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SET BACKS AND FOOTINGS
DATE �� % `� 2 .BY -%` , _-_
O.K TO POUR FOUNDATION WALLS
DATE /�.'�� �Z: BY �� _
PLUMBING GROUNDWORK
DATE _BY
PLUMBING ROUGH IN
DATE Z % "i�'►-- BY OAJ--�
WATER LINE O.K. /
GAS PIPING O.K.. j ` �? �7. � �w �
MECHANICAL INSPECTION
DATE �_ ��- = BY
_
O.K. TO ENCLOSE FRAMING
DATE . r' �Z BY . LA -'V'')
INSULATION
DATE BY l��
WALL BOARD AND FIRE WALL
DATE
FINAL O.K. TO OCCUPY
` /
DATE 'Z .BY *N
UCD
PSD
FD
/✓off GCl r�
RECEIVED Permit
AUG 31 1992 CITY OF FEDERAL WAY
0"y1 1 --FF_ F_P;Ct_�!PAV BUILDING PERMIT APPLICATION
W1.01 Mr — Please Print —
BOX 1 TENANT NAME:
OWNER v3&S" E ITAGRN-P, 7VNGc SITE LOCATIONX33 - %_akVN PLA - 5 W
OWNER'S ADDRESSt 6- S I 5uARL, 44 . CITY. P�, a ,4LL+u,P PHONE 3 4S `� 6 c 1
DESCRIBE JOB MIL-- E5 ►P =nL"
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
SOX 2
CONTRACTOR'S NAME C-1116 fLTqwt�_:�T 1-1GQtTAC_C- G RouP. may►+ c- CONTRACTOR'S REG. #r)C1Z-r1414&12q6C
,89a
( ) MULTIFAMILY (NO. OF UNITS = )
Card MUST be presented
CONTRACTOR'S ADDRESS 1 Q 1 I C'4� ! f) S i = SU k}t. QO J CITY N �/NL -o F _
PHONEA' `t- $- L 4 06
SQ FT
EXPIRATION DATE a'
MECHANICAL APPLIANCES - BASIC FEE $
NO.WATERCLOSETS
-OR-
$
BATHTUBS
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. .
1 GAS HOT WATER HEATER
BOX 3
CONTACT PERSON A " Rr
PHONE -LL.._ 6 4,
BOX 4
SEWER DISTRICT G ZskA -WATER DISTRICT -❑
BOILER, SIZE BTU
BOX 5
ESTIMATED PROJECT COST .!)"1- Ion® EXISTING BUILDING VALUATION
_Q21 -
BOX 6
PROPERTY TAX ACCOUNT NUMBER - L 3 -
HEAT PUMPS, SIZE
$
LEGAL DESCRIPTION 1-0 T it30 L A - A P &'-, EC
-i wd� )N,
$
C:1 0V FC - -Mt W Pk 14 n6, Z;� D 0 --W r 0 6 h?:r)
AIR COOLING UNITS, SIZE
$
(If necessary, please submit a separate page with the legal description.)
_ _COMMERCIAL HOOD
$
K.C. Plat Recording # b "I Q tk 5 -�;L
OTHER
BOX 7
BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 1 02. 2ND
FLOOR I Wk
$
3RD FLOOR / BASEMENT I DECK /
GARAGES
BOX 8 ( ) SINGLE FAMILY
()0 NEW CONSTRUCTION
,89a
( ) MULTIFAMILY (NO. OF UNITS = )
( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES - BASIC FEE $
NO.WATERCLOSETS
GAS PIPING, FEET -� 5
$
BATHTUBS
NO. I FURNACE, ELEC.- - GAS -_L—
$
SHOWERS
1 GAS HOT WATER HEATER
$
. LAVATORIES
CONVERSION BURNER
$
�_-k 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 BREAKERS
OTHER
$
DRAINS
-
$
OTHER
-
$
-t+—TOTAL FIXTURES
$
TOTAL MECHANICAL 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 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 CIT OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLRRN THWC rl AQLQF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: �'+�,� i .MANS, a�y
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:
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
OCCUPANCY - TYPE OF CONSTRUCTION STORES
_..._ BUILDING SQ. FT........
@
BUILDING SO. FT. _
, @
_..... BUILDING SQ. FT. ..... -
@
BUILDING SQ. FT.
_ @ _
_--_ BUILDING SQ. FT.
@ _
BUILDING SQ. FT. .... _.....
@ _
TOTAL SQ. FT.
TOTAL VALUATION
BUILDING DEPARTMENT REMARKS
AUG 3 1 1992
v CF. F-FEMRA . R,,4v
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount - Date .... Receipt #
BUILDING DEPARTMENT APPROVAL
BY _...... __ DATIE
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ACCEPTED FOR FILING
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