90-100233 CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G P E R M I T 941-1555
6�¢ 9� -��a�33
PERMIT NO. 90—O31C)P OWNER'S NAME ��ITT YOUNG JOB ADDRESS 35206 13 PL SW
CONTRACTOR J�� �RG�SRI ADDRESS 36809 2�4 A� $E pIUBU� CONT. PHONE 939-1390
CONT. REG. NO. JJPLUI9C)CC 2�91 OWNER'S PHONE 874-8504 OWNER'S ADDRESS SAME AS SITE
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MUITI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING oTHER�PLUMBING Sc MLCHANICAL ONLY"
TAX ACCOUNT NO. NA LEGAL DESCRIPTION NA
ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 4/11/9 0
BUILDING INFORMATION
NE NA OCCUPANCY NA TYPE OF CONSTRUCTION NA BLDG. SQ. FT. NA
ET BACKS: FRONT N.� 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. 3.5O BOILER
RECEIVED
BATHTUBS _�_ LAUNDRY DRAINS �_ COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER
LAVATORIES _�__ DRINKING FOUNTAINS GAS HOT WATER HTR. 6_50 MISC.
RETURNED
SINKS _1__ MISC. CONVERSION BURNER BASIC FEE �_Q�Q.Q
DISHWASHERS _L_ TOTAL FIXTURES Z�QO UNIT HEATER TOTAL MECHANICAL �Q.QQ AMOUNT NONE
VALUATION N(�NF
PERMIT FEE _
PLAN CHECK FEE
PLUMBING FEE �f1D
CHANICAL FEE _ �.o��fl
TAL BLDG. FEES
ART P/C FEE
SEPA REVIEW
WATER SERVICE DATE PAID: �— � � —CJ �
WATER MAIN CHG. � U.�
S.B.C.C. FEE AMOUNT PAID: �S
OTHER FEES L,L � /l
AMOUNT DUE _�HS_OO RECEIPT �: r C � � �J
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.�RESIUENTIAL AND GRADING PERMITB 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 ���z'�' C� /� �`
DATE °
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 OWNER �r v' � t � 0�+1! JOB LOCATION �-r7 Q �✓�
OWNER'S ADDRESS •�� �4� CITY C'�//P v u c� PHONE �7�'- �S�O�i
DESCRIBE JOB � �M 6�r✓C
�
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME �o ��� 4 'k,� CONTRACTOR'S REG. # � ��`'�� ����C
C 8� Za � �4 Ut'. • • Card MUST be presented
CONTRACTOR'S ADDRESS CITY �) c�,�u��v PHONE 9.��-/3�a
EXPIRATION DATE 2-2- 5/
— 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 J� iv �7��✓ U t�nl% ` PHONE `�7 �J- �3�Q
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.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) iST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 (X) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-i+�s��' MECHANICAL APPLIANCES— BASIC FEE$ ZU-��='O
N0. 3 WATERCLOSETS GAS PIPING, FEET $ 3.Sc�
2 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 $
_ �S� �- .S 5 �� C TOTAL MECHANICAL FEE $ G- ���
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 WHICH PERMIT APP CA ION IS ADE.
OWNER/AGENT: `� � ��` C�D � ���'-C, DATE: ��` �� ( Q
� ANP-006 2/90
v -- 3�G P
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OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIZE REAR HEIGHT LIM
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 COM . ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT ENANT IMP. ROOF 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
EBUILDING PERMIT N0. PLAN CHECK FEE REC'D RECEIPT N0.
PERMIT FEE PLAN CHECK FEE ------- PLUMBING FEE -�3'Tv� MECH. FEE ;3G � �G
TOTAL FEES SBCC SURCHARGE ENERGY SURCHARGE AMOUNT DUE ��S-. � �
BUILDING DEPARTMENT APPROVAL ----------------------------- DATE�- /( � �(�
REMARKS:
ASSIGNED ADDRESS: S �'-� �� ` (�
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
3fl�
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
__�NE 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
ECHANICAL FEE _
.OTAL BLDG. FEES
PART P/C 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 CORfiECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQ�:REMENTS WILL BE MET:
OWNER OR AGENT DATE
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