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Ri!cE!IVED
MAY 18 1999
l
CITY OF FF0SRk
eufwING DSPs AY CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 OWNED
v� �
X108 LOCATION, ZZ'
--`4-
OWNER'S ADDRESS
ME
t S`%+ " TY_ � �
PHONE ;t7
DESCRIBE JOB
BOX 6 PROPERTY TAX ACCOUNT NUMBER
THE PROPERTY IS OWNED BY: SINGLEIMARMED
PARTNERSHIP
CORPORATION
BOX 2 CONTRACTOR'S NAME
A CONTRACTOR'S
REG, #
FLOOR /
3RD FLOOR / BASEMENT /_- DECK /
GARAGE /
Card MUST be presented
CONTRACTOR'S ADDRESS 7-f;'
CITY
PHONE
EXPIRATION DATE -
f 6-9
_ .
SQ FT
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 S
- —
PHONE
BOX 4 SEWER DISTRICT —
WATER DISTRICT 4E�1_
BOX 5 ESTIMATED PROJECT COST
EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION 2
47w—
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST F 2ND
FLOOR /
3RD FLOOR / BASEMENT /_- DECK /
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)
MECHANICAL APPLIANCES — BASIC FEE $ -a-GO
;7p00
N0. WATERCLOSETS
GAS PIPING, FEET`' - _
$
BATHTUBS
NO. FURNACE, ELEC..
GAS__ __ $ 149
SHOWERS
1_—GAS HOT WATER HEATER
$ 6 3�
LAVATORIES
CONVERSION BURNER
$
SINKS
BOILER, SIZE . _ BTU $
_DISHWASHERS
AIR HANDLING UNITS
$
ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE
$
LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
._ COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
OTHER
_ $
$ .
THER _
$-
j�DINS
TOTAL FIXTURES
$
=3
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 PER-
FORM THE WORK FOR WHICH P, IT ATION IS
MADE.
��
15
OWNER/AGENT:
DATE: -
`
ANP -006 2/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT _ SIZE 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. ROOF 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
EBUILDING PERMIT NO. PLAN CHECK FEE RECD RECEIPT NO.
PERMIT FEE PLAN CHECK FEE - - - - - - - PLUMBING FEE - - - - - - - MECH. FEE
TOTAL FEES SBCC SURCHARGE _ ENERGY SURCHARGE AMOUNT DUE
BUILDING DEPARTMENT APPROVAL ------------- ------ .--- ----- DATE
REMARKS:
ASSIGNED ADDRESS:
��yo��
RECEIED
ACCEPTED FOR FILING
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SET BACKS AND FOOTINGS
DATE _ BY
PLUMBING ROUGH IN
DATE _ BY--_ _
O.K TO POUR FOUNDATION WALLS
DATE _ BY _
PLUMBING GROUNDWORK
DATE - _ _ BY
WATER LINE O.K,
GAS PIPING O.K.
INSULATION
DATE BY - - _ -
DCD PSD
MECHANICAL INSPECTION
DATE _ _ _ _BY
WALL BOARD AND FIRE WALL
DATE _ _BY
FD
O.K. TO ENCLOSE FRAMING
DATE _ _ BY _
FINAL O.K. TO OCCUPY
DATE- _ -BY-
Y_
,--10
-10 q-
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