91-101485 , CITY�OF FEDERAL WAY 4� ��� � � �'y
33530 First Way South g V I L D I N G P E R M I T BUILDING INSPECTION
Federal Way, WA 98003 RENEWAL OF 90-863 RA 661-4140
PERMIT NO. 91-1443 RE OWNER'S NAME GERAI�D WELCH SITE ADDRESS 5243 SW DASH PT RD
CONTRACTOR OWNER ADDRESS S�E CONT.PHONE 8�4-0324
CONT.REG.NO. NA ExP. NA OWNER'S PHONE S�E OWNER'S ADDRESS SAMF'
TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBLIC PUBLICADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER �NEWA.L OF 90-863 TO CONSTRUCT ADDITION
TAXACCOUNTNO. 36H14O-14�-6 LEGALDESCRIPTION LOT 2 BLR 4 Sl'.',C 3305 H�..''�Y PALISADES �
ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE , DATE OF APPLICATION 10/15/91
BUILDING INFORMATION
� �
ZONE SET BACKS:FRONT 20 SIDE 5 5 REAR 5 HEIGHT LIMIT 3O
OCCUPANCY R-3 TYPE OF CONSTRUCTION 5-N CENSUS NO. � `S TYPE OF HEAT EXISTING gLDG.SQ.FT. 92 sroRiEs EXISTING
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.
SINKS nnisc. DRAIN 1 ggQ BASIC FEE RETURNED
DISHWASHERS TOTAL FIXTURES 1 ORYER TOTAL MECHANICAL NONE AMOUNT NONE
VALUATION �4��8 4 g
THIS PERMIT EXPIRES 10/15/92 AND CANNOT BE RENEWED AGAIN.
PERMIT FEE �1F)2.OO
PLAN CHECK FEE
"'UMBING FEE 2.SO
:HANICAL FEE
P/I,RT P/C FEE
SEPA REVIEW / ^�
PUBLIC WORKS ^� �j�`�� �f
S.B.C.C.FEE 10/15/91 �j� �� �[ �I � � �l �
FIREFEE DATE: v �t� � ��1/1
OTHER FEES AMOUNT: 164•S� I'�' (�r� � ��x
AMOUNTDUE �� 64 S� RECEIPT: 4097
PD � (82.25) ON 10/15/91, # 4097 — TO PAY BALANCE NOVEMBER 1991. (82.25)
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
�f'�Y r7F FEDERAL WAY
33530 First Way South g V I L D I N G P E R M I T 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
TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBIIC PUBLICADD.
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 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
PLUMBING FEE
MECHANICAL FEE
PART P/C FEE
SEPA REVIEW
PUBLIC WORKS i �
S.B.C.G FEE C� ,,�C/j�p-- ��� � �
FIRE FEE DATE: \„D � A/- /
.j.
OTHER FEES AMOUNT: �� � � � I�
�-ty
AMOUNT DUE RECEIPT:
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
.� f '
r ��,,,'
OWNER OR AGENT DATE � �
��C%���/�� Per ' # � „ ��
OCT 1 5 � CITY OF FEDERAL WAY � �� � �� 3 �
°��,���A� BUILDING PERMIT APPLICATION
—Please Print— ��
BOX 1 TENANT NAME:
OWNER � � L SITE CATIOIV�
OWNER'S ADDRESS � '2 � CITY 1�� ��� �F�v PHONE�� � --�
DESCRIBE JOB � � W�� �
THE PROPERTY IS OWNED BY: SINGL ARRIE PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME f; ��r r. �n �p� �ra ov z � CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
— 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 = �'� c.- PHONE � —
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST `� � � �.� EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER �� � `�I -- ��I (
LEGAL DESCRIPTION �� r - � ��_ � �
(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 (N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
N0. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS N0. FURNACE, ELEC. GAS $
SHOWERS 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 $
OTHER $
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 EMPLOY ES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
1 �'
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OWNER/AGENT: � DATE:
ANP-008 3/90