Loading...
91-101081 CITY OF BUILDING BUILDING INSPECTION FEDERAL WAY PERMIT 941-1555 434 "REVISION TO PERMIT # 91-754" ! ')a/Dg/ PERMIT NO. 91-754 RA OWNER'S NAME TOM BRAATEN CONSTRUCTION JOB ADDRESS 33418 4 CT SW CONTRACTOR BRAATEN CONSTRUCTION ADDRESS 33415 4 PL SW FEDERAL WAY CONT. PHONE 927-39. 98 CONT. REG. NO. TOMBRCI142DR 1/92 OWNER'S PHONE SAME OWNER'S ADDRESS SAME 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 REVISION TO EXISTING PERMIT # 91-754 TAX ACCOUNT NO. 729805-0380 LEGAL DESCRIPTION LOT 38 DIV 6 THE RIDGE SUED BY ELIZABETH SNYDER DATE OF ISSUE //`r7 DATE OF APPLICATION 8/5/91 BUILDING INFORMATION ZONE - OCCUPANCY TYPE OF CONSTRUCTION _..._ BLDG. SQ. FT SET BACKS: FRONT _ SIDEREARSTORIES HEIGHT LIMIT PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CI DSETS ELEC. HOT WATER HEATER GAS PIPING FT. _ BOILER ._- RECEIVED BATHT1;3S LAUNDRY DRAINS COMPRESSOR _ TANK(S) SHOV _RS 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 NONE UNIT HEATER TOTAL MECHANICAL NONE AMOUNT NONE VALUATION $NONE PERMIT FEE _ PLAN REVIEW OF REVISION, 2 HRS @ $30.00 PER HR PLAN CHECK FEE $60.00_. SUMBING FEE CHANICAL FEE TOTAL BLDG. FEES _ PART P/C FEE SEPA REVIEW WATER SERVICE WATER MAIN CHG. W,.. ' S.B.C.C. FEE DATE PD , AMT $60.00 RE'CT 3......7-41 OTHER FEES AMOUNT DUE $60.00 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: -_---- - _ _ - ,__: DATE ��`-‘1I '"ER OR AGENT CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 PERMIT NO. 91-754 NR OWNER'S NAME TOM BRAATEN CONSTRUCTION JOB ADDRESS 33418 4 CT SW CONTRACTOR TOM BRAATEN ADDRESS 33415 4 PL SW FEDERAL WAY CONT. PHONE 927-3998 CONT. REG. NO. TOMBRCI142DR 1/92 OWNER'S PHONE SAME OWNER'S ADDRESS SAME TYPE JOB: NEW RESIDENCE XX ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD NEW PUBLIC PUBLIC ADD. NEW MULTI-FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER . . .AND GARAGE TAX ACCOUNT NO. 729805-0380 LEGAL DESCRIPTION LOT 38 DIV 6 THE RIDGE ISSUED BY ELIZABETH SNYDER DATE OF ISSUE fl" 1 -/ _ DATE OF APPLICATION 6/6/91 111 BUILDING INFORMATION ZONE RS 9.6_ OCCUPANCY R-3/M-1 TYPE OF CONSTRUCTION _5-N,_ - BLDG. SQ. FT 4341 SET BACKS: FRONT 20' _ SIDE 5' EACH REAR___ 'S STORIES 2 HEIGHT LIMIT 30' MAX PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS 3 ELEC. HOT WATER HEATER GAS PIPING _FT. 3.50 BOILER _ BATHTUBS 2 LAUNDRY DRAINS 1 COMPRESSOR TANK(S) RECEIVED SHOWERS 2 URINALS FORCED AIR FURNACE 10.00 AIR HANDLING UNIT _ NUMBER _ LAVATORIES 5 DRINKING FOUNTAINS _ GAS HOT WATER HTR. 6.50 MISC RETURNED SINKS 2 MISC. CONVERSION BURNER BASIC FEE DISHWASHERS 1 __. TOTAL FIXTURES 16 X t9-00 UNIT HEATER TOTAL MECHANICAL 20.00 AMOUNT NONE VALUATION $737,595_00 PLANNING DEPT APPROVAL = LORI SCHILL PERMIT FEE 41.123-110__ PLAN CHECK FEE 214.-5730_00 -- "APPLICANT WILL SUBMIT DESIGN DRAWING OF ROCK RETAINING WALL(LESS PLUMBING FEE - 80_00_ - THAN 4 ' HEIGHT) TO PROVIDE EROSION CONTROL AT EAST PROPERTY MECHANICAL FEE 20_00 BOUNDARY" TOTAL BLDG. FEES __$_195 n n PART P/C FEE (919-50) FIRE DEPT APPROVAL = KEVIN ELLIS SEPA REVIEW WATER SERVICE PUBLIC WKS DEPT APPROVAL = TOM COLLINS AI M WATER N CHG. S.B.C.C. AI 4_50 BLDG DEPT APPROVAL = MIKE MONEN FE -,7--- 1,487.00 _ b OTHER FEES P. WKS. 45_00 DATE PD )--- / AMT $3$fl061) RE'CT 36, y S AMOUNT DUE $2-0-ft2-_-5-0- 1,4-8/.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: - -- i t OWNER OR AGENT �r```�= -- '- __ DATE 3.--Z.---9- CITY OF BUILDING 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 REVIEW OF REVISION 2 HRS g $30.00 PERIM PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE } TOTAL BLDG. FEES 'Ak PART P/C FEE _ • SEPA REVIEW WATER SERVICE 7 WATER MAIN CHG. _ '1 ' ''2 - S.B.C.C. FEE _ )r TT; P€) t ? / .. : CC,00 .; _" 'CT I 'i . 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 31V0 1N3OV HO H3NMO :131AI 38 11IM S1N3W3HIfO31d AVM 1VH303d dO A110 318VO1lddV 3H1 ONV 39031MON)i AIN dO 1S38 3H1 01 103d1d00 ONV 3ndl SI 301 A9 03HSINH11d NOI1VWHOdNI 3H1 1VHl AdI11:130 I •3ONVnSSI dO 31V0 H31dV HV3A 3NO 31:1IdX3 S1IW1i3d oNIOVID ONV 1VI1N301S3H 'O31HVIS SI )IHOM ON Al 33NVI1SSI H31dY SAVO 081. 3HIdX3 SIIWH3d 11V �. �._.. ., . _. _ 3110 1N10I V Tt`)a r5-7rort II4Y Gd W i 933d H3H10 33d '3'3'9'S mallow RMIW 3 NAO tddV Ida(' ocri 'OHO NIVINH31VM ',..14I7100WO1 = 'WAOthTr Y Ldau S) M 3I`IRfd 331AH3S H3IVM M31A31j Vd3S SITU NIAAX = 'I AOHdd .M:.(1 JHId 33d 3/d 11:1Vd 933d '0019 1V101 rAalatineg 33d 1V31NVH3311 3L :i Olid ISVX IV 'I0E1..NOO 40I'0 ? WCIiAO?1d i OI (111DIati a p !MILL 33d ONI9Wmd :'7^ )'Z`iV.. 9KIMIYJ d )1Z.)e:T JO IMY1U U:?ISZQ zawunS r.x 4 INNOI'Idd' w 33d)133H3 NVId 33d 11WH3d TIIHOS 'd0`I = 111110 id3Y Jfc JgI.r .d NoI1Vn1w\ INn0WV . . 1VOINVHO3N 1V101 831V3H 11Nn .s ` S3HniXld 1VIOl SH3HSVMHSIO 33d 315V8 H3N9119 NOISH3AN03 '3SIW S)INIS 03NHn13H 3S11A1 111H H31VM 10H SVD SNIVIN1Od ONDINIHO 5311:1OIVAV1 HM/MN _min ONI10NVH HIV 33VN811d HIV 0309Od S1VNIH11 SH3MOHS (S)NNV1 HOSS3HdI'03 SNIVHO AHON1V1 S8n1HIV8 03A1303H 931108 Id ONIdid SVD 831V3H H31VM 10H '0313 5135013 931VM ONOS '1WV 'IWV S3ONVIlddV 1V3INVHO3W 'ON ON ONI8Wnld 1101111E1013H S311:101S HV3H 3015 1NOHd :9)131/8139 ld 'OS 0019 NO113fUISNO3 dO 3dAl AONVdn330 3NOZ NOIIVWUOdNI 0N1011119 NOI1V31lddV dO 311/0 3nSSl dO 31V0 A9 O3nSSl NOI1d1HOS30 1V031 ON INn033V XVI H3H10 ONIOVHO NOIS 'OOV 'II1nW ( S11Nn) A1iI Vd-I11nI M3N 'OOV 3118nd 3118nd M3N 00V 1VIHIS1ON1 'GOV 1V13H310103 1VI31:131AWO3 M3N lviUISnUNI M3N NOIIIOGV 33N301S3H M3N 90f 3dAl SS3HOOV S,H3NMO 3NOHd S,1:13NMO ON '039 'INO3 3N01-Id 1NO3 SS3HOOV 13013VHlNO3 SS31:100V 80r 3WVN S,H3NMO ON 1101H3d SSSL-1476 1I WEl 3 d Dmamma AVM 11/1:131:13d NOI133dSNI JNIdlInB dO A113 -4 (t ,,,,,...", t-.. _, vl >- >- a >- c.,-4 lz, 1,,.., !s,i Q 1/4 cc Ow r ry - 0 a U � ~ z ~ \ '\ Z ' 0 0+ i NJ b Ni D (n ` Z m a 1 al % It i L l' '''\ ltl O I- J I-~ W < Q Z \i IN \. IC) % &I ' '.. 1 , k' iir -0 .,,i L c\ '• a U a t ,}' 1 N. Z —% `'' h ` 4 M 1 w O O cn. O \ Z O Q N`Q Q G OCSo N — o o o Z o o 0 AS 7 \N. \O . i 1 , ,n. s \,) '• i ~O m Z m Q COcL, }} ,, . ? \J o =U I W a"I C) k• N8lk I V I �\ tN N i '•ti Q nl O J OJ {Nni 0 \ \ (' ccn o a o O o LI o • •mit # / - 7-C4/A/c RECEIVED CITY OF FEDERAL WAY — JUN 0 61991 BUILDING PERMIT APPLICATION S / S _ VOOF��WAY — Please Prin',— 1 TENANT NAME: ----1 Om_ �(L AT6�r OWNER -1- i'ILI4a tsW GoNs f url SITE LOCATION G("r 38 Dkv (o l t 4).UN, - OWNER'SADDRESS 33"Pi c •P?-• 4-0.1. CITY tAL atiskr PHONE 9Z7— 3ag6 DESCRIBE JOB _ THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION t> BOX 2 CONTRACTOR'S NAME i ov4n. Q A-C i-) CONrT' W - CONTRACTOR'S REG. # /or%\14-e-37 1 ike D2 Card MUST be presentecf CONTRACTOR'S ADDRESS �5411 S- "T"--N 'C-- CIL',"- CITY / FFA-k- I^'Ase PHONE cIZ-7- 1,5 tY1 EXPIRATION DATE / -/ -9z— — 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 �� A �/J PHONE �z7- 3��8 BOX 4 SEWER DISTRICT 1b-W/"Y WATER DISTRICT -wf''1 BOX 5 ESTIMATED PROJECT COST 3 85 oar 00 EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER —7l 7 s' O 38.0 LEGAL DESCRIPTION L..0-r- 8 'Poi 6, 1 �Zt1: - (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording # BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 1)75-8 / 2ND FLOOR /l 732- 3RD FLOOR / BASEMENT / DECK / GARAGE es- - / / BOX 8 (VI SINGLE FAMILY ( vc NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SO FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ NO. WATERCLOSETS GAS PIPING, FEET , $ Z- BATHTUBS NO._ / FURNACE, ELEC._ GAS $ L._ 1- SHOWERS l GAS HOT WATER HEATER $ LAVATORIES CONVERSION BURNER $ Z 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 $ (C, TOTAL FIXTURES $ TOTAL MECHANICAL FEE $ ,_26(`) 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 E INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: ,„------ 8*" \`� DATE: 6-6,- ANP-008 3/90 OFFIOSE ONLY (PLEASE DO NOT WRITE BELOW THISLINE) ZONEr6 SETBACKS: FRONT 7--O / SID 5 ' REAR 6 ' HEIGHT LIMIT �d PLANNING DEPARTMENT APPROVAL �� � • -/a-97 '''i.a REI/MARKS:'- 7-/iCan-- wiG1 sub t4,t d ' lra.v,r of re reG I - tcJa , /csr Lrani fa117-79 -6 11---e vide. si n e-erltiol at ebb 71-274F-9-7, A.0 ti -a_Jy. '1t} , SEPA: EXEMPT i--'- NOT EXEMPT FIRE DEPARTMENT APPROVAL t DATE 7- L / REMARKS: PUBLIC WORKS DEPARTMENT APPROVAL rG DATE 6/1/7/?/ 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 OCCUPANCY 0 TYPE OF CONSTRUCTION VN STORES 7/(4.'0 /'' d-L.crp✓ BUILDING SQ. FT. 173 @ 72* = /01g/3a 2"J --ii.7 BUILDING SQ. FT. /73a @ 7d-1` = /9 6 ;Id Z \1,41.7.,.._ BUILDING SQ. FT. 9.5/ @ /f(3 = / 5 7-3 BUILDING SQ. FT. @ = BUILDING SQ. FT. @ = ,) 6 779Y �� BUILDING SQ. FT. @ /Y)44440.._ X . Cit = TOTAL SQ. FT. 4',3 y/ ' TOTAL VALUATION ;3 7 c 75 CC' BUILDING, DEPARTMENT REMARKS: 1/023 PERMIT FEE PLAN CHECK FEE 710 PLUMBING FEE '(', ,...I MECHANICAL FEE TOTAL BLDG. FEES 7_s_i PART P/C FEE �.. ("C-N5 P SEPA REVIEW iaw' -4.57,00 40111111116- S.B.C.C. FEE /{ OTHER FEES _ AMOUNT DUE r Ca.%e, /1( s 7. cn, ASSIGNED ADDRESS: 33'1 1 S Li fl'` Cf S S . w• PARTIAL PLAN CHECK FEE RECEIVED Amount Date Receipt# BUILDING DEPARTMENT APPROVAL RECEIVED BY / „,),""fl"T`-c..._ DATE ;-/S-9/ ACCEPTED FOR FILING Pee it # 4 s-4 I � RECEIVED a AUG g 0 CITY oF Few CITY OF FEDEhAL WAY BLU0EP't BUILDING PERMIT APPLICATION (--e___LV, ?JAMS ( 4_ } QeasePrint— BOX 1 TENANT NAME: OWNER A / Go m,5.'' SITE LOCATION 33 4-1 t5 4- c— T S,LJ . OWNER'S ADDRESS 3511 .E 44"- Vt-- s..,-/ CITY F6�c�tAL- IA/AYPHONE qz-7-3186' DESCRIBE JOB / - ii i_: c-6- THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION // BOX 2 CONTRACTOR'S NAME e rA ,AEar Cobs i- CONTRACTOR'S REG. #T^N Se !4-zb 12,�z Card MUST be presented CONTRACTOR'S ADDRESS 3311.5 1 eL-- ScJ ' CITY f- -1>f--40.- Wk( PHONE QZ7-35aG' EXPIRATION DATE 1/4z — 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 (Om ie--AA-1---�i-) PHONE cis Z7-1119 BOX 4 SEWER DISTRICT f L wkt WATER DISTRICT -t)1 AL (i%�`r BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 7i'180s - 5380 LEGAL DESCRIPTION Lo"T - 3€5 DtV tsroN S lX ¶) Ptb(,- (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 ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (includin ough-ins) MECHANICAL APPLIANCES — BASIC FEE$ NO. . WATERCLOSETS GAS PIPING, FEET /jam $ -• BATHTUBS NO. / NFURNACE,` ELEC. GAS ►! $ . SHOWERS / GAS HOT WATER HEATER $ s LAVATORIES CONVERSION BURNER $ SINKS BOILER, SIZE E BTU $ D : WASHERS AIR HAND UNITS $ "LECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $ L W UNDRY WASHER OUTLET UNIT HEATERS $ UR ALS - AIR COOLING UNITS, SIZE $ DRINKING FOUNTAINS COMMERCIAL HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS OTHER $ DRAINS $ OTHER $ ( /G 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 KNOWLED AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATIO MADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORN FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSI( AND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDI' OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATIOP ,---- >. OWNER/AGENT: DATE: T S" avislscl OE USE ONLY (PLEASE JO NOT WRITE BELOW THIS LINE) 111A. ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT .x 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. D/ALT NEW INDUSTRIAL IND. ADD/ALT NEW COMMERCIAL COMM. ADD/AL 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: f(aG\ !kV real a- PERMIT FEE Kt t S ( c> G1 r 6' 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 CO - e e. O ASSIGNED ADDRESS: J� 40 y �� t PARTIAL PLAN CHECK FEE RECEIVED 64/ 4 � �� Amount Date Receipt# BUILDING DEPARTMENT APPROVAL RE, A BY DATE ACCEPTED FOR FILING