90-101171 ,
9� � iol t7 l
CITY OF BUILDING INSPECTION
FEDERALWAY BUILDING PERMIT 941-1555
(434) INSPECTION REQUEST LINE-946-6794
PERMIT NO. 90-137H � OWNER'S NAME TDS GROUP JOB ADDRESS 35606 13 AVE SW
CONTRACTOR OWNER - TDS GROUP ADDRESS 1401 31 AVE S SEATTLE CONT. PHONE 32H-7SHO
CONT. REG. NO. NA OWNER'S PHONE S�' OWNER'S ADDRESS SAMF'
TYPE JOB: NEW RESIDENCE ADDITION XX NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING OTHER �SIDENTIAL ALTERATION
TAX ACCOUNT NO. 7137HO-O31 'rJ LEGAL DESCRIPTION ATTACHED
SUED BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 8�2 O�9 O
BUILDING INFORMATION
ZONE NA OCCUPANCY R-3 TYPE OF CONSTRUCTION S-N (DEMOLITION) BLDG. SQ. FT. NA
SET BACKS: FRONT NA SIDE NA REAR NA STORIES NA HEIGHT LIMIT 3O� MAX _
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)
SHOVt-'ERS 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 NS�I� UNIT HEATER TOTAL MECHANICAL ��. AMOUNT NONE
VALUATION $ 2,000_00 PLANNING DEPT APPROVAL: NO CHANGE IN USE/OCCUPANCY
PERMIT FEE $ 4 5_0 0 BUILDING DEPT APPROVAL: REVIN ELLI S ON 9/5/9 0
PLAN CHECK FEE 29_OO
UMBING FEE FIRE DEPT APPROVAL: NOT APPLICABLE
!CHANICAL FEE
OTAL BLDG. FEES $ 74_00 PUBLIC WORRS DEPT APPROVAL: NOT APPLICABLE
PART PIC FEE
SEPA REVIEW
WATER SERVICE C
WATER MAIN CHG. ��ry
S.B.C.C. FEE �4•5� � !j
OTHER FEES DATE PAID � AMOITNT $78.50 RECEIPT I � /
AMOUNTDUE � �IH.SO
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.�RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET: .�
OWNER OR AGENT �/ -�_ � S � 6' DATE ' �/
. � nit # �U -,�� 7�. JS��
R�C��vEn CITY OF F�DERAL WAY -
AU� 2 019�a BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME:
OWNER � r � `'— ' SITE LOCATION '- ( �
OWNER'S ADDRESS � — �s"T ;� , SD- CIT _ =� PHOJ,VE �' �
DESCRIBE JOB �� %a'i
THE PROPERTY IS OWNED BY: SIN E/MARRIED PARTNERSHIP CORPOR TION
BOX 2 CONTRACTOR'S NAME G��-' A-',���-�`S CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS CITY PHONE
EXPIRATION DATE
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON � � `1 PHONE e E /� �'�
BOX 4 SEWER DISTRICT � �' WATER DISTRICT -
BOX 5 ESTIMATED PROJECT COST ��� • EXISTING BUILDING VALUATION � �'�r
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION ��
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FL00 �"� 2ND FLOOR /
3RD FLOOR / BASEMENT / � / GARAGE /
BOX 8 (?�) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(N0. OF UNITS = ) (�L� EXISTING STRUCTURE I � �
O COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY �� � SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
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 $
�`yL$� TOTAL MECHANICAL FEE ' ��1/�g� $
�
I CERTIFY UNDER PENALTY OFPERJURY 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 ASTO 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 TH��ORM�TIOI��UPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
�� e��c'..��//
OWNER/AGENT: �1 �_ J�--_ DATE:
ANP-008 3/90
• '
- OFFICE USE ONLY(PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL ,
REMARKS: � ' � �'- �%� � a C :
,
�r-
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 NEW MULTIFAMILY ' � . (UNITS ' )
MULTIFAMILY ADD/ALT . TENANT IMP. OTHER �e-�-til ( �'( U �'�
OCCUPANCY �'� 3 TYPE OF CON� CTION �� STORES
�' i�'� BUILDING SQ. FT. `� @ �, �_ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ '�
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION .��
Zc c?C��O o
BUILDING DEPARTMENT REMARKS: PERMIT FEE �� � �' `'
PLAN CHECK FEE �� � `'�
PLUMBING FEE �l
MECHANICAL FEE L
TOTAL BLDG. FEES —{
PART P/C FEE �'
SEPA REVIEW r
S.B.C.C. FEE � '-� �'
OTHER FEES _ ��
AMOUNT DUE -� r}
ASSIGNED ADDRESS: S�'�_ � �S /C2
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt#
BUILDING DEPARTMENT APPROVAL
RECEIVED BY t—�-- DATE � � ( C' ACCEPTED FOR FILING
� �t. ' . �
SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
i -• ., , '
DATE_____ . —___—BY _— DATE _- —..%`�. BY �'��—___—. DATE �.�� �Z _ BY '�„� _
_—........ _
PLUMBING ROUGH IN WATER LINE O.K. _ .—_...—_..__—____ MECHANICAL INSPECTION
,
DATE_���` G��BY _ -��__---__ GAS PIPWG O.K.-,-��.��-L ""�-...__ DATE SL..L--G-L�_� BY��_
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE��`�1�_�Y ��L�__- DATE S^ ?7'y2___BY C�:._/�' _—__ DATE t9''���y�2 _ BY � _
d�"� �ol/Z • -
FINAL O.K. TO OCCUPY
/'�� DCD PSD FD
DATE_/..1 G��.�BY _'
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