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H Q O m m �n n m N H m v z '►�° m m O m n (D H a 0 x m Z c x m m O r q� I c m v N.. m C F b Cr" z CD m m v o 1 ? m n Z �3 O m r r+ N c I W b �l H v { � o f� C r Z %i Cr] SET BACKS AND FOOTINGS OX TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK DATE . BY _ _ DATEBY DATE -__ _ - BY PLUMBING ROUGH IN WATER LINE O.K. _ MECHANICAL INSPECTION DATE _ _BY GAS PIPING O.K._-_ DATE _ _ _BY U.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL DATE _---. _BY - _ DATE - ---_.BY DATE FINAL O.K. TO OCCUPY JJ � DATE_ �f�6l Y`, DCD PSD FD RECEIVED _ ermit # I] U JUL I-1992 W" ��0� �� OF FE RAL W1AY BOX 1 TENANT NAME: CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — OWNER SITE LOCATIO "�--' 3 OWNER'S ADDRESS V` CITY- PHONE--Z Z 9 . [�P-- DESCRIBE JOB - THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP.. ORPORATION BOX 2 CONTRACTOR'S NAM � CONTRACTOR'S REG. # C�aard� MUST be resented CONTRACTOR'S ADDRESS ©� ' �` t , CITY �1(JC51(Yl �.�� PHONES_ EXPIRATION DATE tINITIONS ORI HAVE READ CHAPTER 18.27.010 RELATING T OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. .. BOX 3 CONTACT PERSON PHONE—� BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST r EXISTING BUILDING VALUATION BOX 6 CII PROPERTY TAX ACCOUNT NUMBER Al D -�O - 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 ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY —SOFT BOX 9 PLUMBING FIXTURES (including rough -ins) MECHANICAL APPLIANCES — BASIC FEE $ N0. WATERCLOSETS GAS PIPING, FEET $ BATHTUBS NO. _FURNACE, ELEC. GAS $ SHOWERS I 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 $ 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 ASTO 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: DATE: 0 ANP-008 3/90 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 DAME 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 SO. FT. @ . BUILDING SO. FT. @ — BUILDING SQ. FT. @ — BUILDING SQ. FT. @ — BUILDING SQ. FT. @ — TOTAL SO. FT. TOTAL VALUATION — BUILDING DEPARTMENT REMARKS: RECEIVED ASSIGNED ADDRESS: PARTIAL PLAN CHECK FEE RECEIVED Amount Date Receipt # BUILDING DEPARTMENT APPROVAL BY DATE 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