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92-100440 CITY OF FEDERAL WAY 91. !0� `IYD Fede al'Way\,NW 98003 B U I L D I N G P E R M I T BUILDING INS 661 4140 PERMITNO. 92-403 MH OWNER'SNAME ERNESTO SERRANO SITEADDRESS 3001 S ZgH ST #384 CONTRACTOR AORIZON CONST ADDRESS 1940 ELM ST SE AUBURN CONT.PHONE 939-1342 CONT.REG.NO. HORIZCS132LA EXP. �-0�92 OWNER'S PHONE 241-0532 OWNER'S ADDRESS 13356� 37 A� S FEDERAL WAY TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD.___NEWPUBLIC PUBLICADD. NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER SET—UP MOBILE HOME ONLY TAXACCOUNTNO. 04210'4-9231 LEGALDESCRIPTION SPACE 384 CAMELOT SQUARE MOBILE HOME PARK ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE � � DATE OF APPLICATION 3/18/92 BUILDING INFORMATION �ONE RM 3600 SET BACKS:FRONT 9� SIDE 22� I4� REAR 5� HEIGHT LIMIT NA ICCUPANCY R-3 TYPE OF CONSTRUCTION S-N CENSUS NO. ��S TYPE OF HEAT NA BLDG.SQ.FT. 924 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 �TQI�' DRYER TOTAL MECHANICAL NQNFi AMOUNT NONE VALUATION �4,065 PERMIT FEE $72.00 PI'ANNING DEPT APPROVAL = DEB BARRER PLAN CHECK FEE ' FIRE/BLDG DEPT APPROVAL = REVIN ELLSI PLUMBING FEE MECHANICAL FEE RT P/C FEE 'PA REVIEW PUBLIC WORKS �-5--� S.B.C.C.FEE a-� _� j._ � � FIRE FEE DATE: S � OTHER FEES AMOUNT: 123. rJO 123.50 AMOUNT DUE RECEIPT: �7'7 -' I�� 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 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. <� � __ � � �� OWNER OR AGE DATE ITY OF FEDERAL WAY -ede al IWay`,NW 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. 1 NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GFADING OTHEF TAX ACCOUNT NO. LEGAL DESCRIPTION ISSUED BY DATE OF ISSUE DATE OF APPLICATION � BUILDING INFORMATION ONE 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 AIF FUFNACE 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 VA�UATION PERMIT FEE PLAN CHECK FEE PLUMBING FEE ECHANICAL FEE "ART P/C FEE SEPA REVIEW PUBLIC WORKS 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 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. ~ �WNER OR AGENT DATE ( � t �� ... �'1 D T D � D � p m - `�, � m D m � m � m -{ r ' 1� ` - - r ' � � ' D _.,� �• ^ ^-� p , � i Z ' C� _�1 � �,�� I Z I � I t�/� -� '.. n I 7f7 " ~ h fi^• O �I O � � 0 � m � � � � � � _ � O i '� c� � oo � lo� z m O l= "� Z _ � '�� Z I � � ,1__� � i Cn L✓- f. � Y\ � �t , \� \ I � , r \ ' �� i ;� '� �! � � n � Z D S� p O �, � . � � -i C � D � T. � � m r � m m Q � \ �, � j � � � , v , O Z Z � � I C �� Z � m � . Z i � ° � � � � o � i i i i z 0 ' D �, , W I W O � � ' Z � , � � � D � � � � �, � I � , ; ! I� � � � o � o � o � ^- m A m = m � i �, i y W o z i z :".7! ' D ' � � � j � D � i � r � I Z � z ; O ;.��. �i o �� v � 2 1 m � � � I n � � ' � I O � m O � . �> � � W z � � � D { � r 7 ' . ' I � ] ' ' I I � ' j I � ��liED �rmit # �' � _ `-jc, ��17,� �I�� 1 g ��92 CITY OF FEDERAL WAY �� `� °'�-�n��!�+p'"�'� BUILDING PERMIT APPLICATION �"�"''``"""'��y' —Please Print— BOX 1 TENANT NAME: �-�p �i OWNER SITE LOCATIO _ 0 l OWNER'S ADDRESS 13.35(v ` 3'?�-I- �!� c , CITY �--r� PHONE �'�i—(�_C3�- DESCRIBE JOB � ��- �� THE PROPERTY IS OWNED BY: SINGLE/MARRIED �� PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME ��r�`�'z�� Cs-,,r�S��v`��o•. CONTRACTOR'S REG. # � ��-�S13�� Card MUST be presented CONTRACTOR'S ADDRESS �C`f✓ �. • S�� TY �\�-'�,��r� PHONE �,J�( —I3��- EXPIRATION DATE I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUIN PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON � � � � � � �� -5 PHONE ��1{" 14�1� BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION )(BOX 6 PROPERTY TAX ACCOUNT NUMBER _�_'�c�LC`�'.—`'�-.,�---�C� c�{'�.,r�=�,:�3 ('� i t�`��-��'��R I S�S �v � 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 (N0. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAVINDUSTRIAL 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 EM YEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. � — � ` OWNER/AGENT; ��`�"� DATE: `� �� - ANP-OOB 3/90 OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIJ LINE) ' , ZONE 113�`C SETBACKS: FRONT �J SIDE Z2� � REAR �� HEIGHT LIMIT -"� PLANNING DEPARTMENT APPROVAL � Z REMARKS: SEPA: EXEMPT ; NOT EXEMPT FIRE DEPARTMENT APPROVAL �G DATE �' %-�`� � Z 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 CCUPANCy �3 TYPE OF CONSTRUCTION V� STORES �.t.l.-Lc�tC{ � t BUILDING SQ. FT. � @ S ` U� _ �6 Z-U BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDINGSQ. FT. @ /1i(d (, �(�<"�^_ _ �" 8 � TOTAL SQ. FT. TOTAL VALUATION ��s �� BUILDING DEPARTMENT REMARKS: PERMIT FEE 2- 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: e- � S � ��'�D PARTIAL PLAN CHECK FEE RECEIVED MAR 18 1992 Amount Date Receipt# o�r��av ` pj,�� BUILDING DEPARTMENT APPROVAL RECEIVED BY � DATE / �'� � -1 Z ACCEPTED FOR FILING . �� '��'+� . . ��.�'�� 1�� - _ ��..�y�►�r'1 . m � �.. an �`M �� a:.. .w..w.,...a;,.�w...wwaws...�awss. .....�.�a. ....,....:.<-+,�z._:.�.,ti: .,.,...�...,. ..�w�_,.:,:..,..w�... ..�.� .w.,.:.., , � �!� a �. .�_,._ ,_.,.... . � __„_.. .. ,.,..,..� --�,....�.w�.......�.,..w_�.�....._...� °f �� o._..�.,.�.._............�....... ,,�...�,�,._..._.. ,�„ .—....�,,..e�_..........,.W.�....._.�. � ,"�. t� �� .. � � ! � ra � � ;� � , � � � �.�� a..__ __T�.�..__._.�, � :� � � � �� a. � '+�s .,,,s � w.,. � �� Dw 'xI� � � � � � � � � '� � � �` � � � n � � ^� I C1 � -� ...�, �, � � $.7 � Q, �:a � l.� � l i .4 � � ..,.,.p,'�, ' � ' � �� v`W`1 � '` ,�, �^^�y z �� p� � � '[/\� g's`� '� (X1 r+4rJ . "�.� e � � � � � � {U � � � �' �� °� ',,� � w � � � g � � �a 1 � c hlOBlLE Hu�ulk dH(�L(-Gll�liu��heti�"p�q � � � �`D ,�s�. FIXED DEPT.Of L 31 OR H.U.D.iNSPECTI�U1� '�►� � � 2.I STALLATION OF 7HE MOBILE HOME SHA�I.BE PER '�"$'#° c �'�^�. ""� NUfACTURER'S RECOMMENDATION3, � � � �~ 3.P OVIDE A JOB SITE COPY OF THE MANUFACTURER' � � � S T-UP BOOKLET. ��,. � �" � _w� ...�. r.�, , .,. � ,- QV� �� ' � 1� -� �m��' � � P�rmit :��ui: � A�Proved B � .,�� . �.._ � Daoe: _ � 'jL�ll�f _ � .�..� ��; _ � .��. c�r � � ��"� �,� � d'TY F FEDE L WAY �,, �° �' �EPT. � CO MUNITI( EV�L,OPMENT � � ,..,.....�......�.._.�,_ � � ,�, PERMITNU� ��`` a �,...�___.,._ � � ADDRE�S � S. , '' -�S f�--.� �/ PLAbv� F�R � e - _ . C,,','�!`� s � ��0 TH�' ; µ�'v �� t .,.��.Y..,,m_ _ � - - UNLES;:. h,�� ,j �.�t�r "ti�r��J6 ;��:'v��iGY 4---C� THE FEU�R�;l.�+�t,�,� ;i�i�.,�-.�;v�:,� D�;�T. �a� � +�� '� � �� . '�� ,S��AL�` �"� a�� i�� r�� 1 a �ssz �pF F�C1�Rk4 VVAY .�.-.. .,��,�.....�...---- - BUIt.Q�MfC�DiEPT.