92-100745 CITY OF FEDERAL WAY 9 �" � ���Y�
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
PERMITNO. 92-0779 � OWNER'SNAME �NNETTE JOHNSON SITEADDRESS 2611 S ZHHTH m2S
CONTRACTOR �INIER PATIO SIDING ADDRESS 13616 HTH STREET SUMNER CONT.PHONE 863-3331
CONT.REG.NO. �INIPS197CF EXP. 1�930WNER'SPHONE 839-2487 OWNER'SADDRESS 26�-�- S. ZBHTH �ZS FEDERAI, WAY
TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBLIC PUBLICADD.
NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER CARPORT & DRIVEWAY
TAXACCOUNTNO. 28392O-OZSO-OE) LEGALDESCRIPTION LOT ZS CODE ZZO7 GOODMAN VILLAGE CONDOMINIUM
ISSUED BY JOANNE JOHNSON DATE OF ISSUE �' � 2' DATE OF APPLICATION 5-19-92
BUILDING INFORMATION
'_ONE RM 2400 SET BACKS:FRONT 22� SIDE lO� �5� REAR 17� HEIGHT LIMIT
OCCUPANCY Ml TYPE OF CONSTRUCTION VN CENSUS NO. TYPE OF HEAT BLDG.SQ.FT. 308 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
LAVATOflIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
RETURNED
SINKS MISC. BBQ BASIC FEE
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL AMOUNT
924.00 P�NING DEPT APPROVAL: NO BUILDING SHALL ENCROACH ONTO ANY BUILDING SETBA R
VALUATION LINE OR EASEMENT, SHOWN OR NOT SHOWN. PAVE DRIVEW Y
25.00 PER F'WZC 105.105. DB 6-1-92
PERMIT FEE
PLAN CHECK FEE 1 F).O O
PLUMBING FEE BUILDING DEPT APPROVAL: KC 6-1-92
MECHANICAL FEE
�RT P/C FEE
EPA REVIEW
PUBLIC WORKS
S.B.C.C.FEE 4•5� C�
FIF1E FEE DATE: � '� � ���
OTHER FEES AMOUNT: �4 S.S O
AMOUNT DUE 45.5� 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.
� J
OWNER OR AGENT �" � DATE � ^ / � � ��
CITY OF FEDERAL WAY
Fede aFlWay`,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
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 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 y�q`"' �. �
PLUMBING FEE �''"'I., ��
MECHANICAL FEE �
PART P/C FEE `r �"�=,
SEPA REVIEW
PUBLIC WORKS
S.B.C.C.FEE �� ��
FIRE FEE DATE: /���,��I�
OTHER FEES AMOUNT: DH
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.
OWNER OR AGENT DATE
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M p►`I � g 199 2yr p�t C I T Y O F F E D E R A L W A Y
,�r��,� BUILDING PERMIT APPLICATION
� — Please Print—
BOX 1 TENANT NAME:
OWNER N 01/�-v 0�V SITE LOCATION .S '�
OWNER'S ADDRESS a � +�" CITY r�s��1 wr.i HONE -
DESCRIBE JOB � f �t � +�r ��.T�G�e1-+�+� ;vsc �v CRI 1 *, J�o/r (� YL�..''�'� 1
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME �u l � � CONTRACTOR'S REG. # RO��tJ/�'-�.5 / i )C�
Card MUST be pre tenes d
CONTRACTOR'S ADDRESS /36( � CITY ScJM�u�I'� _ PHONE g63 - �5r°ll
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 ��1 � PHONE g63 ` yU�//
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 3,0�.aD EXISTING BUILDING VALUATION
j� BOX 6 PROPERTY TAX ACCOUNT NUMBER ..2t�S3 �Z� ���f.���:�-,
x LEGAL DESCRIPTION Lof �K c nds �7�27 ��s�- a'�'� ��L t�-.c^�v,',->:
�c � � �35
(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� $
LAVAT RIES CONVERSIO BURNE� $
SINKS BOILER, SIZ BTU $
DISHWASHE AIR HANDLIN U S $
ELECTRIC W R HEATER HEAT PUMPS, E $
LAUNDR ASHER 0 ET UNIT HEAT S $
URIN AIR C00 G UNITS, ZE $
DRI ING 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 EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
���
OWNER/AGENT: �,�1�--�A ���;�Li�L/�1 G.
DATE: —,� -- ✓� ' A �
ANP-008 3/90
OFn�E USE ONLY (PLEASE DO NOT WRITE BELOW i rnS LINE) . . '
ZONEI�'�? Z�/�SETBACKS: FRONT v�� SIDE �� � REAR�HEIGHT LIMIT ✓`�y
PLANNING DEPARTMENT APPROVAL
REMARKS:"{�o„v �� a=�,., 7 =,. _ ..r,.,rr� w. *�_ ,�� r Y. �,, �,.�„ ....,,- . �K+.., .,• +, N� � . .
O�tlt3 fJt1dUG��� .�.... ...-..c,v c... .s.. ..�� �..�
i'. ZEy .�.f7-�d u, .
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
OCCUPANCY TYPE OF CONSTRUCTION � STORES
< < G'� � '' BUILDING SQ. FT. �G �`: @ � - � = R� Z�
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION `�z y
BUILDING DEPARTMENT REMARKS: 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
��"�►�' SSIGNED ADDRESS: -��- �- -S l �
MAy19199.
�������. � PARTIAL PLAN CHECK FEE RECEIVED
�p�l�'� Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
RECEIVED BY � `� DATE �` I — I Z ACCEPTED FOR FILING
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