90-100337 CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G PE RM I T 941-1555
o y�e� � 7
-��C 3
PERMIT NO. 9O-4E)HP OWNER'S NAME ROBERTS CONSTRUCTION JOB ADDRESS �'A'g� 13TH PL SW
CONTRACTOR INTERURBAN PLUMBING ADDRESS 36056 MILITARY RD S AUBURN ��t"�,� CONT. PHONE 838-1463
corvr. aEG. No. INTERI*204CL OWNER'S PHONE 874-6306 OWNER'S ADDRESS 952 S.W. CAMPUS DR FEDERAL WAY
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 PLUMBING/MECH
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 4-30-90
BUILDING INFORMATION
NE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SO. 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 _1_ LAUNDRY DRAINS �_ COMPRESSOR _ _ TANK(S)
SHOWERS �_ URINALS FORCED AIR FURNACE _�p AIR HANDLING UNIT NUMBER _
LAVATOF�IES �._ DRINKING FOUNTAINS GAS HOT WATER HTR. MISC.
SINKS __L_ MISC. CONVERSION BURNER BASIC FEE
�n_�D RETURNED
DISHWASHERS _�_ TOTAL FIXTURES 13X5=�_--00 UNIT HEATER TOTAL MECHANICAL �_��.� AMOUNT
VALUATION
PERMIT FEE _
PLAN CHECK FEE
PLUMBING FEE �� �l�_
CHANICAL FEE - ��T�-A DATE: � C L,/
� TAL BLDG. FEES �� , ��
PART PIC FEE AMOUNT:
SEPA REVIEW /� ,�
WATER SERVICE RECEIPT: ��i -��
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE Q l r,(1
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 '� ��'��' �l i`'�' DATE 4 � ,� ` ��
" � .y �/
11'tlt #
CITY OF FED RAL•WAY R�CE�V
� APR 3 �D
BUILDING PERMIT APPLICATION ���.�, 0 199Q
— Please Print— BCO/F qL
CD E�ER W Y
BOX 1 TENANT NAME:
. /
OWNER < < rcn SITE LOCATION '�'`' L.• S-
OWNER'S ADDRESS�S Z S� c.�� � C�ca�.�Q�_ CITY PHONE 87 �}- �3D�,
DESCRIBE JOB �Ls��,-,s
THE PROPERTY IS OWNED BY: �NGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME ��-'�-�'u-�-� P I u�-P�,-�4 CONTRACTOR'S REG. #-a-r,�i F2-L�`z��c�
Card MUST be presented
CONTRACTOR'S ADDRESS (�osZ, VYl� ) � � 2�S CITY ,A-µ-2�c,�.�-- PHONE S3� -/�l 6_�
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 PHONE �3 �- /y 6 �
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(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 (x) NEW CONSTRUCTION
( `) MULTIFAMILY (N0. OF UNITS = ) (( ) EXISTING STRUCTURE
( ) COMMERCIAVINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
N0. WATERCLOSETS I i i GAS PIPING, FEET $
BATHTUBS � N0. FURNACE, ELEC. GAS $
_SHOWERS I� GAS HOT WATER HEATER $
LAVATORIES 11�1 CONVERSION BURNER $
_�SINKS I BOILER, SIZE BTU $
_�_DISHWASHERS E 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��.�.�t i?'I' ' �R� $
���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, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE:
ANP-008 3/90
'� 4 �tik _'r.__"� v�'�Wi-.,1.�. . .f . . _. .�a;..
- �.,r, . , �! a � ' 'J.. . . . x '3 ' _ ;.0 "'<:T �r a. � i.��,. �
OFFICE USE ONLY(�PLEASE DO NOT WRITE BELOW THIS LINE)
.
ZONE SETBACKS: FRONT SIDE 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 INDUSTRIA�_IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
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
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS:
�J� o
� � P
� e�O��PQ- PARTIAL PLAN CHECK FEE RECEIVED
` ,QQ� ������ Amount Date Receipt#
��J�v�` BUILDING DEPARTMENT APPROVAL
RECEIVED BY DATE ACCEPTED FOR FILING
CITY OF BUILDING INSPECTION
FEDERALWAY BUILDING PERMIT 941-1555
3 �a
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 GFiADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
�NE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT. _
T 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 �
G���
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE _
ECHANICAL FEE _
TAL BLDG. FEES
, ART 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 CORFECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT DATE
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