90-100782 3 0400-78a
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
"INSPECTION REQUEST LINE-946-6794"
PERMIT NO. 90-1303 P OWNER'S NAME SCHURR BROTHERS CONST JOB ADDRESS 123 S 363 PL
CONTRACTOR H & H PLMG ADDRESS 926 E 96 ST TACOMA 98445 CONT. PHONE 535-3455
CONT. REG. NO. HHPL****255QK 10/90 OWNER'S PHONE 841-8888 OWNER'S ADDRESS 9709 124 ST E PUYALLUP
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 PLUMBING ONLY
TAX ACCOUNT NO. NA LEGAL DESCRIPTION NA
ISSUED BY ELIZABETH SNYDER DATE OF ISSUE glIr / DATE OF APPLICATION 8/6/90
• BUILDING INF•R'AT ON 1
ZONE NA OCCUPANCY NA TYPE OF CONSTRUCTION PL i:I G ONLY BLDG. SQ. FT. NA
SET BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS 5 ELEC. HOT WATER HEATER 2 GAS PIPING FT. BOILER
BATHTUBS 3 LAUNDRY DRAINS 1 COMPRESSOR TANK(S) RECEIVED _
SHOWERS 1 nrmmrs BASIC FEE 20.00 FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVATORIES 6 _ _ DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. _
SINY(S 1 MISC. L.TRAY 2 CONVERSION BURNER BASIC FEE RETURNED
DISHWASHERS 1 TOTAL FIXTURES 22 X $5.00 UNIT HEATER TOTAL MECHANICAINONE AMOUNT NONE
VALUATION NONE
PERMIT FEE
PLAN CHECK FEE
SUMBING FEE $ 110_00
CHANICAL FEE
TOTAL BLDG. FEES $
PART P/C FEE
SEPA REVIEW
WATER SERVICE (1/ (b
WATER MAIN CHG. ,`) o
S.B.C.C. FEE DATE PAID AMOUNT $130.00 RECEIPT 3 / I t VLOTHER FEES
AMOUNT DUE $ 130.00
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 INFORMAT N FURNISHED BY M' . TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET: .2 --
I
7 0
OWNER OR AGENT DATE
F
CITY OFBUILDING INSPECTION
FEDERAL WAY 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 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
PART P/C FEE
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
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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RE'CE • ..IVEp
AUG 0 61990 CITY OF FEDERAL WAY
CITYOFFEDERBUILDING PERMIT APPLICATION
BUILDING DEpT AY - Please Print—
BOX 1 TENANT NAME:
OWNER J--u' --8hcc �>ti 3 7' SITE LOCATION /L 3 So- ��3A�
"L '�-- CI
....5 c=
OWNER'S ADDRESS 9J /at Y1-6 Sic._ CITY ( .A/• PHONE 11-
DESCRIBE JOB Nift/../ ('c�a'5Z-t; CA) tz s-,D%n�tb
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP ,... )T-''''l ORATIO�j
BOX 2 CONTRACTOR'S NAME HI-H Pc--C.41 6iN6 CONTRACTOR'S REG. #221 t�%aN-i�'-r 04)(01.5.11-X.
Card MUST be presented
CONTRACTOR'S ADDRESS �' f^ 96 /4 91 CITY 779Ct 4' CO- '— — PHONE S:I JY/JT"
EXPIRATION DATE ltd/',o (i e'
— 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 Ru,v //Mae— PHONE 53.) -3`/i3 -
BOX 4 SEWER DISTRICT WATER DISTRICT
-- -BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
-BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(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 (4NEW 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 $
3 BATHTUBS NO. FURNACE, ELEC. GAS $
/ SHOWERS GAS HOT WATER HEATER $
6 LAVATORIES CONVERSION BURNER $
/ SINKS BOILER, SIZE BTU $
/ DISHWASHERS AIR HANDLING UNITS $
x ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
I lgt LAUNDRY WASHER OUTLET _ UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS _ COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
.•C OTHER G,A(.:ti_'),7 7:.Nq/S $
TOTAL FIXTURES `J $ ( _
_-)_�\(-S •1 a. TOTAL MECHANICAL FEE $,,,Lis-,----
`-
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, UP N/T/H/E/A/C,CU�RlACY THE INFORMATION SUPPLIED TO THE CITY AAS-A PART OF THIS APPLICATION.
OWNER/AGENT: C �' -GGLk c� '-- DATE: g6`�Lw
ANP-008 3/90
• 1.1\ V '
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 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
-fy .7y ASSIGNED ADDRESS:
41 76p,
0 '0 'O PARTIAL PLAN CHECK FEE RECEIVED
4,1
/1/`, 01Y Amount Date Receipt#
y�V BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING