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SET BACKS AND FOOTINGS
DATE J r(_1_Clo BY
OX TO POUR FOL
DATE 9/0
d 5�
PLUMBING GROUNDWORK
DATE BY
PLUMBING ROUGH IN
DATE __ __ BY _
WATER LINE O.K.
GAS PIPING O.K.
MECHANICAL INSPECTION
DATE _BY
O.K. TOfENCLOS FRAMING j�
DATE [- BY �< _
INSULATION/ ��a
DATE �1� 6Y ���
•((��'�'DCD
WALL BOARD AND FIRE WALL
DATE 7.`"2.`- ` BY .�
UPY
FINAL O.K. TO;j!2-
DATE _ �,[p� BY
PSD.
FD
zq
A
7
o r �a)v
CITY OF FEDERAL WAY�a
S�
BUILDING PERMIT APPLICATION °��
— Please Print
BOX 1 OWNER TugT s JOB LOCATION��� � •�
OWNER'S ADDRESS 22.06 SW 3�141=� PI ;;ee CITY Federal Way PHONE A 8-2195
DESCRIBE JOB -FEEWith PROPOSED ADDTION
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP_ CORPORATION xx
BOX 2 CONTRACTOR'S NAME SIStX5F3iX5LSi'�StK CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS
EXPIRATION DATE
CITY
PHONE
—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 PHONE 83 2-21 95 ia��_n933
BOX 4 SEWER DISTRICT FedeniI Wav WATER DISTRICT -
BOX 5 ESTIMATED PROJECT COST 2�_R7�_z� EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMOER_ 321 ❑3-90 -3-B1 -
LEGAL DESCRIPTION
SEE AT!17 CHED LEGAL DISCRIPTION
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR2769J$40 ►�PI2110waI<OOR _ 1
3RD FLOOR / BASEMENT J. DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( MULTI F ILY (NO. OF UNITS = 208 ) (� EXISTING STRUCTURE W/ addition
( ) COMMPALANDUSTRIAL TOTAL AREA OF PROPERTY _SO FT
BOX 9 PLUMBING F TURES (including rough -ins)
NO.— -3-1j,WATENCLOSETS ALL EXISTING
—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
$
--A]R COOLING UNITS, SIZE
$
COMMERCIAL HOOD
$
_OTHER
$
TOTAL MECHANICAL FEE
$
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORREC_rTO THE
BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER-
FORM THE WORK FOR WH. H_I?_ER0T APPLICATION IS MADE.
OWNER/AGENT:
AC;E�'-
DATE: 04-10-90
ANP-006 2/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIZE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
ccu uKs_
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL -DATE
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. ROOF OTHER
OCCUPANCY if 3 . TYPE OF CONSTRUCTION U _ STORES
BUILDING SO. FT. D @ 6_�_ • °Z
BUILDING SQ. FT. @
BUILDING SO. FT. @
BUILDING SQ. FT. @ —
BUILDING SO. FT. _ @
BUILDING SQ. FT. @ ? —
TOTAL SQ. FT. TOTAL VALUATION g 8 7 f 3 Z a
EBUILDING PERMIT N0. PLAN CHECK FEE REC'D RECEIPT NO.
PERMIT FEE 0 <E'PLAN CHECK FEE —2-6-5:�— PLUMBING FEE -- --- MECH. FEE �—
TOTAL FEES 6 SBCC SURCHARGE SO ENERGY SURCHARGE AMOUNT DUE C 77 `-5—y _
BUILDING DEPARTMENT APPROVAL ----------------------- — — — OAT
REMARKS: z)of- PoLAble__ FQ-9--W
ADDRESS: S I
�k
fE�cEIVED
ACCEPTED FOR FILING