91-101465m n
z Om
m
T
O m{
7° m
m � -1
z �2
rm
r
m z
m0
M�
O
z
T
z
2
0
03
I1�.4
H
2
c
m
D
z
v
n
O
2
2
n
O
2
m
co
m
Ln
H
O
T
z
O
v �
1 v
m G)
m
D
z
v
D
D O S `2 � J 1 K T T T
O m n m m D D O 2 g Z g
c
p m m D m�, O Z Z m T
C) O m
c m m Z M m O D T z m
< r
m n n m T T m T
x m m m m
Cl)
N
O
O
ni
0
rt
sv
m
m
N
U7
O
"O.
rt
O
�r
ro
H
ro
O
a
rt
m
n
r
(D
ZJ`
O
rt
(D
O
z
ro
OR
I
In
It
H
ro
H
9
LTJ
H
y
Hy
Z
cn
U)
H
ro
'=J
H
H
H
$r
H
r
r
H
L=J
D
D
D
m
C
3
D
O
m
c
z
m
m
m
L7
En
r
G)
to
m
I
v c r m
D r
O L7 Z Z Z 0
r Z D p
r m
T G -< O
� OC D_ D
ami z z m
D Cf)7)
z m
Ln D
m
z
0
�Z
p m
n
n
IJ
D
z
O
0
0
c
a
z
L�
fn
rn
�J
Ln
c
m
p
33
D
m
z
m
uDi
42
m-U
K
Cl)n
v
2
-0
m
O
=
D m
v
m
z
OT
T
L7
D
cn
G)
f 1
m
C
Ln
m z
I
T
m
N
r
D z
v
m
D
D
7Co
Z
Z
D
�
r
C
C)
D
D
m
D
71
z
m
z
N
3
1
O
Z
3
O
D D O
D
r
n
U) 7°
T z
m Hv
m
m
m 0
=
D
Z
9 G)
K
D
D
z 7C
r
O
m co
O
m v
2
K
m c m
O
Oc
c m m
G
r O
D
D
m v
v
D
m
m
O
T
D
v
v
r
D
O
z
m O O m
g m z z D
0 c O m 9z
c O
z m O D
z { i Z
A
m O ~
� � I
m H �A
z N
Z m Ul
uj
W Ln I+
COI H
vcc
H
I � g
N� z i
z
Ov I m
v En
z
Z D
m K
m
v z
�g o
O v
D Z m l=J
> 33 ti
G) G) -0
v z
G) M m
H
n 0 N
0
o �
z O� m rJ
m n A
m D �
� r
b
1
n
O
3
m O
o Z
D Ln W
v o
rn 9),
a,.
In
w
p
70 -
D
D O vi
g
i rn v
v
v
<
v_
v_�
to
co
g-0
w
N
m
no
Q
m
m
O m
r
D
m
z
c
c m n
m
m D
D x
z
D
2
m
D
`L
-1
m
D
3
p
n
v
m
m
Z i�
D v
D
0�
�
a
O
m
c
m
O
0
c
O D
0°
n
O
O
m<
m
c m m
D
m m m
o a
T n
m
z
m
m
a)�
O
{
z
ii
�
p
a 71
�o
m�
m to
z<
i m
- r
m x
D
w
m
„
�
a
m o
z=
m-Di
w
m
c�
G=i
c�
m
„ m
m m
m m
m
O
�o
z
K
cn
z
U
a
rm
m
o
z
mT
o
Z
m
mD
ml
<
w
p
Z
D
-1
O
K
(n
v
D
c
D
c
r
m
O
n
D
v
C
A
r
0
Z
Z
Z
p=
n
n
c
c
v_
Z
(/)
X
G)
m<
O
0O
z
m
-�
r
v
s
v
z
=
m
a
Z
m
m
c
Z
a
Z
m
v
I
p
Co
n
m
� '
D
Cl)
m
�
Z
3
Z
n M
pi
z
m
m
m
c
ro
n
Z
c p
o
c
7C
�
ro
H
r
N.
ZO
z
D m
m
m
t"
(OD
m
v�
z
v
CO)
ro
7C
7ti
, d
H
ro
r
O
D
a
I o
C�
O
O
I --I
z
O
D
O
O
D
m
{
v
m
m
O
G)
Z
m m
v
m
IO H
y
�
z
to
m
K
m
n
O
(�
►�
m
N
O
O
Cyr]
cn
m
>
m
cn
O
v
y
m�
cn
z
n
z
O
T
m
m
D
O
K
n
p
C
z
W
N
N
H
3
m
D
0
ao
m
�o
c
p
9
>
m
0
z
m
Z
m
ci
Z
m
d
D
r,
�+
k-6
2
CA
D
Z
D
=
z
vCD
m
m
m
a
r
(�
D
ty
�
Z
p
m
Z
O
O
I
0
[xj
m
z
3
ro
[D
Hy1
N
O
CrJ
<
D
G
G
y
3
z
H
m
z
0
n
m
y
v
m
�
Z
rd
[x�
C7
r- X
D y
o
m
m
m
_
H
m
Grrr
m
w
m
FF--'
+�
H
1
m
�_
D
m
o
m
vv
m
m
N
(D
O
Z
LTJ
�
m
O
a
v
m
�'
v
(y]
m
m
D
z
m
(]j
O
p
=
D
z
:G)
D
v
m
c
m
0
z
x
O
a
�
D
a
�TJ
v
r
p
m
rt
3
a
v
'a^
VI
F�
.. b
Z
m
X
CD
m
z
n
:�
H
v
C
T
a
C
T
Col
fD
H
D
0O
m
-4
z
3
m
A
m
z
r
p
=O
r
m
NFj.
Z
D
m
<
G
n
m
Q
z
Z
o
D
v
A
D
I
m
0
i
�
Z
C
�
Ul
H
r
()
VI
c
n
C,
o
0�
O
Z
RECEIVED Permit
OCT 10 19g1 CITY OF FEDERAL WAY
op I;L,DE AL WAY BUILDING PERMIT APPLICATION
WLDW DES — Please Print —
BOX 1 TENANT NAME:
OWNER - SITE LOCATION ��
OWNER'S ADDRESS �1 J -CITY. PHONE f 3e-f— 6Q_!T
87
DESCRIBE JOB •`
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME Q Lve-, - U'f)-X CONTRACTOR'S REG. # &LtL u51 b1j'r
Card MUST be presented
CONTRACTOR'S ADDRESS 14 9 b- 3q[ 511 {� CITY PHONE_461—
EXPIRATION DATE —'s
— 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 l A_rn PHONE -26 5 2-
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER d — 5-2-40
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 I GARAGE
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = } ( ) EXISTING STRUCTURE
( ) COMM ERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY —SOFT
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
DRAINS
OTHER
TOTAL FIXTURES
MECHANICAL APPLIANCES —
BASIC FEE $
GAS PIPING, FEET . a5 `
$
NO. FURNACE, ELEC. GAS
$
GAS HOT WATER HEATER
$
CONVERSION BURNER
$
BOILER, SIZE BTU
$
AIR HANDLING UNITS
$
HEAT PUMPS, SIZE _
$
UNIT HEATERS
$
AIR COOLING UNITS, SIZE.
_ $
COMMERCIA HOOD
$
OTHER bay
$
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 5 A P T OF THIS APPLICATION.
OWNER/AGENT: DATE:
ANP-008 ?
OFFICE USE ONLY (PLEAS':'DO NCT WRITE BELOW THIS LINE)
ZONE SETBACKS:FRONT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT _ --NOT EXEMPT_
FIRE DEPARTMENT APPROVAL
REMARKS:.
SIDE_
REAR HEIGHT LIMIT
DATE_
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
BUILDING SO. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SO. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
OCT 10 0A
RPL
OEM.
cT eu LD
RECEIVED
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
ACCEPTED FOR FILING