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91-100827 E ERAL WAY B I L D I N PE R M I T BUILD1941�N555ECTIOh U G PERMIT NO. 91-784 OT OWNER'S NAME FRED MEYER JOB ADDRESS 33702 21. AVE SW CONTRACTOR �DERSON CONST ADDRESS � N CUTTER CIRCLE PORTLAND, OREGON CONT. PHONE 50 -28 -67 2 CONT. fiEG. NO. �DERCCZZZM� �I 91 OWNER'S PHONE 503-721-3529 OWNER'S ADDRESS SZOO SW MACADAM PORTLAND, OREGON 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 24 X 6O� TEMP TRAILER ON SITE (TEMPORARILY) TAX ACCOUNT NO. 242103-9090 LEGAL DESCRIPTION LOT 2 OF SHORT PLAT NO 27H132 ACCORDING TO THE SHOItT PLAT RECORDED UNDER R.C. REC # 8210260642 ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE �I-�� DATE OF APPLICATION 6/12/91 BUILDING INFORMATION �ONE BC OCCUPANCY B-2 TYPE OF CONSTRUCTION 5-N BLDG. SQ. FT. 1440 T BACKS: FRONT 2�� SIDE �� REAR �� 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 DRAINS COMPRESSOR TANK(S) SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _ LAVA70RIES DRWKING FOUNTAINS GAS HOT WATER HTR. MISC _ " RETURNED _ SINKS MISC. CONVERSION BURNER BASIC FEE DISHWASHERS TOTAL FIXTURES NONE UNIT HEATER TOTAL MECHANICAL NONE AMOUNT NONE VA�UATION $63 3 6.0 0 PERMIT FEE $90.00 PLANNING DEPT APPROVAL = DEB BARRER PLAN CHECK FEE 59.00 TEMPORARY ACCESSORY USE ONLY AS PERMITTED WITHIN BC ZONE. PLUMBING FEE TRAILER SHALL BE REMOVED NO LATER THAN AUGUST 1, 1991, AND SITE MECHANICALFEE RESTORED TO ORIGINAL, PRE TRAILER CONDITION. REFLECTIVE MATERIAL TOTAL BLDG. FEES $149.00 SFiALL BE USED AT CORNERS TO DETECT TRAILER WHEN LOT IS DARR. T P/C FEE ��PA REVIEW FIRE D. 4.50 FIRE/BLDG DEPT APPROVAL = REVIN ELLIS WATER SERVICE PUBLIC WRS DEPT APPROVAL = TOM COLLINS WATER MAIN CHG. S.B.C.C. FEE 4.5� OTHER FEES P� �S 35.OO AMOUNT DUE $193.00 DATE PD 7�"�r AMT $193.00 REC'T ��y�7 ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET: OWNER OR AGENT DATE � lI /�T l - ' ermit # � �— 7 ��T CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION — Please Print— BOX 1 TENANT NAME: �� r�� v'� � /J� �-v� �-�� y'�ya�� OWNER �/�.tD ,,�� SITE LOCATION /�,�F��L ��✓�v OWNER'S ADDRESS _�`/vn S�� .4cA�f.}m CITY ��,f�,�� PHONE �S�..� ,�.Z/�.?�� DESCRIBE JOB �r�4�c ,�.(;�' ,�--��>�.�� ✓` �-, r� s�r2 � �,.,,L-.c�x �� THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION �{ BOX 2 CONTRACTOR'S NAME � nrv� �:.��i Gq,v. �:�'��=�r� �-�, CONTRACTOR'S REG. # �4�voE2f�/2 i m r.,a Card MUST be presented CONTRACTOR'S ADDRESS � ,7�L ,it!" Gi.�TT.��' �=/�2 CITY �'C��7G�3�iy2 PHONE � :t - �'�?� - E aJ Z EXPIRATION DATE �i /9/ — OR— I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON �Y?rn��v �7�1"� PHONE ��?�'- ?z/"3.S�a2� BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER U .3 - � G% �% - '' LEGAL DESCRIPTION Q- , � �,�h�i�"�� (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording# BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR /�� 2ND FLOOR / 3RD FLOOR / BASEMENT / DECK / GARAGE / BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY(N0. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ N0. WATERCLOSETS GAS PIPING, F T $ BATHTUBS , N0. FUR CE, ELEC. GAS $ SHOWERS GAS T WATER H ER� $ AVATORIES CONVE SION B ER $ S KS BOILER, IZ BTU $ DI WASHERS AIR HAN NG UNITS $ ELE�TRIC HOT WATER HEATER HEAT P PS, SIZE $ LAUNDRY WASHER OUTLET UNI�HEA RS $ URINALS �COOLIN UNITS, SIZE $ DRINKfNG FOUNTAINS OMMERCIA HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS ,�OTHER $ DRAINS � $ OTHER ' �J $ 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 QF 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 P�ON THE ACCURACY OF THE INFORMl�TION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: r � � " DATE: z-- ANP-008 3/90 f OFFICE .,,.�ONLY (PLEASE DO NOT WRITE BELOW THIS "..E) ZONE �' SETBACKS: FRONT �! SIDE � � �iEAR � HEIGHT LIMIT �� y PLANNING D�PARTI�I�F. T APPROVAL � /� / � c�o.,c4fic,� REMARKS� �` -:� � '� j`' �!''Lfii � Y � �t � � �� ` �l�� - i � � SEPA: EXEMPT_�NOT EXEMPT ��h � � ✓�_ �' •Ia L(�lCc;f" traiP�Y r,�ihYn �d� i�5 Gcac-rk. FIRE DEPARTMENT APPROVAL � Ci DATE ��" ��'�— � I REMARKS: PUBLIC WORKS DEPARTMENT APPROVAL�� DATE ��8�:� `r/ 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 \)/�I STORES �'�V� Q BUILDING SQ. FT. �.�'{� U ---@ - ��U = 7�—�=U BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ �' � � '� ��'['� _ �' �%� �o TOTAL SQ. FT. TOTAL VALUATION � � 3�� BUILDING DEPARTMENT REMARKS: PERMIT FEE �� PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE TOTAL BLDG. FEES PART P/C FEE SEPA REVIEW ��,,� 3S. v-cJ S.B.C.C. FEE S G OTHER FEES f D �`��- �� AMOUNT DUE � ' �� ASSIGNED ADDRESS: � �- � PARTIAL PLAN CHECK FEE RECEIVED Amount Date Receipt# BUILDING DEPARTMENT APPROVAL RECEIVED BY ��i DATE ' L' � ACCEPTED FOR FILING