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BY i O.K. TO ENCLOSE FRAMING DATE BY FINAL O.K. TO OCCUPY 1 DATE , r g"­L BY �� r INSULATION DATE -_ I]CD Ott .�. WALL BOARD AND FIRE WALL BY _ _ DATE BY i]SD FD {� :.,��`.. �,?. •z U . _ C 7 /�T AH00760 ^Armit # ( (i � "- CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print — BOX 1 TENANT NAME - OWNER .Schneider Homes VP-15 SITE LOCATION 30014 2nd Ct S. Federal Way OWNER'S ADDRESS 6510 Southcenter Blvd CITY Tukwila PHONE 248-2471 DESCRIBE JOB, New Residence -Install Gas heater system. _ THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION X BOX 2 CONTRACTOR'S NAME RENEXXXXXXXIR B & B Heating & AIC ... CONTRACTOR'S REG. # .B Card MUST be presented CONTRACTOR'S ADDRESS CITY Redmond PHONE 881-7920 EXPIRATION DATE 1-1-91 —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 Marybefh Falsat-fa _ _ PHONE 881-7920 BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST $3804.00 EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 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 — I -_. DECK / GARAGES BOX 8 (X) SINGLE FAMILY ( X) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY —SO FT BOX 9 PLUMBING FIXTURES (including rough -ins) N0. WATERCLOSETS BATHTUBS SHOWERS LAVATORIES SINKS DISHWASHERS ELECTRIC HOT WATER HEATER LAUNDRY WASHER OUTLET URINALS DRINKING FOUNTAINS SUMPS, SPRINKLER VACUUM BREAKERS DRAINS OT0_ HER _ . TOTAL FIXTURES MECHANICAL APPLIANCES — BASIC FEE $ 2 r 1 GAS PIPING, FEET _ __ $ NO. ] FURNACE, ELEC. GAS X $ 1 GAS HOT WATER HEATER $ CONVERSION BURNER $ BOILER, SIZE BTU $ AIR HANDLING UNITS $ HEAT PUMPS, SIZE — $ UNIT HEATERS $ _ AIR COOLING UNITS, SIZE $ COMMERCIAL HOOD $ 1 OTHER Range stub. $ - _ $ 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. 1r 1 OWNER/AGENT: DATE. (-c'tt-CkC-) ANP-000 3/90 OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZONE SETBACKS: FRONT SIDE REAR. HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL REMARKS:. SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DA REMARKS: PUBLIC WORKS DEPARTMENT APPROVAL DA 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 BUILDING SQ. FT.. @ — BUILDING SQ. FT. @ BUILDING SQ. FT. @ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ — BUILDING SQ. FT. @ TOTAL SO. FT. TOTAL VALUATION BUILDING DEPARTMENT REMARKS: ASSIGNED ADDRESS: PARTIAL PLAN CHECK FEE RECEIVED Amount Date Receipt # BUILDING DEPARTMENT APPROVAL BY DATE 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