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SET BACKS AND FOOTINGS OX TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE 2-1"'2-S;2� BY � DATE _ �y-12 BY . -. DATE
- - BY
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE �2._gy GAS PIPINGO.K..-'- Z-%� DATE _�--�Z___gy
O.K. TO ENCLOSE FRAMING INSULATION l WALL BOARD AND FIRE WALL
DATE �.,/ry._BY - DATEBY �l DATE -__G' -z.
- —__eY--
FINAL O.K. TO OCCUPY
DCD :�[PSD FD
DATE 5 y2 BY 1Z i
n
Permit # Ale
Ft -7 CITY OF FEDERAL WAY y o/ a
'IAN 1 51992 BUILDING PERMIT APPLICATION `S 1 -Is 9 2-
1wN Please Print
BOX 1 TENANT NAME:
OWNER 4- . JA0ZSITE LOCATION CA
OWNER'S ADDRESS S -r- IK4 - &7.1rea* CITY- .&LSP 1553 .PHONE 8A I
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SI GLE/MARRIED PARTNERSHIP _ CORPORATION
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. #.
q Card MUS be presente
CONTRACTOR'S ADDRESS liy% '9, M&A ST. V41A� __ CITYE LAAAf &n2,,PHONE��'I- �yG7
EXPIRATIONDATE
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 2659 &WA
BOX 4 SEWER DISTRICT L, WATER DISTRICT FM91M2.,
BOX 5 ESTIMATED PROJECT COST 0 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER 41
LEGAL DESCRIPTION Lt77r
(If necessary, please
K.C. Plat Recording #
�Itty
legal description.)
BOX 7. BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR /1tA4 2ND FLOOR k
3RD FLOOR / BASEMENT / DECK 1_ GARAGE 1 46d
BOX 8 (y() SINGLE FAMILY (X) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = } ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY _ & ;i SQ FT
BOX 9 PLUM NG FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
NO. WATERCLOSETS
GAS PIPING, FEET �' i S $ •Qd
BATHTUBS
NO. FURNACE, ELEC. GASB_ $ 16 .00
SHOWERS
GAS HOT WATER HEATER $ o
LAVATORIES
CONVERSION BURNER $
_SINKS
_BOILER, SIZE BTU $
I DISHWASHERS
AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE $
WASHER OUTLET
UNIT HEATERS $
_LAUNDRY
URINALS
AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS
COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER $
DRAINS
— $
OTHER
$
TOTAL FIXTURES
$
S-
TOTAL MECHANICAL FEE $ r r
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 PERMITAPPLICATION 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 EMPLOY UPON TSI CURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART 0'1115 APPLICATION..
a rj
OWNER/AGENT:
DATE: '- 1
ANP -008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE -2— SETBACKS: FRONT SIDE 5� REAR `' HEIGHT LIMIT 36
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPkEXEMPT' ✓� NOT EXEMPT
FIRE DEPARTMENT APPROVAL DAT
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE/ Z
REMARKS:. GwnC.oc _ k^p d",.Ai &,d dant► rnn. C 0 n.,. 1�.a91 10_ z. t'
Slur Ac t V.. -we
TYPE OF JOB: NEW RESIDENCE. "( _ RES. ADD/ALT NEW INDUSTRIAL-• IND. ADD/ALT.i
NEW COMMERCIAL . COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY A3Li u _ TYPE OF CONSTRUCTION _LZ&' STORES
1 st 'Caa,* BUILDING SQ. FT. @ q cr 66
.N9 .f BUILDING SQ. FT. @ 63F,2-77. zo
BUILDING SQ. FT. Eft_ @ / `$'• 3D _`�_��3�f S • 00
BUILDING SQ. FT. @
BUILDING SQ. FT, @ 82 1
BUILDING SQ.'FT. @ >Mc�+�rt�✓ ,� $�' _
01sya
TOTAL SQ. FT.
BUILDING DEPARTMENT`REMARKS:
i qa k Lae.i S G C j4VpLL4 t peQvirec�
1 [.( L k L LA LV C tAWLL, Q KvOe ,vf-A
'RECRI Y ED
JAN 15 1992
'9r 00`''60ERALWAY
%Ls6 wow p.PT.
RECEIVED
TOTAL VALUATION 13 1 q 13 , I, S
PERMIT FEE
7s"z_
PLAN CHECK FEE
v`+:;27• 00
PLUMBING FEE
Zo- Q
MECHANICAL FEE
g- D
TOTAL BLDG. FEES
57.
PART P/C FEE
'- -
SEPA REVIEW
°
%�wr. �`e e
3S�•co
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS: '511 2-7 1 Z _ . • LA)
PARTIAL PLAN CHECK FEE RECEIVED
Amount 5_� Date _ _�— �S' �2 Receipt # . `1473
BUILDING DEPARTMENT APPROVAL
BY DATE
ACCEPTED FOR FILING