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SET BACKS AND FOOTINGS
DATE BY- _
OX TO POUR FOUNDATION WALLS
DATE BY
PLUMBING GROUNDWORK
DATE _._ BY
MECHANICAL INSPECTION
DATE _ BY
PLUMBING ROUGH IN
DATE BY
O.K. TO ENCLOSE FRAMING
DATE BY
WATER LINE O.K. _
GAS PIPING O.K...__�"
a� [�'
j
INSULATION
DATE _ _ _BY
WALL BOARD AND FIRE WALL
DATE
FINAL O.K. TO OCCU Y
DATE _ BY -
DCD
PSD
FD
AZL
f
id-
cLL •{r L� .J � r
11919,9
CITY OF FEDERAL WAY �r
BUILDING PERMIT APPLICATION
— Please Print —
OWNER'S ADDRESS I
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SI
BOX 2 CONTRACTOR'S NAME NL) U OtA LuonGte A CONTRACTOR'S REG. # �t���_hiurJ 1,a2k.J_
Card MUST be presented
CONTRACTOR'S ADDRESS CITY, 12fCAM PHONE C q:� ' "
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110, HICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. _
BOX 3 CONTACT PERSON
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUM
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK. —jGARAGE /
BOX 8 rj'
SINGLE FAMILY ( ) NEW CONSTRUCTION
) MULTIFAMILY (NO. OF UNITS = } ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SO FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
NO. WATERCLOSETS
BATHTUBS
SHOWERS
LAVATORIES
SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
LAUNDRY WASHER OUTLET
URINALS
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
.r D IN5
THER _
TOTAL FIXTURES
MECHANJCAL APPLIANCES — BASIC FEE $ 1-0, Op
GAS PIPING, FEET $
NO. I FURNACE, ELEC. GAS — $ 10-00
_GAS HOT WATER HEATER
CONVERSION BURNER
BOILER, SIZE BTU
AIR HANDLING UNITS
HEAT PUMPS, SIZE
UNIT HEATERS
AIR COOLING UNITS, SIZE
COMMERCIAL HOOD
OTHER
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 PER-
FORM THE WORK FOR WHICHPERMITAPPLICATIPN IS MADE. J C�
OWNER/AGENT: '(I1��_1 c i (- ±Q f� ;( 0 0 ' — DATE: t"r `
ANP-006 2/90
OFFICE USE ONLY
(PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE_ SETBACKS: FRONT SIZE
REAR HEIGH MIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
DATE
REMARKS:
F;
PUBLIC WORKS DEPARTMENT APPROVAL
DATE
REMARKS: r
_
TYPE OF JOB: NEW RESIDENCE _,% RES. ADD/ALT
NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL M- ADD/ALT
NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT_TENANT IMP.
ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION - STORES
_ BUILDING SQ. FT.
@ -
_ BUILDING SQ. FT.
@ -
BUILDING SQ. FT. _
@ _
- BUILDING SO. FT. _
_ - @ -
BUILDING SQ. FT- -
@ — -
BUILDING SO. FT.
@
TOTAL SO. FT.
TOTAL VALUATION
EBUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NO.
PERMIT FEE -_ PLAN CHECK FEE — —
— — — — — PLUMBING FEE — — — — — — — MECH. FEE_ G�S
TOTAL FEES SBCC SURCHARGE _
ENERGY SURCHARGE-_ AMOUNT DUE - S
BUILDING DEPARTMENT APPROVAL ------------------------------
DATE V c�
REMARKS:
ASSIGNED ADDRESS:
ACCEPTED FOR FILING