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RECIENF-D
JUL 2- 1992
fisr-raveaskLwAv BUILDING PERMIT APPLICATION
Permit # 2.Z - � � /
CITY OF FEDERAL WAY
Please Print
BOX 1 TENANT NAME:
r
r
OWNER !aw 4 Phtr-RIAtL
SITE LOCATION UIt K
i1 i- Ir e ti
OWNER'S ADDRESS � -7 60 60'
CITY FeDEM-._ w�Y
PHONE Y 7
DESCRIBE JOB E
THE PROPERTY IS OWNED BY: SINGL MAR
PARTNERSHIP
CORPORATION
BOX 2 CONTRACTOR'S NAME
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 WMIJUHI 11') I CPfE
L 5
PHONE 4[ _ 7 7
BOX 4 SEWER DISTRICT (` 1 . 1.�� �` y
WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST O
EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 3 3-7 S
P'_ 0-3
LEGAL DESCRIPTION LCT 5<?, :h1LL-SIUE
HFJ& HTS
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # _
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST FLOOR 1 2ND
FLOOR
3RD FLOOR / BASEMENT / DECK1—��9
GARAGE /
BOX 8 (X� SINGLE FAMILY
( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
( EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL
TOTAL AREA OF PROPERTY ,_
SQ FT
BOX 9 PLUM ING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET
$
BATHTUBS
SHOWERS
NO. FURNACE, ELEC.
GAS HOT WATER HEATER
GAS $
$
LAVATORIES
CONVERSION BURNER
$
SINKS
DISHWASHERS
BOILER, SIZE --BTU
IR HANDLING UNITS
$ _
$
ELECTRIC HOT WATER HEATER
PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
HEATERS
$
URINALS
OOLING UNITS, SIZE
$
DRINKING FOUNTAINS
ERCIAL HOOD
kUN
$
SUMPS, SPRINKLER VACUUM BREAKERSR
$
DRAI NS
_ _
$
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 PE13FORM THE WORK FOR WHICH PERMIT APPUICATION 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, INCLUDNG THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE,OF THE CITY,.INGLUpING ITS
OFFICERS AND EMPLOYEES, UPON JOE AOURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT:
DATE:
ANP-000 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZON E SETBACKS: FRONT SIDE EAR _ r HEIGHT LIMIT —3a
PLANNING DEPARTMENT APPROVAL
REMARKS:
bDtldfng Shaff encrown onto any bU!Idlrig se ack line or easernent, shnifim nr not Q r
SETA: EXEMP T JV'- NOT EXEMPT
FIRE DEPARTMENT APPROVAL A 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 Ni `L TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @
BUILDING SO. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SO. FT- @ _
BUILDING SQ. FT- @
TOTAL SQ. FT. — TOTAL VALUATION '7 -5 ' ' Z
BUILDING DEPARTMENT REMARKS:
RECEIVED
JUL 2 - 1992
Ci'IYMMMM DEPT
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount _ _ Date _ _ _ Receipt #
PERMIT FEE Z r
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
BUILDING DEPARTMENT APPROVAL
BY DATE
ACCEPTED FOR FILING