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92-100532 CITY OF FEDERAL WAY �f a' ���5.3 J 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 PERMIT NO. 92-OS�.O P OWNER'S NAME FARMERS INSURANCE GROUP (SEiTNG S�E�EE) 31260 PACIFIC HIGHWAY S CONTRACTOR �L AROiJND PLUMBINGAooaEss 3454 1/2 175TH S SEATAC CONT.PHONEZ4H-lO3O CONT.REG.NO. 0921.04-92GS EXP. OWNER'S PHONE OWNER'S ADDRESS TYPEJOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEW PUBLIC PUBLICADD. NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER TAXACCOUNT NO. 092104-92F)S LEGAL DESCRIPTION i ISSUED BY JOANNE JOANSON DATE OF ISSUE DATE OF APPLICATION 4-6-92 BUILDING INFOR ATION NE 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 WATEfi HEATER 1 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 1 DRINKING FOUNTAINS CONVERSION BURNEF MISC. SINKS 2 nnisc�ERMIT FEE Z O.O O BBQ BASIC FEE RETURNED DISHWASHEfiS TOTAL FIXTURESSXS ZS.OO DRYER TOTAL MECHANICAL AMOUNT 45.00 VALUATION PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE 45.OO IT P/C FEE SEPA REVIEW PUBLIC WORKS ���n � S.B.C.C.FEE �� � FIRE FEE DATE: OTHER FEES AMOUNT: 4S.OO AMOUNT DUE ��n 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 r ✓ DATE� � CITY OF FEDERAL WAY Fede aFWay\,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 ZONE 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 PLUMBING FEE MECHANICAL FEE PART P/C FEE SEPA REVIEW PUBLIC WORKS S.B.C.C.FEE FIRE FEE DATE: OTHER FEES AMOUNT: 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 , i � � , . � � J } } Q } Y m Z m � m � j Q O W , � U � � � � o ' u1 �- z '� a o : � � I z O z 4 � J '�, 0 '��. � � i C� U � 'Q ' Z I Z m m , Q � w U � � � w Q a o � o � o I j ( � J I j i o _ J (n � � � I j a z ' o m �I i m a � � � I i z � O i� Y Y I 0 0 � z W o I z z 0 a -r a F � d O W W a j W F- 0 0 � � z o 0 i , � j I I �� � � � � �� I �' ; � i c� c� � z � � m m � m r m Z ``���� a a O I = (Vi � '�I � \ � � U fj p � �I, c�i� p �,.,y_ Q � �� O i p , _�`� Y I Z� z Y \�' W I, \ Q m I p O ,,:� m w � w � w Q w F- F- �- �- uwj o a o O o LL. o � P nit # `�� � S �v �° �����v�� CITY OF FEDERAL WAY APR n�.1992 BUILDING PERMIT APPLICATION ��`^'�����Y —Please Print— BOX 1 TENANT NAME: ,�j�,�,n�-�r /NS, C����� S��/rriG Ci-�v� ��e OWNER Sc��!>NG- n��l� b�� SITE LOCATION :3I�Go /�Ac, Iaw� se�. OWNER'S ADDRESS 312�� /��Fr y��,� � CITY /�. ' " PHONE .�z- zs3`Z DESCRIBE JOB i?�'�s�od�L.� 9 5i/-3/�y THE PROPERTY IS OWNED BY: SINGLE/MARRIED �� PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME r�-« �i�s�,,�per�.�.r�s�.��- CONTRACTOR'S REG. # �� ���'�-�ey Card MUST be presented CONTRACTOR'S ADDRESS 3�/.SY/ /� /7s` .� ,t'c� CITY .SG�A-Ti1-� PHONE Zs/g'/�:3a EXPIRATION DATE Sr- r - c � — 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 /�'� PHONE �Y�''-tc�3o BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER o 2/ 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 F100R / BASEMENT / DECK / GARAGE / BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE �G�OMMERCIAL/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 $ / LAVATORIES CONVERSION BURNER $ f SINKS BOILER, SIZE BTU $ DISHWASHERS AIR HANDLING UNITS $ � ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $ �LAUNDRY��;;"", ^"T' LT � UNIT HEATERS $ URINALS AIR COOLING UNITS, SIZE $ DRINKING FOUNTAINS COMMERCIAL HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS OTHER $ DRAINS $ / OTHER >'=C�x�z .r7.vK $ ��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: � DATE: ��� �� ANP-008 3/90