90-100427 CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G P E R M I T 941-1555
�qa 90-��o Y��
PERMIT NO. 90-592 P OWNER'S NAME BLUE RIBBON JOB ADDRESS 35313 137.'A PL Sw
CONTRACTOR INTERURBAN PLUMBING ADDRESS 36056 MILITARY � S AUBU� CONT. PHONE 838-1463
coNr. RE�. No. INTERI*204CL OWNER'S PHONE 859-0448 OWNER'S ADDRESS 27�-03 31ST AVENUE SE
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MU�TI-FAMILY (UNITS ) MULTI. ADD. SIC,N GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION MEDRONA MEADOWS LOT 36
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 5-15-90
BUILDING INFORMATION
E 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
•F3ATHTUBS �_ LAUNDRY DRAINS �— COMPRESSOR TANK(S)
SHOWERS �_ URINALS FORCED AIR FURNACE AIR HANDLING UNIT NUMBER _
LAVATORIES _�_ DRWKING FOUNTAINS GAS HOT WATER HTR. MISC. _
SIinKS __1_ MISC. BASIC FEE --2-O-�D CONVERSION BURNER BASIC FEE RETURNED __
DISHWASHERS _�_ TOTAL FIXTURES 12xS= _—F1Q_�D UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION 8O.OO
PERMIT FEE
PLAN CHECK FEE
�LUMBING FEE � (1��A�__
HANICAL FEE
AL BLDG. FEES
PART P/C FEE DATE: �� ���
SEPA REVIEW
WATER SERVICE �O�T: � `
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES RECEIPT: �� � S'
AMOUNT DUE ���
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMIT�S 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:
� s-- /�-- �'�
OWNER OR AGENT DATE
, nit # �U — S j' �, /�
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 TENANT NAME:
OWNER �L�t.�. Q.� gR�1:s SITE LOCATION 3S3t 3 �3- L. S•1-�.-
OWNER'S ADDRESS �'7 ��� � �31 S.: �.1�F - S E• CITY ���r PHONF�85�-�4�
DESCRIBE JOB I wrr �
THE PROPERTY I OWNED B . INGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME `�' �e,►-u..�-L�Q-r' P(u.�'r b�nG CONTRACTOR'S REG. # �����1- * Z(�'�C G,
Card MUST be presented ��
CONTRACTOR'S ADDRESS ���b�cP (11i I I�v� � S, CITY �-c.�-Q;�.n v` PHONE B3� " 1�-I 4�...3
EXPIRATION DATE `�./// 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 a-�� PHONE Fr�- I� �3
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST �25�`'= EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION inec�rr�rvA- wicclow 5 /r�j'� 36
(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 (x) SINGLE FAMILY ( � NEW CONSTRUCTION
( ) MULTIFAMILY (N0. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
N0. �' WATERCLOSETS I�� GAS PIPING, FEET ���� $
I BATHTUBS 1 N0. FURNACE, ELEC. GAS $
� SHOWERS 1 _-1—GAS HOT WATER HEATER $
�I LAVATORIES II I I CONVERSION BURNER $
� SINKS 1 BOILER, SIZE BTU $
�_DISHWASHERS 1 AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
�_LAUNDRY WASHER OUTLET 1 UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER_ $
DRAINS $
OTHER � C C3i' 0 A�. ' W " $
TOTAL FIXTURES ►� �S c� ' � 'r�c $
�fffl'AL"� ANICAL 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 TH!E 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: ��✓'r't!'/�i- r`�'��Y'^� l" U=�� DATE: �7 �� `��
ANP-008 3/90
CITY OF BUILDING INSPECTION
FEDERAL WAY B U I L D I N G P E R M I T 941-1555
05��
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 L�MIT _
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
�uTAI 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
- :/
\ 0 �t � O 0 � 0 (n
� j .� � D � � D C D �
t \ m r m -i m W m w
C Q O � D
� � � � T. I z I-av _ � i �T.
N � I �
� � ' � � � O � � i Z
' � ' O m t � ! p
� �� � � � C� � � �,� 2 �7
I � � ����� � ��� °
ti 3 W � W � W Z �m °
U. �' z
y � Z �'
� �(��,� +• ��, I G� i� � cn
� ��„ � �
. �^ � ` ' � '
, ; � � ! �
' \ I '
� � � �
� :
N
� t� � o fl Z G� S o O
C) D � D y D �
( _ o m c � m m �
r -D O
�` G� D � �
� � r O
�` p`� � O � � � c
� O �
\ � � � I O
N I I� � � I z
0
� � \ �� � � 'W D
� ' I � O
tF� n. , z
� � � � i � �
l� � � y
� � r
� � � I � ( I �
� � � � ' ! � I
� � �
�
� o � o � o �
\ � � p r D n -pl C
h v� \ m r m = m W
� � �i j W� � D
Z Z
♦ p n �
� Z � o I � ', �
� � � ' �
D
� Z � Oc
�` I � � I z
� -n rn �
`�^ � � � �
� ' � m � I O
� � � � � � � � W �
f � -< p -< -t
( � � � r i
� ` �
I � _ � �'+
+ � !
� I I i i\ :
_ �