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SET BACKS AND FOOTINGS
DATE BY
OX TO POUR FOUNDATION WALLS
DATE BY
WATER LINE O.K. _
GAS PIPING O.K. _ _
PLUMBING GROUNDWORK
DATE -_._-_BY _
PLUMBING ROUGH IN
DATE BY
MECHANICAL INSPECTION
DATE
O.K. TO ENCLOSE FRAMING
DATE BY
_ -
INSULATION
DATE - _BY - _ •
WALL BOARD AND FIRE WALL
EIVED
RECEIVED BY
DATE �4M�rry-9Fp0PMENVDEPARTMEW
FINAL O.K. TO OCCUPY
DATE BY
DCD
PSD
F
Perm I &4,7 92- ,2/,7r z.
RECEIVED CITY OF FEDERAL WAY
SEP 1 51992 BUILDING PERMIT APPLICATION
W ( F FF-06RALWAY — Please Print
W—
MP'_
BOX 1 TENANT NAME: r+-t-\j
OWNER [l 13 SITE LOCATION U ��-
OWNER'S ADDRESS I �\0 ` ClT PHONE
-DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME B S:jtr� ME,
CONTRACTOR'S REG. #Sm U4 M 1?S to OV
Card MUST be presented
CONTRACTOR'S ADDRESS !4. �C�_ CITY'To CZ PHONE. 173.
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
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 9 MCC EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT N
LEGAL DESCRIPTION AAA
0l
(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 I
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) 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)
N0. 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
$
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
$
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 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.
OWNS AGEN : %'' _ _ _ DATE: . 9115A2_
ANP-008 3/90
ZONE SETBACKS:FRONT
PLANNING DEPARTMENT APPROVAL .
REMARKS:
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
SIDE REAR HEIGHT LIMIT _
SEPA: EXEMPT NOT EXEMPT —
FIRE DEPARTMENT APPROVAL DATE / 6'
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 _ _ TYPE OF CONSTRUCTION _ _._ — _ . _ _ -STORES .
BUILDING SO. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SO. FT. @ .. _ .
BUILDING SO. FT. @ _
BUILDING SO. FT. @
BUILDING SO. FT. @ _
TOTAL SQ. FT. - TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
RECEIVED
SEP 1 51992
Ily OF
WLDI AER�1F i
RECEIVED
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
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount . Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE
ACCEPTED FOR FILING