a
O ASSIGNED ADDRESS: 5 �� (5I ( Gy
Q'
4,41.1
QQ
U. O fg� eel OW PARTIAL PLAN CHECK FEE RECEIVED
O00 Amount Date Receipt#
t'
CrCI
"T d BUILDING DEPARTMENT APPROVALc ( �{ /
RECE11 BY DATE (.6— 1 l 1 ACCEPTED FOR FILING