92-100151 CITY OF FEDERAL WAY �Z�l�OaJ 5 J
33530 First Way South B U I L D I N G P E R M I T BUILDING INSPECTION
Federal Way, WA 98003 661-4140
PERMITN0.92—OO9E) MH OWNER'SNAME CRAIG DAMERON SITEADDRESS 3001. S ZHH ST SPACE 3SO
CONTRACTOR HORIZON CONST ADDRESS 1940 ELM ST SE AUBURN CONT.PHONE 939'1342
CONT.REG.NO. HORIZCS132LA EXP. 10�92 OWNER'SPHONE 839-7575 OWNER'SADDRESS ZZH14 12 S FEDERAL WAY
TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBLIC PUBLICADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER INSTALL MOBILE HOME ONLY
TAX ACCOUNT N0.�42104-92ZZ LEGAL DESCRIPTION SPACE 3SO CAMELOT SQUARE MOBILE HOME PARR
'SSUED BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 1�22I 92
BUILDING INFORMATION
ZONE �3600 SET BACKS:FRONT 21� SIDE 4��8� REAR 7� HEIGHT LIMIT NA
OCCUPANCY R-3 TYPE OF CONSTRUCTION 5—N CENSUS NO. �I S TYPE OF HEAT NA BLDG.SQ.FT. 14 S 6 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 N_ OI�E DRYER TOTAL MECHANICAL �_ AMOUNT NONE
VALUATION �6,406
PLANNING DEPT APPROVAL = DEB BARRER
PERMIT FEE �9O.OO
PLANCHECKFEE 59.00 "RF.AR yARD EMBANKMENT/SLOPE MAY NOT BE DISTURBED� CUT OR
.UMBING FEE GRADED�
ECHANICAL FEE
PART P/C FEE BLDG DEPT APPROVAL = KEVIN ELLIS
SEPA REVIEW
PUBLIC WORKS nCAI�L 661-4140 FOR INSPECTION"
S.B.C.C.FEE 4.50 �
FIRE FEE DATE: � s
OTHER FEES AMOUNT: ��-S3.�JO
AMOUNT DUE $153�SO RECEIPT:
ALL P,ERMITS 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 INF MATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET. �
�V�- � 3 f��
OWNER OR AGEN DATE
CITY OF FEDERAL WAY
Fede al'Way\,NWA 98003 B U I L D I N G P E R M I T BUILDING INS 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. NEWPUBLIC 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
)NE 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
ECHANICAL FEE ^F'
ART P/C FEE � ���� �
SEPA REVIEW �� � " :�j
PUBLIC WORKS
.3 '„
S.B.C.C.FEE �
FIRE FEE DATE:
OTHER FEES AMOUNT:
AMOUNT DUE RECEIPT: � , �� -
�
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING P�NN E 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 APPIICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
OWNER OR AGENT DATE
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JAN 22 1992
!)ITy pF���E�H��� C I TY O F F E D E RAL WAY ��
�"-�� BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME.
OWNER o� SITE LOCATION 0 a. d
OWNER'S ADDRESS � CITY PHONE -
DESCRIBE JOB �"bb �- � ♦ ✓
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP � CORPORATION
BOX 2 CONTRACTOR'S NAME +� m� CONTRACTOR'S REG. # R�ZC.�S �,L�
� Card MUST be presented
CONTRACTOR'S ADDRESS � ^�- s•�� CITY ^- ��• PHONE �(�— �3�c�
EXPIRATION DATE
— OR—
I HAVE READ CHAPTER 18.27.010 RELAT DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON t'r� PHONE �
BOX 4 SEWER DISTRICT �"'"'— WATER DISTRICT �—
BOX 5 ESTIMATED PROJECT COST CO EXISTING BUILDING VALUATION — -
BOX 6 PROPERTY TAX ACCOUNT NUMBER a"�� 0 �D ' '"O a-1 — <<S �
LEGAL DESCRIPTIO , d ^'
dV a-5�,..
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording#
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLO �Z 2ND F200R /
3RD FLOOR / BASEMENT / DE .K _ . / 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 o GAS PIPING, FEET $
BATHTUBS (V�� ��--� 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 $ '
SUM S, SPRINKLER VACUUM BREAKERS OTHER $
D INS $
OTHER $
TOTAL FIXTURES
TOTAL MECHANICAL FEE $
I CERTIF 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(I NCLUDING 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.
c-
OWNER/AGENT: � �� DATE: � �a` �
ANP-008 3/90
/
• . .
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE 36odSETBACKS: FRONT ZI� SIDE �� � REAR � HEIGHT LIMIT i�
PLANNING DEPARTMENT APPROVAL � S
REMARKS: ►i 'e1'v► � �0 Y)f�" � V
�'�--��
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL � DATE
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
OCCUPANC TYPE OF CONSTRUCTION lI� � STORES
�vc.�lG v BUILDING SQ. FT. �`�S�,E @ ' S � �cG - 7Z �Q
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ � " _
BUILDINGSQ. FT. @ -��GG `(��= � `
TOTAL SQ. FT. TOTAL VALUATION � 1 G���/C!
BUILDING DEPARTMENT REMARKS: PERMIT FEE v( �
PLAN CHECK FEE
PLUMBING FEE
� MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE `S �
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS: "L--�- S ( ��
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
BY DATE � � 1 Z ACCEPTED FOR FILING
RECEIVED —�
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;` AFFIXED DEPT.OF L i OR H.U.l1.IN�PECTION LABEI �
t':; � '�' �- � 2.INSTALLATION OF TH t
-------------- —:°� � ITi %',� A�OBILE HUMf SHALL BE PER t_._...-.
� :� r-- MANUFACTURER'S R ^l'�ip�ENpH�I!�i�S.
U � 3.PROVIDE A J08 SfTE OPY OF TF►E�,1h;�FpCTURERS
SET-UP BOOKLET
THERE A�iE TO B�NO DEVIATIONS ;
TO THE APPRCVED DRAWINGS I
UNLESS OTHERWISE APPROVED BY a i �
THE FE�ERAL WAY 8�!IL[?IN�PF� �
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