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D d Zj v m d m D v d m �v U) O 07, Cn D O v N d Vii �c 7, H 00 z (n Ho� tij z N W 0 r O z m co :Z o W � 0 N o W v CL W CYI w CA) � -n TI N y >'< v>'< )m coo C) 3 sr r v z 13 m ic �l Perry # 9 z -,/ 01E 'je_4 RECEIVED CITY OF FEDERAL WAY � JUL3 11991 BUILDING PERMIT APPLICATION O 01TV OF FeDe iAL WAY — Please Print 61111 DING DEPT BOX 1 TENANT NAME: OWNER C�-A'" U -e iAW� � SITE LOCATION �G &0 HONE OWNER'S ADD ESS DESCRIBE JOB MW—dQ�---�37t THE PROPERTY IS OWNED BY: SINGLE/MARRIED ><' PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG. I ` ' 7 J Card MUST be resented %u CONTRACTOR'S ADDRESS ��r='� � CITY-�'i PHON EXPIRATION DATE I I ` 16J61- OR 6J1OR — 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'G S t 4G ��Gin-� PHONE -6ii `V a8"K?' BOX 4 SEWER DISTRICT � L &QAC• WATER DISTRICT �'-Af t BOX 5 ESTIMATED PROJECT COST 2a, "-7J EXISTING BUILDING VALUATION r A' BOX 6 PROPERTY TAX ACCOUNT NUMBER -0 10 1 .a LEGAL DESCRIPTION Geer- 0 1 S (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording # BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR'2Cv-3 1 1 2ND FLOOR / 3RD FLOOR / BASEMENT / DECK / GARAGES LJ BOX 8 t><SINGLE FAMILY ( )NEW CONSTRUCTION ( ) MULTIFAMILY (NO. OF UNITS = ] EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SO FT BOX 9 PLUMBING FIXTURES (including rough -ins) NICAL APPLIANC — BASIC FEE $ NO. WATERCLOSETS GAS PIPING, FEE$ BATHTUBS N0. _FULEG. GAS $ SHOWERS GATER H TER $ LAVATORIES COON U ER $ SINKS BOIZE BTU $ - DISHWASHERS .SIR HA DLI U TS Xt, $ ELECTRIC HOT WATER HEATER HESIZE $ LAUNDRY WASHER OUTLET UNERS $ _URINALS AING UNITS, SI $ DRINKING FOUNTAINS GQIAL HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS OT$ DRAINS $ OTHER $ TOTAL FIXTURES $ K'E ' ZS_ ®- TOTAL MECHANICAL FEE $ 1 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, INaWIDING THE UNDERSIGNED, AND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH UAIRAPSESOUTOFTHE C TY, INCLUDING ITS OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMA N S R J�0_Tjll CITY S �1F TH PLICATION. OWNER/AGENT: ANP -008 3/90 OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZONEF5 SETBACKS: FRONT 20' SIDE ✓C"' REAR S' HEIGHT LIMIT PLANNING DEPARTMENT APPROVALf1W Zc3 ZC° q_ -v . SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DATE REMARKS: PUBLIC WORKS DEPARTMENT APPROVAL 7�l DATE /&— A ` f ( REMARKS:._ f c nr — r•- , 1 - q z— TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT—X--NEW INDUSTRIAL IND. ADD/ALT. NEW COMMERCIAL. COMM. ADD/ALT NEW MULTIFAMILY (UNITS ) MULTIFAMILY ADD//LLT___. _ TENANT IMP. OTHER OCCUPANCY I.1 Z _ TYPE OF CONSTRUCTION PERMIT FEE STORES IV, i I,%- BUILDING SQ. FT. ZIf q @ 2 -C(O — 1 �- BUILDING SQ. FT. @ PART P/C FEE BUILDING SQ. FT. @ _ P� BUILDING SQ. FT. @ — OTHER FEES BUILDING SQ. FT. @ s_ BUILDING SQ. FT. @ O TOTAL SQ. FT. TOTAL VALUATION BUILDING DEPARTMENT REMARKS: RECEIVED JUL 31 1991 RECEIVED ASSIGNED ADDRESSr_ PARTIAL PLAN CHECK FEE RECEIVED Amount Date _ Receipt # — BUILDING DEPARTMENT APPROVAL BY 4— — — DATE 1 f'' ACCEPTED FOR FILING t6 Z PERMIT FEE PLAN CHECK FEE fo S— PLUMBING FEE Z MECHANICAL FEE TOTAL BLDG. FEES PART P/C FEE SEPA REVIEW P� S.B.C.C. FEE S � a OTHER FEES AMOUNT DUE ASSIGNED ADDRESSr_ PARTIAL PLAN CHECK FEE RECEIVED Amount Date _ Receipt # — BUILDING DEPARTMENT APPROVAL BY 4— — — DATE 1 f'' ACCEPTED FOR FILING Z o O W© I © U) Z 2 cc LU no } � z S § \ ) 2 z e § g ? m § ° o § _ S ' § = = b R z _ ) = [ = & 0 2 « � Ul S 4 w § v } Z m / 2 LL § LU o a ± § § } E \ g : LL§ c ` w oc ± 2 6 2 « d 8 $ w g # b m § / z 0- o CL CL U) D 0Cl) 2 z � w § F- CC § m m o -j eƒ O 9# w3 = Co k 7§§) § w § U & § CL LLj L § $ # w z \ k )= k k 2 S / o § § a § � ; .j ƒ LL LLI < ( CC Z CO C-) z § IL » $ X ( ( m LU w © IX 2 z w 5 ® v c J° LLJ o 9) § R cc z E o§ _ F- z z w M § < z 2\}\/ m 0 1 cc 7 § CC / \ § c k § < § a a § he j \ z ( \ Z z § § w Cl) k § c « w LUz m 6 F- § z - = E 2 § m w >- z CO § k § } k \ z§ z ) c z L ® A § § 2cc m § 6 w w z _ z _ § z d B j e LU 2 ` o 5 &( 0 § } k / J ® 2 § cc o z z $ ■ w o O 6 I � § ( z LU e w = o k ! z+= & « z G » o / $ E 2 z LL W n/ ± § ƒ w o k o ± c < j s» o o e U « o = u = o ° = z <: z g o C= _ 2 o _ � « o o g = z o> w z= o@ W E e LL_§ w LL P = w F- cc G k p ° S_ = o E 2 k e k « S E o 7 2<&� ® - mo o IL 2= w z 2 E S& E±/ Cl) 9 z r u 0 e ««_« R e m< o# = g o < > § w m= m e, o« -i o w «_ m 0 CL z� / SET BACKS AND FOOTINGS DATE _ BY ___ _ _ OX TO POUR FOUNDATION WALLS DATE __ BY PLUMBING GROUNDWORK DATE PLUMBING ROUGH IN DATE l BY� WATERLINE O.K. GAS PIPING O.K._ MECHANICAL INSPECTION DATE __. __BY O.K. TO ENCLOSE FRAMING DATE )Z��Sy _ F INSULATION DATE 3111Ao 81' _ffj WALL BOARD AND FIRE WALL DATE _8Y ' <� FINAL O.K. TO OCCUPY DATE BY DCD PSD FD