90-101138 9o -161)38
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
#434
PERMIT NO. 90-1347 RA OWNER'S NAME WAYNE MORITZ JOB ADDRESS 30213 5TH AVE S
CONTRACTOR BENCHMARK CONST ADDRESS 30521 56TH AVENUE S AUBURN CONT. PHONE 839-4774
CONT. REG. NO. BENCHC*132BM OWNER'S PHONE 941-0354 OWNER'S ADDRESS 30213 5TH AVE S.
TYPE JOB: NEW RESIDENCE ADDITION_ XX NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. _ INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY _ (UNITS ) MULTI. ADD. SIGNGRADING OTHER
TAX ACCOUNT NO. 064310-0060-08 LEGAL DESCRIPTION LOT #6 BELEARO PARK DIV
SUED BY JOANNE JOHNSON DATE OF ISSUE -2 7-L`) DATE OF APPLICATION 8-13-90
BUILDING INFORMATION
ZONE _ OCCUPANCY R3TYPE OF CONSTRUCTION _.VIN BLDG. SQ. FT. 305
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.
SINKS 1 MISC. 5X2 1 0_00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS 1_ TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL _. AMOUNT
VALUATION 18,519-60
PERMIT FEE 198_00
N CHECK FEE 129_011
WUMBING FEE 10.00
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE �j
SEPA REVIEW
DATE: 5- ^ ; 7 G
WATER SERVICE
WATER MAIN CHG. -\
S.B.C.C. FEE 4-50 AMOUNT: �` Z// U
OTHER FEES RECEIPT: 17S'�/ (6 7
AMOUNT DUE 341. 50
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 INFORMAT N FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE ME . -' 1://?:* )
OWNER OR AGENT tQ// DATE 61/4 7//9d
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CITY OF
FEDERALWAI61- �� BUILDING INSPECTION
� I 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 6P-c27- I D 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 Ji I C '^'
PERMIT FEE .
PLAN CHECK FEE
UMBING FEE
Mr ECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW DATE;
WATER SERVICE �_
WATER MAIN CHG. i'il"1tJ N i t
S.B.C.C. FEE
OTHER FEES Rrc E.r
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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Permit # U -13 `/) 1 .A
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER /-1A, ►tAE S Id'4v.Je Mom/rz< SITE LOCATION
OWNER'S ADDRESS 302•13 - 5.41)6 S" . ��L PHONE 9y/-03S'7
DESCRIBE JOB NdP/f'ian)/,Cc,�.abEz iCrrc .) /N 4
THE PROPERTY IS OWNED BY: SINGL � PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Cm c=re jc 'ii/ _CONTRACTOR'S REG. # 'x f fC
Card MUST be presen d\
CONTRACTOR'S ADDRESS 'oszl - Aff S - CITY Avd5PHONE s
EXPIRATION DATE //9/9/
— 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 evil-r- U. heti c\ PHONE 83P-L/77
BOX 4 SEWER DISTRICT +9 C- L. WATER DISTRICT 6 ,4-r L✓,1 `f
BOX 5 ESTIMATED PROJECT COST aSR EXISTING BUILDING VALUATION /7Scoda
BOX 6 PROPERTY TAX ACCOUNT NUMBER 0143/ ®obo- of;
LEGAL DESCRIPTION (o 736 L ' t7, DrJ 04, .
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR /41E 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) .�--yEXISTING 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 $
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 $
Z- TOTAL FIXTURES $
acs'= /o_ kTOTAL 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 EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNEF{IAGENT.) DATE: 11111 ,
ANP-008 3/90
OFFICE USE ONLY (PLEASE DO 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 ''V STORES
if%/t BUILDING SQ. FT. 3o 5 @ = (p N c
BUILDING SQ. FT. @
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ /46()` 6- o'
BUILDING SQ. FT.
TOTAL SQ. FT. TOTAL VALUATION ( " ! q` �' 0
BUILDING DEPARTMENT REMARKS: PERMIT FEE 16(46c d0
PLAN CHECK FEE (741. 06
PLUMBING FEE IG-e-,G
MECHANICAL FEE O
TOTAL BLDG. FEES 33 7° Gc
PART P/C FEE
SEPA REVIEW C�
S.B.C.C. FEE q, 5--0
OTHER FEES
AMOUNT DUE 3`f/`Sc'
ASSIGNEE) ADDRESS: =?< (5+l Cq
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING