91-101209CITY OF
FEDERAL WAY
BUILDING PERMIT
9�,�aiao q
BUILDING INSPECTION
941-1555
91-1159 P MARK ROBINSON 28815 7TH AVE S
PERMIT NO. OWNER'S NAME JOB ADDRESS
DEAN THE PLUMBER - DFOEAIDDLE 11827 26TH AVE S CONT. PHONE 248-1898
CONTRACTOR
DEANPIK182RP 941-1883 28815 7TH AVE S FEDERAL WAY
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. 515292-0060 LEGAL DESCRIPTION
SSUED BY JOANNE JOHNSON DATE OF ISSUE _._. - DATE OF APPLICATION 8-26-91
BUILDING INFORMATION
ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SO. FT.
SET BACKS: FRONT SIDE REAR_ STORIES HEIGHT LIMIT
PLUMBING NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS 1 ELEC. HOT WATER HEATER
GAS PIPING _ FT. 3.50 BOILER
RECEIVED _
BATHTUBS LAUNDRY DRAINS -
COMPRESSOR TANK(S)
SHOWERS 1 URINALS -
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES 1 DRINKING FOUNTAINS
GAS HOT WATER HTR. 6.50 MISC. _
SINKS MISC.
CONVERSION BURNER BASIC FEE 20.00
RETURNED
DISHWASHERS TOTAL FIXTURES 3X5= _15.00
UNIT HEATER TOTAL MECHANICAL 30.00
AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
LUMBING FEE 15 _9 -- _
ECHANICALFEE
TOTAL BLDG. FEES _
PART PIC FEE
SEPA REVIEW -
DATE:
WATER SERVICE
WATER MAIN CHG.
AMOUNT : $45.00
S.B.C.C. FEE
OTHER FEES
RECEIPT:
AMOUNT DUE 45.00
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 ME .
_ i L
OWNER OR AGENT -�`' - DATE
1
CITY OF
FEDERAL WAY
BUILDING PERMIT
BUILDING INSPECTION
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 ADC..
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 PIC FEE
SEPA REVIEW
/ Cj
WATER SERVICE
WATER MAIN CHG.
PATE
S.B.C.C. FEE
OTHER FEES
B�
AMOUNT DUE
v
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS
STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. r
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
\
SET BACKS AND FOOTINGS
DATE ----BY
O.K TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE BY P3
PLUMBING ROUGH IN
DATE A �_P27�//,BY
WATER LINE O.K.
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE BY
O.K. TO ENCLOSE FRAMING
DATE, --- _ ____ BY
INSULATION
DATE -BY
WALL BOARD AND FIRE WALL
DATE __,__13Y
FINAL O.K. TO OCCUPY
DATE_ -BY
DCD
PSD
FD
0 46
46it #
RECEIVED
AUG 2 6 199j CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
C�'ry OF FeDtFAAL WAY — Please Print —
BUILDING DEPT.
BOX 1 TENANT NAME:
OWNER /Ve/tc6 SITE LOCATION -5 fir/ 3"
OWNER'S ADDRESS J S`S/5 'Jtn S, CITY 1 PHONE 9'H -/8 Sr 3
DESCRIBE JOB iLdin e cl e_1 6q 1-�
THE PROPERTY IS OWNED BY: SINGLE(ARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
J-Yct K `tke "t k.ti
CONTRACTOR'S ADDRESS C+I, 6U-5 CITY
EXPIRATION DATE /a -7 ci
—
OR—
CONTRACTOR'S REG. # Duxn 1'10S? erg.
Card MUST be presented
G -I c PHONEJ'4 — I M
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 1-1< PHONE 2 VS l "/
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(It 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
:1
PLUMBING FIXTURES (including rough -ins)
N0.__ WATERCLOSETS
BATHTUBS
_SHOWERS
/ LAVATORIES
SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
DRAINS
OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEET
$
NO. FURNACE, ELEC. GAS
$
GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE
$
COMMERCIAL HOOD
$
OTHER
$
TOTAL 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.
OWNER/AGENT � "yl 13�t�k _ DATE: % ! /
ANP -008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) �1�V1►�'"
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL
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:
AUG 2b1991
01N 0� rfI)i RAL W
jU)lw Eept
RECEIVED
ASSIGNED ADDRESS:
Amount
Cl9
PARTIAL PLAN CHECK FEE RECEIVED
Date
Receipt #
BUILDING DEPARTMENT APPROVAL
DAT
DAT
DA
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
ACCEPTED FOR FILING