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TO OCCUPY DCD PSD Fp DATE z`yZ BY _ !, 7 92 - ;,^/ /7 -1vc1/I- U.;1, permit # f RECEIVED - FEB 18 *92 CITY OF FEDERAL WAY oor-f-�.I.:►l wP4_wAv BUILDING PERMIT APPLICATION WLDRC 9M — Please Print — BOX 1 TENANT NAME: OWNER ❑ - = GVA)UP SITE LOCATION J-Ai�b f S P -& OWNER'S ADDRESS 161k abq CITY U is &4❑(- PHONE 24 K-&40(- DESCRIBE JOB , W G \% 5 CD CA DESCRIBE THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP_ CORPORATION X BOX 2 CONTRACTOR'S NAME 0� s N 7;P �'CA-�8 Gr 'j P 7LOr • CONTRACTOR'S REG. # & 13'766 Card MUST be presented CONTRACTOR'S ADDRESS I b Jl & M!k to ST So, kA-ab`t CITY_]] Ao.u+P PHONE '� U664 EXPIRATION DATE - -OR— ZTEFINITIONS I HAVE READ CHAPTER 18.27.010 RELATI OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. _ BOX 3 CONTACT PERSON PHONE `L4k LU�- BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER \-k \ to rl 9 �, - 0 LtG - b L DESCRIPTION a� s r �� �' n r Lis• M IEG -IN Td✓V (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording # a NOI v1 � O - BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 11LQ 2ND FLOOR �sa 3RD FLOOR / BASEMENT / DECK_____J_ GARAGEI 4qle— BOX 8 (}() SINGLE FAMILY ('X} NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = _) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY S SQ FT BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE $ N0. WATERCLOSETS GAS PIPING, FEETS`A _ $ ' dQ .3 BATHTUBS N0. 1 —FURNACE, ELEC. GAS^ $ C' "CC) SHOWERS t GAS HOT WATER HEATER $ LAVATORIES CONVERSION BURNER $ SINKS BOILER, SIZE _ BTU $ DISHWASHERS AIR HANDLING UNITS $ ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $ _ 1 LAUNDRY WASHER OUTLET UNIT HEATERS $ URINALS AIR COOLING UNITS, SIZE $ DRINKING FOUNTAINS COMMERCIAL HOOD $ .SUMPS, SPRINKLER VACUUM BREAKERSOTHER ` $ _DRAINS $ OTHER $ 1� TOTAL FIXTURES $ O�T T L MECHANICAL FEE $ 1S�a 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 T ITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS OFFICERS AND ES. UPON„T,191s ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION, OWNER/AGENT: DATE: �f? \b ANP -008 3/90 OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZON L `SETBACKS: FRONT �'° SIDE REAR_ _5' HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL ,01>q REMARKS: r _ SEPA: EXEMPT LL NOT EXEMPT FIRE DEPARTMENT APPROVAL _ DATE3-1� ` 17, REMARKS: TYPE OF JOB: NEW RESIDENCE__ RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT D NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS ) MECHANICAL FEE MULTIFAMILY ADD/ALT TENANT IMP. OTHER. PART P/C FEE 12 OCCUPANCY TYPE OF DONS 1 RUCTION AI STORES a� L irc S r BUILDING SQ. FT. Ir) o @ "�� _ BUILDING SQ. FT. „ _ q 'L @ Q _ CoQ dam( BUILDING SQ. FT. BUILDING SQ. FT. @ _ BUILDING SQ. FT. BUILDING SQ. FT. @ _ . �� @ (� J TOTAL SQ. FT. TOTAL VALUATION 7(t BUILDING DEPARTMENT REMARKS: ASSIGNED ADDRESS: S I -2 S ' W, PARTIAL PLAN CHECK FEE RECEIVED Amount Date eceipt # PERMIT FEElq D PLAN CHECK FEEmS PLUMBING FEE 7o MECHANICAL FEE 'y TOTAL BLDG. FEES PART P/C FEE SEPA REVIEW a� P. e L'' e 3s S.B.C.C. FEE ISO OTHER FEES AMOUNT DUE BUILDING DEPARTMENT APPROVAL BY DATE. J I'4 q Z- ACCEPTED FOR FILING SGS 17 w I til , l vT Gvv e�r, cop -q P7 60 ARra L,, ;I , �lt-1l�lk ,sT=1.G�7F� IUAr pia. k, 1 L7 1--A -(P" A l E J'F , �P2 A�a�v SSG I a .4 ct- OD' �= f LA FVEc vett FEB 18 1992 on SWAY 1 ��