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90-100045 CITY OF � BUILDING INSPECTION FEDERAL WAY U I L D I N G P E R M I T 941-1555 90-/aD�y 5 PERMIT NO. 9O-OO�IO REV.OWNER'S NAME ANDERSON TEDRICR HOMES JOB ADDRESS 34503 13 AVE SW CONTRACTOR OWNER ADDRESS POB 5204 REDONDO CONT. PHONE 839-7644 CONT. REG. NO. �DERICI IOMC 6/90 OWNER'S PHONE SAML' AS ABOVE OWNER'S ADDRESS SAML AS ABOVE TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. tNDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD. NEW MULTI-FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER REVISION TO EXISTING PERMIT TAX ACCOUNT NO. �-92104-9O4H LEGAL DESCRIPTION LOT 6PARKT.ANE DIVISION 1 ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 3/3 0/9 0 �' BUILDING INFORMATION _ONE RS7.2 OCCUPANCY R-3 TYPE OF CONSTRUCTION S-N a��. sQ. Fr. GARAGE=352 SET BACKS: FRONT ZO� SIDE S� EACH REAR_ S� _ STORIES NA HEIGHT LIMIT 3O� 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 LAVfiTORIES DRINKING FOUNTAINS GAS HOT WATER HTR. MiSC. RETURNED SINKS MISC. CONVERSION BURNER BASIC FEE DISHWASHERS TOTAL FIXTURES __NQNE UNIT HEATER TOTAL MECHANICAL _NpISE AMOUNT N�NE VALUATION S_3 S S_R 5 PERMIT FEE $i$�. OO - PLAN CHECK FEE ��_ n n "LUMBING FEE :CHANICAL FEE .OTAL BLDG. FEES �i �d_nn PART PIC FEE PAID IN FULL ON �'1�q ' C �-/ SEPA REVIEW WATER SERVICE � � AMOUNT PAID WATER MAIN CHG. � S.B.C.C. FEE 4_50 gECEIPT $ OTHER FEES AMOUNT DUE 13g_5O 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 T THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET: � OWNER OR AGENT • DATE � ` ��, o � � . ., o � _ � � �� . CITY OF FEDERAL WAY UILDING PERMIT APPLICATION — Please Print— BOX 1 OWNER r�- � 2.c�t- ��ru �c� JOB LOCATION �v< � � rc •�/ ��/, � OWNER'S ADDRESS_1�D /s'c9 h S��J CITY o-.�. PHONE S�3`f 7� �/f/ DESCRIBE JOB /':Ce v; S i 0�1Z_;o /��c r�;� �- Qp� Dp7� THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP `�"'� CORPORATION BOX 2 CONTRACTOR'S NAME S/7-iz-t� CONTRACTOR'S REG. #�9�1/�4�'K/C/'/�/y!C Card MUST be presented CONTRACTOR'S ADDRESS S-�� CITY PHONE .5<�1 r• 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 e'r✓' rt-�- �.� BK- rfrt- `�' ' � PHONE `�� f�'i/ I BOX 4 SEWER DISTRICT �v.. WATER DISTRICT f'�'u BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER /4Z I F�tj �l� �! � , , LEGAL DESCRIPTION Lv T � ��,9rr�c�/�.ve fJ/f� .i /�H r �cc'„ P� r•`v i/�'tr /� ��d�C�r�s 5 9—�:,L �,;�; Cs �a w,� (If necessary, please submit a separate page with the legal description.) BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR / 3RD FLOOR / BASEMENT / DECK / GARAGE�� BOX 8 (�SINGLE FAMILY �� i S l�1JU O 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 $ 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 PER- FORM THE WORK FOR WHIC RMIT APPLICATION I MADE. OWNER/AGENT: -� - �— DATE: Y" ��` �f� ANP-OOfi 2/90 . . . -W; ,c�,.�+»x L�, �, - •i ,.• '�1 r �. a.tr"�_;,,4 �+.-,qc.` ,�'�a+ r�" �S.s� �, �� , xx e� �^+M�,..« .-.. k. ' . . ..1..� . . .. . � . . .. , . ' ' �` . � � . � ` OFFICE USE OiVLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZONE SETBACKS: FRONT SIZE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL REMARKS: 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 IVEW MULTIFAMILY (UNITS ) MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER OCCUPANCY �:�_TYPE OFCONSTRUCTION t�-ti STORES C;ut� � �E% BUILDING SQ. FT. �S� ' @ %7 - 3 � = E L <s�� C' BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ � < — ` BUILDING SQ. FT. @ � � ��' �� — � ` L� TOTAL SQ. FT. TOTAL VALUATION � �J S . c�,S EBUILDING PERMIT N0. PLAN CHECK FEE REC'D RECEIPT N0. PERMIT FEE �j<<='� PLAN CHECK FEE —��-`—'�— PLUMBING FEE --�---- MECH. FEE rtT TOTAL FEES �,3'�l r � SBCC SURCHARGE �j ` �v ENERGY SURCHARGE � AMOUNT DUE I 3� • S O BUILDING DEPARTMENT APPROVAL ----------------------------- DATE `�` S� '- �G REMARKS: ASSIGNED ADDRESS: �� i�l�B\ �.,,� � IJJ� fTY 4� ��.►��=F�AL WAY BUII.DiNG DEPT. RECEIVED ACCEPTED FOR FILING CITY OF BUILDING INSPECTION FEDERAL WAY B U I L D I N G P E R M I T 941-1555 PERMIT NO. 9O-0070 OWNER'S NAME �DERSON-TEDRICK CUSTOM JOB ADDRESS 34503 13 AVE SW CONTRACTOR �DERSON-TEDRICR HOMES ADDRESS POB 5204 REDONDO � � CONT. PHONE 839-7644 CONT. REG. NO. ANDERICZZOML 6/90 OWNER'S PHONE SAME AS ABOVE OWNER'S ADDRESS S AS CONTRACTOR TYPE JOB: NEW RESIDENCE XX 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. 192104 9048 LEGAL DESCRIPTION L�T 6 PAFtF.L.ANE DIVISION 1 ACCORDING TO THE PLAT THEREOF RECORDED IN VOL 150 OF PLATS, PAGES 59-62 INCLUSIVE IN RING COUNTY WASH ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 3/6 90 BUILDING INFORMATION E RS7�2 OCCUPANCY R-3 TYPE OF CONSTRUCTION 5-N BLDG. SQ. FT. 2SH5 tOt81 SET BACKS: FRONT 20� SIDE S� each REAR 5� STORIES 3 HEIGHT LIMIT 3O� PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS 3 ELEC. HOT WATER HEATER GAS PIPING 20 .FT. 2.OO gOILER RECEIVED BATHTUBS 1 IAUNDRY DRAINS 1 COMPRESSOR _ TANK(S) SHOWERS 1 URINALS ___ FORCED AIR FURNACE ZO.OO AIR HANDLING UNIT NUMBER _ LAVATORIES 4 DRINKING FOUNTAINS GAS HOT WATER HTR. 6.SO MISC. SINKS 1 MISC. SUMP� VAC. 1 CONVERSION BURNER BASIC FEE RETURNED DISHWASHERS 1 TOTAL FIXTURESBRKR 13 UNIT HEATER TOTAL MECHANICAL Z�.�Q AMOUNT �N NE VALUATION �132,393.�� PERMIT FEE �755_00 PLAN CHECK FEE 491_OO PLUMBING FEE 65_00 CHANICAL FEE _ 1 H S O TAL BLDG. FEES 1 �29 �iO � PAID IN FULL ON: 3 ` �G � �'� PAfiT PIC FEE SEPA REVIEW AMOUNT PAID: I 3 � Y•��` WATER SERVICE WATER MAIN CHG. RECEIPT ��: '3 3 v ,� /� S.B.C.C. FEE 4.5� OTHER FEES $1334.�� AMOUNT DUE ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET: OWNER OR AGENT R DATE � � J��-CJ ' X`" . . �� ' � �'�c �� \ � � �/� � M ��'D \ qR '"` � �� 61 �'o�� 990 CITY OF FEDERAL WAY f�Uj�O��p��Ay BUILDING PERMIT APPLICATION . —Please Print— BOX 1 OWNERAP�DER,S��—TEDRICK CUSTO�� NOMES �OB LOCATIO� � _ � OWNER'S ADDRESS � � � PHONE DESCRIBE JOB S - '� �' �� THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP��'�CORPORATION BOX 2 CONTRACTOR�s NaME �1idDE�SOP!—TE�RI CK CUSTGf� HOf°ES CONTRACTOR'S REG. # Card MUST be presented CONTRACTOR'S ADDRESS P � 0 , BOX 52C4 CITY �E�� r� PHONE 839—�644 EXPIRATION DATE G6/ — OR — I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON sT��n�ni��c��n� -rr�v ��Cl_�7�TPHONE��►�/1Q1 BOX 4 SEWER DISTRICT FEDERAL I��:�� WATER DISTRICT FEDER ;ti BOX 5 ESTIMATED PROJECT COST �� r�nr, EXISTING BUILDING VALUATION =a_ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION LOT E �',�R � � ! . ,�.L� � , I P VOLUf'�E 1�� +� ��AT�� PAf ES 'z9—�-�� T►�l'I�l€�TVE, I I`d KI I�i� COI�I'�TY. L^!�SH I idGTON � (If necessary, please submit a separate page with the legal description.) BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR �� 2ND FLOOR IS 3RD FLOOR�/ BASEMENT / DECK / GARAGE�J BOX 8 (k) SINGLE FAMILY (X ) NEW CONSTRUCTION ( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY 16,2QO SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$ � �.,,, NO.�_WATERCLOSETS GAS PIPING, FEET �� $ � �? �BATHTUBS NO.��FURNACE, ELEC. GAS� $ ��_-- _�_SHOWERS �_GAS HOT WATER HEATER X $ � ��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 $ OTHER $ �_TOTAL FIXTURE �—�-,;,, $ ��'j 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 PER- FORM THE WOR O WHI H ERMIT APPLICATION IS MADE. OWNER/AGENT: DATE: ��,R('N�. 1.AA(1 , � ANP-006 2/90 ', .•...'::.N.i'E�p':.'!"��,,�7F...�.�, .-� . --•-•-,� .m•yv;-x. ....9._'Tr;..-.r;--.. �. . ..., - -_'.,mv.n . . +•ranY-v .. . R:. ,r_'- _ _r. �. .. . .. .�,,,.:...,y�,.: ..� OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE) ZONE S' 7. 'SETBACKS: FRONT � '3 ' ,SIZE ��o'r �s ' REAR S ' HEIGHT LIMIT v�t� � PLANNING DEPARTMENT APPROVAL � �_�� 5 -�� - �� ' ' REMARKS: . , �,._ , � �_�> _<.u.�� ,L,.r�e. _ �-- ��+'� .. SEPA: E E P��,_NOT EXEMPT FIRE DEPARTMENT APPROVAL DATE REMARKS: /' �.0 �-SS �c�.vt (Z � v'� S, � PUBLIC WORKS DEPARTMENT APPROVAL �<-- DATE 3 Z7� �O REMARKS: TYPE OF JOB: NEW RESIDENCE i' RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS ) MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER OCCUPANCY I`��3 TYPE OF CONSTR CTION � N STORES �{=� BUILDING SQ. FT. 2--��5' @ C-� --- _ ��CcE� BUILDING SQ. FT. .>`f�� @ c = Z BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. •�-�43�G�L-- �,��,'�EL� � � _ BUILDING SQ. FT. @ _ ' TOTAL SQ. FT. TOTAL VALUATION Z, EBUILDING PERMIT N0. PLAN H CK FEE REC'D RECEIPT N0. PERMIT FEE PLAN CHECK FEE -- PLUMBING FEE -- �`--=� MECH. FEE `L TOTAL FEES � �-`' ----- SBCC SURCHARGE '�" •� ENERGY SURCHARGE AMOUNT DUE �'" BUILDING DEPARTMENT APPROVAL ----------------------------- DATE "?�-7 � '�_ REMARKS: ASSIGNED ADDRESS: 3 y S� 3 ( S�l� `'� ��-- 5- �` RECEIVED ACCEPTED FOR FILING , �I +0 . .��, AfJI� ERSU �J - �� E= �� RI CiC +3/� 9 CU � T �' h1 F� Of�1ES �J�, P, O , BJX 5204 � RELO«1��,� 4�'A 9U05�� +'.'� LOI�JER - �71 ::r �?3g--��!t4%9�7-5491 � � f-iA i�d = ?15 Sc � p�/ UPPER = 759 ��: SCALE: ti�� . TUTAL =Z045 Sc_ �„ = 20'0" _-_� - - _ '.- GARAGE 540 Sr; _ ��- P�1R� '. � . �� , _ - - Lo-r � , � +6 < �� -��- � +� VAr?i«-�-r.lE - --� � -� ,. �S'T� 1 �S ` - .. � +4 � �_3 2� :---- ----f{fr1-�.`. �--�;,.�,-�k ', ----- r' r . - ' .c'- _ -. -i : — --7�_r "� — c !1 S E �1 �: .. = ` " t,Jf1C�',�=1:� . "; �/� . -_'�-- �' llf'�1 V�l�.'l�;Y� � , _. � �,, r� ",_.__�, ' � ,� _y , ��'4� � �- .�� .��' i � �� ,�� ,� � ' � / '� �; � � -�-� �� .. ;. , �, � +3 � ./ � "�' f �' � �, Lfl �� / '� � ' �j'� � % � W , / / i / �—I � //' N � �,f, /i'� ,' .�. / � / � � , � � / � �,�%, C.O �/ ��/ �/j w '' / / ./� / y1. ' R • � +2 �� . �-� —�� d +1 �f� -� � � -�-7 .�-., � C�d r--1 1G ' �. ' ��' +p � �� q c�� eo,��6, �o ,�o��R9 9� i �F�OT�'qY � �1 ..�,�._.�._. _ ' � �,.A �.....��.�....��...,�. �....�,..�.__._.._.t ��0 C�,�fY O� 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 AODITION 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 _ONE 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 PERMIT FEE PLAN CHECK FEE PLUMBING FEE __ iCHANICAL FEE 'l �OTAL BLDG. FEES ��. ��/ PART PIC FEE SEPA REVIEW WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE OTHER FEES AMOUNT DUE QLL PERMITS EXPIRE 180 DAYS AFTER ISSl1ANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR QFTER 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 J CITY O� 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 _ONE OCCUPANCY TYPE OFCONSTRUCTION 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 PERMIT FEE PLAN CHECK FEE PLUMBING FEE :CHANICAL FEE ,OTAL BLDG. FEES PART P/C FEE , _ SEPA REVIEW -R'"' � � WATER SERVICE .��T p�� ,: 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 � Q1 f\ i r " � \�` D -n yp p pD � p m �' �� f• � � Z � T � C � � � � � � \ .� �; � m D m m � m � �.J N �} 'C ,� � � p w y n � `�. � � � r, 1�n "(� � � . .. ^` � �� !� z � . � � na � v> 'Q � � �� 1 p �� , A n (� �, �l i � u o � O ��,,' z � � � 1 � '� � 1 ' p � I cn �,�i� � '� �� I� �, ) �, � a �� m � v� z y � -n �' o r� � ` �� : � � � � . � ^` �,� ��.a � � ) �" i ^; ', �. 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N � � ^ nl \� \) , � � V ' ' '