92-100402 CITY OF FEDERAL WAY 9a .- icyb LiD
33530 First9800
Way, WA 98003
Way
Federal BUILDING PERMIT BUILDING INSPECTION
661-4140
PERMIT NO. 92-381 MH OWNER'S NAME DOUGLAS/LOIS YEAROUS SITE ADDRESS 3001 S 288 ST #252
CONTRACTOR HORIZON CONST ADDRESS 1940 ELM ST E AUBURN CONT.PHONE 939-1342 _
CONT.REG.NO. HORIZC5132LA EXP.10/92 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 INSTALL MOBILE HOME ONLY
TAX ACCOUNT NO. 042104-9222 LEGAL DESCRIPTION SPACE 252 CAMELOT SQUARE MOBILE HOME PARK
KING 0 WASH
ISSUED BY _ ELIZABETH SNYDER DATE OF ISSUE „,1--I a--- DATE OF APPLICATION 3/12/92
1
• BUILDING INFORMATION
ZONE RM 3600 SET BACKS:FRONT 20' SIDE 10' /3' REAR 15' HEIGHT LIMIT NA
OCCUPANCY R-3 TYPE OF CONSTRUCTION 5—N CENSUS NO._ 0/S _. _ TYPE OF HEAT NA BLDG.SQ.FT. 1070 STORIES NA
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC.HOT WATER HEATER _ GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS _ URINALS GAS HOT WATER HTR. AIR HANDLING UNIT NUMBER
LAVATORIES _ DRINKING FOUNTAINS CONVERSION BURNER _ MISC.
RETURNED
SINKS _ MISC. _ BBQ BASIC FEE
DISHWASHERS TOTAL FIXTURES NONE DRYER _ TOTAL MECHANICAL NONE AMOUNT NONE
VALUATION $4,708
PERMIT FEE $72.00 PLANNING DEPT APPROVAL = DEB BARKER
PLAN CHECK FEE 47.00
PLUMBING FEE "SOUTH SLOPE SHALL NOT BE IMPACTED BY DEVELOPMENT"
MECHANICAL FEE
PART P/C FEE FIRE/BLDG DEPT APPROVAL = KEVIN ELLIS
SEPA REVIEW
PUBLIC WORKS
S.B.C.C.FEE 4.50
FIRE FEE DATE:
OTHER FEES AMOUNT: $123.50
AMOUNT DUE — $123'SU RECEIPT:
ALL PERMITS EXPIRE 180 DA AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFQRMATIs'N FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
3E MET. I'
OWNER OR AGENT i __ DATE `-�
CTY- r FEDERAL WAY -
33530 First Way South BUILDING PERMIT BUILDING INSPECTION
Federal Way, WA 98003 661-4140
PERMIT NO. OWNER'S NAME SITE ADDRESS
CONTRACTOR ADDRESS CONT.PHONE
CONT.REG.NO. EXP. OWNER'S PHONE OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE ADDITION NEWINDUSTRIAI NEWCOMMERCIAI 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
GONE SET BACKS:FRONT _SIDE REAR HEIGHT LIMIT -
OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. _ TYPE OF HEAT BLDG.SQ.FT. STORIES
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC.HOT WATER HEATER - GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS _ FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS - CONVERSION BURNER MISC.
RETURNED
SINKS MISC. BBQ BASIC FEE
DISHWASHERS - TOTAL FIXTURES DRYER TOTAL MECHANICAL AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE - T •NI ,
PLUMBING FEE
ECHANICAL FEE . F'iirk
WART P/C FEE — I. •ti .t
SEPA REVIEW - 3«rs ,
PUBLIC WORKS - . '
S.B.C.C.FEE a _
FIRE FEE - DATE: DA\
OTHER FEES —- AMOUNT:
AMOUNT DUE _- RECEIPT: VNI
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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• RECEIVED • Petit # y 2 — U 17M /f
MBAR 12 1992 CITY OF FEDERAL WAY
QM OF 4UEilAfr.WAY BUILDING PERMIT APPLICATION
gotsio DEPt - Please Print—
BOX 1 TENANT NAME: ' .= Q.. (. r DOOGLIIS ' LCIS
OWNER M SITE LOCATION 041, _ - c, C.-- SP`,. —
OWNER'S ADDRESS CITY 'i I Ills Y PHONE
DESCRIBE JOB /Nj7 LLATf ON `f• .sET-(�I� uF z x4c NICa]LE %'IOC, ..
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME HO E(zoN CYOI\LC I , . 1 N c CONTRACTOR'S REG. #/ e%Z<_ 5I3Zl�
,,// EL
qA
Card MUST be presented
CONTRACTOR'S ADDRESS 161/40
�}4o ELIA S I • - CITY ALP-A.)0\1 PHONE93art - 1 4 2-
EXPIRATION DATE /O/I I/( a
— 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 Z—t2=L 8AL L ? L)R PHONE ee 4' 144
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER o42-I O4— C[ Z Z-Z"O
LEGAL DESCRIPTION SPRC=E— 4' Z 'Z CAMELOT S 3�I tea• ZeE 1-
FEDE L WAN. ; vJA c E300
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR/004/ 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 /Q lv 7 SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE $
NO. 0WATERCLOSE S GAS PIPING, FEET $
BA HTUBS NO. FURNACE, ELEC. GAS $
Z- SHO ERS GAS HOT WATER HEATER $
Z LAVA' ORI' CONVERSION BURNER $
I SINKS BOILER, SIZE BTU $
1 DISHW SHERS AIR HANDLING UNITS $
I ELEC r• HOT WATER HEATER HEAT PUMPS, SIZE $
1 LAU DR WASHER OUTLET UNIT HEATERS $
URI ALS AIR COOLING UNITS, SIZE $
DR KING 'IUNTAINS COMMERCIAL HOOD $
SU PS, SPR KLER VACUUM BREAKERS OTHER $
I D'AINS $
OTHER $
I_a_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 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: —"e! /j '4 i DATE: MAR. I Z , 19 _l Z.
ANP-008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELO•IS LINE) . '
Zh?3.�as 2 0' (C)' L
ZONE SETBACKS: FRONT SIDE � -� REAR >r-� 1 HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL -3PIM"? 1 A,A-------
REMARKS: � 1 ,'�'.1,.- .S _ --Q A4, ,t' /t.4--t --',-f �l e-Vee . i Cr: c j nt-
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE 3 - za ra,
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL A I /� DATE
REMARKS: /1/ //f'-j-
I
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/tSTORES
` o l v il BUILDING SO. FT. 07(3 @ .c° O = S-35-0
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @
BUILDING SQ. FT. @
BUILDING SQ. FT. @ AnOd l c( t(, = U` g S
TOTAL SQ. FT. TOTAL VALUATION 11.7° a
BUILDING DEPARTMENT REMARKS: PERMIT FEE 72-
PLAN CHECK FEE Lt 7
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE 1 SCD
OTHER FEES '1
AMOUNT DUE 9-)--
ASSIGNED ADDRESS: See- e-Y-(S—((A/
'� 1c 2 PARTIAL PLAN CHECK FEE RECEIVED
kAla �,wP( Amount Date Receipt#
W� BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE 3 ✓ 5 Z ACCEPTED FOR FILING
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