90-101131 CITY OF � BUILDING INSPECTION
FEDERAL WAY U I L D I N G P E R M I T 941-1555
(o/S) 4b-/O J/3�
PERMIT NO. 90-1335 MH OWNER'S NAME SHERRI RITRE JOB ADDRESS 3001 S ZHS ST #37H
CONTRACTOR A & B MOBILE H��, TOWI1�oaEss 9822 32 A� S TACOMA CONT. PHONE 584-7833
CONT. REG. NO. ABMOBI*ZZ�JL�J 3/91 (OR) OWNER'S PHONE 271-5842 OWNER'S ADDRESS SAMF
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIA�ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING OTHER SET—UP MOBILE HOME
TAX ACCOUNT NO. 042104-9155 LEGAL DESCRIPTION NE 4-21-4
9231
9222
ISSUEv BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 8�1 O�9 O
BUILDING INFORMATION
ONE= RM3600 OCCUPANCY R-3 TYPE OF CONSTRUCTION S-N BLDG. SQ. FT. 1344=FOUNDATIO
SET BACKS: FRONT IS� SIDE 4� S� 12� REAR 9� STORIES NA HEIGHT LIMIT NA
PLUAABING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. BOILER
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) RECEIVED _
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 NONE� UNIT HEATER TOTAL MECHANICAL NONE AMOUNT NONE
VALUATION $5,913_0 0
PERMIT FEE $A� -�� — pJ,ArJrJING DEPT APPROVAL = BILL RINGMAN ON 8/2 0/9 0 (SETBACRS AS SHOWN)
PLAN CHECK FEE rj3 ��
PLUMBING FEE
MECHANICAL FEE BUILDING DEPT APPROVAL = REVIN ELLIS ON 8/16/90
TOTAL BLDG. FEES �i �a_n n
PART P/C FEE
SEPA REVIEW (
WATER SERVICE v� / `
WATER MAIN CHG. '�/ �
S.B.C.C. FEE 4.50 DATE PAID � p(� AMOUNT "�� RECEIPT � /
OTHER FEES
AMOUNT DUE �13 S.5 O
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.�RESIDENTIAL AND GRADING PERMIT$ 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:
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Permit # � � �.�
RECEIVED �1�
r . � . ( �
1�UG 1 O 1990 CITY OF FEDERAL WAY
���rp�� F�pERALWAY BUILDING PERMIT APPLICATION
�3UII,QING DEPT. —P�ease Print— �� (��-- = � S�
BOX 1 TENANT NAME: � s �
OWNER SITE LOCATION -" `��L ��� ,�'
OWNER'S ADDRESS � - CITY -� � �' PHONE
DESCRIBE JOB � `t°-
THE PROPERTY IS OWNED BY: SINGLE/MARRIED X' PARTNERSHIP COR ORATION
BOX 2 CONTRACTOR'S NAME/-f�� /�af3�,�'� ��1� Tc,c>%.vC� /C'- CONTRACTOR'S REG. # � . s
" N� p�jnY��b° ?�2�_ `� ard MU T be presented�
CONTRACTOR'S ADDRESS �80� �?'--'�l��� CITY C� f - PHONEJ�y-'7�.j.3
EXPIRATION DATE � -�`
�i�-t�((�i �- �-�C--�"���
— OR — ��__1__ _ �
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 � � / � �t�i � PHONE�S`��`/- ��':�3
BOX 4 SEWER DISTRICT �f_T-�E��L �,� )�Y WATER DISTRICT f������JL: ��t%
BOX 5 ESTIMATED PROJECT COST � ��n • ��� EXISTING BUILDING VALUATION �-
BOX 6 PROPERTY TAX ACCOUNT N MBER � ��� �' C� �-�1 L I - c�
LEGAL DESCRIPTION � � �Z � � 7`� � i i --c�
(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 f I AIR COOLING UNITS, SIZE $
�DRINKING FOUNTAINS ��� COMMERCIAL HOOD $
,1. SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
U� 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 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.
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OWNER/AGENT: DATE: � �� � �
ANP-008 3/90
x}
. � . �
OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE) ,
ZONE RM3�ETBACKS: FRONT S� SIDE 2� REAR �� HEIGHT LIMIT � �� `+ �
PLANNING DEPARTMENT APPROVAL $'ot�- `�� ' ��' j�' - �'
REMARKS: �
SEPA: EXEMPT � NOT EXEMPT
FIRE D€PARTMENT 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
OCCUPANCY - TYPE OF CONSTRUCTION v��'V STORES
��-�.C� G � BUILDING SQ. FT. (�y �/ @ �° "� = G•� Z`�
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. ' @ �L �' �E,— — �- T �
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION � �f� � ��'�'
BUILDING DEPARTMENT REMARKS: PERMIT FEE �`' �`���'
PLAN CHECK FEE 3 • c�c�
PLUMBING FEE �'
MECHANICAL FEE L
TOTAL BLDG. FEES i` ` `J r'
PART P/C FEE C�
SEPA REVIEW �'
S.B.C.C. FEE ��S �
OTHER FEES ''
AMOUNT DUE " ''- S c'
ASSIGNED ADDRESS: �- � � S � �
�bM���o��N�a PARTIAL PLAN CHECK FEE RECEIVED
066�0'��yyo Amount Date Receipt#
O�^/ ` .�I/�6. �`� BUILDING DEPARTMENT APPROVAL /
REC� BY � DATE �� � y�' ACCEPTED FOR FILING
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