91-101369 9) , Jol3:. S
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT941-1555
PERMIT NO. 91-1 321 P OWNER'S NAME TONY STARKOVICF JOB ADDRESS 1105 S 348TH STREET
CONTRACTOR PUGET _SOIIND MECHANICAL ADDRESS 10015 19TH AVENUE E TACOMA CONT. PHONE 537-8900
CONT. REG. NO. PUGET1217T.Q OWNER'S PHONE 927-6862 OWNER'S ADDRESS 402 S 333RD ROAD FEDERAL WAY
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. 202104-9140 LEGAL DESCRIPTION
(rll, r
•UED BY JOANNE JOHNSON DATE OF ISSUE P� '( J DATE OF APPLICATION 9-23-91
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. _
SINKS 2IIsCLEAN OUTS 10.00 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS TOTAL FIXTURES 20.00 UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION 3000
PERMIT FEE
IPAN CHECK FEE
UMBING FEE 30-00
MECHANICAL FEE
TOTAL BLDG. FEES
6164
PART P/C FEE
DATE: 1 1 1
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG. AMOUNT: $30.00
S.B.C.C. FEE
OTHER FEES RECEIPT:
-p 621________
AMOUNT DUE 30-00
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 BE MET: r
(.(OWNER OR AGENT DATE q <2, --9
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. OWNER'S NAMEJOB 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
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
PLUMBING FEE
MECHANICAL FEE _ -
TOTAL BLDG. FEES
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PART P/C FEE 47 i
I 1
SEPA REVIEW f.,„ _.._..i._.,- _ - -
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WATER SERVICE
WATER MAIN CHG. i -- 3 -�.)� ------
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S.B.C.C. FEE ` J
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
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RECEIVED �
SEP 2 3 1991 CITY OF FEDERAL WAY
alTyo FEDERALwAY BUILDING PERMIT APPLICATION
sukoiNG OEIT - Please Print—
BOX 1 TENANT NAME:
OWNER 279/1,,,v 57;92 k o d i'c/2 SITE LOCATIQN //OS rk 57-
OWNER'S
rOWNER'S ADDRESS /eca S, X33 ", J. CITY le c U PHONE -686.2 S0b+4
DESCRIBE JOB ..rNiTALL Foic ��T�,c�f T. S. ( r'aa 33 SS co..,Tt,
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME /79,e r �So✓,vcI pies 4iv,,4 G CONTRACTOR'S REG. # Pu6snr.7 *`J/7'L
C' Card MUST be presented
CONTRACTOR'S ADDRESS /ob,Cs / 9 79 R vg: C_ CITY T cow A PHONE 5:37 erS o 7
EXPIRATION DATE /3 - P _
— 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 /77 vier /n CLI,'LLis PHONE,. -2,ef900
BOX 4 SEWER DISTRICT WATER DISTRICT --
BOX 5 ESTIMATED PROJECT COST _ EXISTING BUILDING VALUATION --
BOX
BOX 6 PROPERTY TAX ACCOUNT NUMBER /Ec,L( .7D /Dy S' Jy0 Jr/7Z% S. l..J. SC; >0 2/ - y
LEGAL DESCRIPTION
C
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) 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 $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
c2 OTHER y" Tri/i,4_ Z,A/A (.2 C/e4. o c.1 5) $
o % TOTAL FIXTURES ffv 4a =6(0 op
3 TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWL DGE
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.
OWNER/AGENT: c- G��eZ DATE: S
ANP-008 3/90