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91-100887c r v 1� �C L1] Zr) x Z H n r m =J :D Z =A�+ z N1 y "' m ro tid m r= a 0 9 cn v D D v v v < v to m OD -Ir" v m z n n m C7 Om r ao v" c m x� Z< D p> c -mi z x v m z x Z C C m i� m m a 1 D= z 3 c x m 3 w m m D n � m m D O m C D n p n C 0 x D m< T Co Z c m Cl) m m y r C 1 0r. 3 c m m p (� n m z m z G7 O m =1 m N Z<� m P r m A m m zO x -1 N 2 m m m '" m � � z m Cl)� m n m m m U) z O _ y o~ r m r m Z Q p co CD O z 0 H� w c ~z n m 01 H N ,� ao rn H zn m V o g m D 5 m m Q p� W O` Do I--� p b „ J+r ' p n z Z z c z n c) 7 I O g � Imo+ LA Ca H T N D x v N c 4 Z vi -n p� z 7a �� z z = D D Oc D D Ov m 0 (n a' m Op m o{) _ D z D Cl) D m m m m O n n rt m cn z O O ro (D 7) z c a C A rr H H ro s x i x llq Z w t� z Z O I r Z (D:$U) i m o> CO)0 ro O O ro ro m D D a n� O x x H p r 6 oz Q Z O D O O D m m T m m 7D H (Z z. x n G) n m 70 pI O y Lij D < �x p� n o v m x m O O U) 33 p W UP N O Z � p O W H m 0 D m m n x n C c O Z-0 �! z N N x z m m r c m a z a m m C' W x d a I ~ c x D D a k cn 9 z 0 x m n W y mDm a c x Ui V8 Z o o O 3 cZi z m ►d o n �P rt z N x 0 o li -M s z z Z n N D K O o 0 H cn 0 3 -� n z m � o F- m o 3 Cr] COU7 Gam) rt,'� o o CIlo D m N F=I H --I m K a m D d x mm V � h[] Q G D n n D O (n Vii m rt cn ro r x a m a n IfC!', (� m ;U LT8 (�] 3 m m z m � Z Io m z m O y O m a z c)D p 1 c W �,"W O >O n x D �� r n m W N D r z N o T r F� Y W W mO N D r D m m O r rt 0 Y Y / C7 3 >-, y N Uoi z 0 O m "-' co 1p m y �P v m z m � E 3 m c m 0 �ro�ro ;W ° N r c m m o 9 CO v �_ N N ,�' r D a n cn a Z I m 2) pm CZi O qy p N Fy m En C I t a v }C c r v 1� �C L1] Zr) x Z H n r m =J :D Z =A�+ z N1 y "' m ro tid 1, rMit # � - Y L-& 24 'EFCEIVeD CITY OF FEDERAL WAY JUN 2 �gg� BUILDING PERMIT APPLICATION — Please Print — OWNER SITE LOCATION nlr�I.� /�Z _job OWNER'S ADDRE Cl Y_ PHONE 5.3 9' -3v�-3 DESCRIBE JOB THE PROPERTY IS O1NE0 BY: SIN LEIMARRIED PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME S CONTRACTOR'S REG. #1/2 d MUST he presented CONTRACTOR'S ADDRESS I 1. CITY. PHONE Car/- S EXPIRATION DATE Y ..-....� JR 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/]: S �� L"l7 PHONE_I��I-a BOX 4 SEWER DISTRICT WATER DISTRICT BOX 5 ESTIMATED PROJECT COST . EXISTING BUILDING VALUATION 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 FLOOR / 2ND FLOOR _ I 3RD FLOUR _I ___..._.-- BASEMENT / DECK 1 GARAGE / BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY _ SQ FT BOX 9 PLUMBING FIXTURES (including rough -ins) N0. WATERCLOSETS BATHTUBS SHOWERS LAVATORIES SINKS DISHWASHERS ELECTRIC HOT WATER HEATER LAUNDRY WASHER OUTLET URINALS DRINKING FOUNTAINS SUMPS, SPRINKLER VACUUM BREAKERS DRAINS OTHER TOTAL FIXTURES MECHANICAL APPLIANCES — BASIC FEE $ GAS PIPING, FEET $ NO_ / FURNACE, ELEC._. -GAS $ GAS HOT WATER HEATER $ CONVERSION BURNER $ BOILER, SIZE BTU $ AIR HANDLING UNITS $ HEAT PUMPS, SIZE $ UNIT HEATERS $ AIR COOLING UNITS, SIZE $ COMMERCIAL HOOD $ OTHER $ _ $ 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 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 EMPLOYES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: as WW ANP -008 3/90 OFFIG, dSE 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 SQ. FT. _ @ BUILDING SQ. FT. _ . @ — BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ — BUILDING SQ. FT. @ _ TOTAL SQ. FT. — TOTAL VALUATION -- BUILDING DEPARTMENT REMARKS: 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 ASSIGNED ADDRESS. �j PARTIAL PLAN CHECK FEE RECEIVED PL mount _ Date Receipt # BUILDING DEPARTMENT APPROVAL BY DATE _ ACCEPTED FOR FILING Z m D mm Zin m m Am c m T (mil - -Zi D (n cm m Z m0 m z c M ? 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TO ENCLOSE FRAMING DATE __ .BY ..-- -..._- INSULATION DATE - BY _ WALL BOARD AND FIRE WALL DATE FINAL O.K, TO OCCUPY DATE DCD PSD FD