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91-100492 CITY OF BUILDING INSPECTION FEDERAL WAY B U I L D I N G P E R M I T 941-1555 PERMIT NO. 91-453 FSS OWNER'S NAME FRED MEYER JOB ADDRESS 33702 21 AVE SW CONTRACTOR THE SAFETY TEAM ADDRESS 670 S LUCILLE ST SEATTLE 98108 CONT. PHONE 762-1450 CONT. REG. NO. SAFETIIII ORG 11�91 OWNER'S PHONE OWNER'S ADDRESS TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD. NEW MULTI-FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER AUTOMATIC FIRE SUPPRESSION SYSTEM TAX ACCOUNT NO. 2'42103-9099 LEGAL DESCRIPTION NA ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 4/16/91 BUILDING INFOR ATI N E NA OCCUPANCY TYPE OF CONSTRUCTION S—N BLDG. SQ. FT. NA „" BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT NA _ PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. BOILER RECEIVED BATHTUBS LAUNDRY ORAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _ • LAVATORIE3 DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. _ RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE DISHWASHEaS TOTAL FIXTURES L1TQN�� UNIT HEATER TOTAL MECHANICAL _._�� AMOUNT �])j,F VALUATION $3 _500_00 PERMIT FEE $6 3 0 0 _ FIRE DEPT APPROVAL = GREG BROZER ON 4/18/91 PLAN CHECK FEE 4� ,�O PLUMBING FEE BLDG DEPT APPROVAL = REVIN ELLIS ON 4/2 9/91 MECHANICAL FEE _ AL BLDG. FEES �i n 4_n n ,,,,.7 P/C FEE � SEPA REVIEW '� WATER SERVICE � WATER MAIN CHG. DATE P AMT $16 O.S O REC�T S.B.C.C. FEE 4.50 OTHER FEES FIRE= 52.OO AMOUNT DUE $�-6�.5� 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 URNI ED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE PLICA LE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET: sl OWNER OR AGENT �� DATE ` � � CITY OF BUILDING INSPECTION FEDERAL WAY B U I L D I N G P E R M I T 941-1555 PERMIT NO. OWNER'S NAME JOB ADDRESS �� CONTRACTOR ADDRESS CONT. PHONE CONT. REG. NO. OWNER'S PHONE OWNER'S ADDRESS TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD. 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 OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT. SET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT _ PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT. BOILER RECEIVED _ BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _ LAVATORIES DRINKING FOUNTAINS GAS HOT WATER HTR. MISC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT VALUATION _.... .. � , � _ ,. ._... �._.. . . . . , v: .� . PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE _ TOTAL BLDG. FEES PART PIC FEE SEPA REVIEW WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE OTHER FEES AMOUNT DUE 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 � O T O O � � � � D z D � D � D m C -i m D m � m � m W O ' � � ' D n � � I z I '� �! � O i � O D � � Z O cn � ' O �� C � I = I O -D D Z O � � � � W W Z z � � � I � I II ��, � I' I o lo - Ic� lo C� D � D y�i D � � m � � � m � D � � 0 p Z Z O z G) m I c � � O � � � � i O ' ' C I � � Z � W �� W -Di -� I < O Z � � � i � � D 0 I I I r r � i �i � i �I� I i ! C1 � (7 � � v p D � n � C m � m = m � I W I D 0D z j z � � ' n � i p � D � � � Z � o � � O -n m � � T � j � ' � m I O 00 � 'ao �z m � { D � � r I i I �, -ermit # Cl / - �� S �EG�IVED CITY OF FEDERAL WAY APR 1 6 1991 BUILDING PER1iVIIT' APPLICATION —Please Print— GI'fY QF ��4��i�t.WAY BOX 1 �NAN NA E:! -�' � OWNER ' � ��'-- SITE LOCATION � OWNER'S ADDRES-$ CITY PHONE DESCRIBE JOB 1�l��.t�- (�r�' r �} S j YS� fir`(1 i/�J �j iZ" �l� �'� THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION i� BOX 2 CONTRACTOR'S NAME ��n �,�1_st� �\Lsl��(Vl 1Y�� CONTRACTOR'S REG. # �F�i 1- I ID .,� � Card MUST be presented `,,, CONTRACTOR'S ADDRESS �oPl� S �-��-� SI� CITY �(.-�1 l� PHONE 7_�_/��y�C� ' EXPIRATION DATE 11I a i �� ;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 % �` PHONE�� J } G BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST � '��- EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER ��O'�=�%�� '_ 1 LEGAL DESCRIPTION �%7=�,�C'Ac'i�� (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 / GARAGE / BOX 8 ( ) SINGLE FAMILY ( +�j�NEW CONSTRUCTION ( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE ( �'COMMERCIAL/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 $ SINKS BOILER, SIZE BTU $ DISHWASHERS AIR HANDLING UNITS $ ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $ LAUNDRY WASHER OUTLET UNIT HEATERS $ URINALS AIR COOLING UNITS, SIZE $ DRINKING FOUNTAINS COMMERCIAL HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS OTHER $ DRAINS �'7V�,�t1)LS7= �_ �'i E �`:S �Z'Y11 S $ OTHER $ 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, UP N THE A CURACY OF THE INFORMATION SUPPLIED TO TH CITY AS A PART OF THIS APPLICATION. . OWNER/AGENT: � DATE: `� f� �i � ANP-008 3/90 /� � i OFFICE __� ONLY (PLEASE DO NOT WRITE BELOW THIS _.._E) ZONE SETBACKS: FRONT SIDE �REAR HEIGHT LIMIT '"�" � i, � PLANNING DEPARTMENT APPROVAL � �, � REMARKS: . ,;,•; SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL `�'SeQ DATE �-1� -4 I REMARKS: K�,- `�' Zq- `�� PUBLIC WORKS DEPARTMENT APPROVAL DATE REMARKS: � ! TYPE OF JOB: NE1N-RESIDENCE RES. ADD/ALT NEW INDUSTRIAL . IND. ADD/ALT NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS ) , MULTIFAMILY ADD/ALT TENANT IMP. OTHER /�t�l l� f S � � OCCUPANCY TYPE OF CONSTRUCTION VN STO E BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ - _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ TOTAL SQ. FT. TOTAL VALUATION �'}'>c:>G BUILDING DEPARTMENT REMARKS: PERMIT FEE �� PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE TOTAL BLDG. FEES PART P/C FEE SEPA REVIEW S.B.C.C. FEE � r� OTHER FEES`r D Fz�- � � AMOUNT DUE � ' s ASSIGNED ADDRESS: S�%'�'— �-� l S � � , �C�Ei�/�p PARTIAL PLAN CHECK FEE RECEIVED ��,�,APR 3 0 �99t Amount Date Recei t# �F�'�D� p eVlLDING�EPr AY BUILDING DEPARTMENT APPROVAL RECEIVED BY �,�� DATE `I �� / ACCEPTED FOR FILING