90-100335O
2—
D
D
O �n
m�-1
**
to T
m M
-
T
c
v
5
T
m
<
�
v_ w r
Z<
w
m
g
-0
c
to !
� ��
_
�
z
0 C)
z z
p m
r
0=
rj
c
= a
O�
rn
v
m
z
c
m n
m
m a
a
r
x
z
9
m
x
m
3
m
m
a
-�
m
S
m
z
-A
x c�
�o
�0 7o v
m
mr
a
z
z
0�
x
�
D o
x
c
x
m
�
v
n
T
�{
m
3
�
m m
y
g
cn n
m m
T
m
O
z
cn M
m
cn
m
n
z
w
j
p
r m
m z
m
m
m
Z
m
m
a
T
z
m
O
z
T
9
zD
N
2
m
m
m
m
m
cn
m
cn
m
C7
m
m
U) -A
m
O
m
m
m
O
{
m
z
2
L
m
O
y
mm
U1 CJS w
Co z
m -n
mo
Oj
z m
I Zi O
�
D
'Za
>
cn
H cn In
z
n
O m
D>
m
O
C -I
ro
-n
mC
n ZT.
D
p
O
oa
2
z
m
N
-n z
X 0 O
C)
x
<
x
O
v
z
N
O
z
O 5 O
`z
2
D
H Oc
a
v
{
'Zi
v
Hm
m
z
m0Z
z�
7cn
ma
F-� m
"'
m
m
Cl)
m
m
G) z
T
M
cn
Z
��
Ln
-A
x
n
Ln o
p
O
H
��
z
p
-1
m
m
N
g
m
H
ro
H
••
O
O
a
m N
w
..
r
r
x
� G
v
a
D
_
n
r
a
O
2
p
z OO D
O
D
m
v
m
m
g
m m
Z
m
Z (n
M
O
K
Cn
n
{
Om
cC
u) rZ
70
N
x m x
m x
m
v
m
m
x
Z
m
O
O
d1 N �Zi
a
m O�
D
m
L
n
m
z
'° Z -A
m
m
r
y
z
0
im
Z
o m
I d
2
CD
D
x
cn
x c-
U)
mD=
z
m>
N i!1 Cq
m
m 70
a
m
r
D
T
W H
W
Z
`
z
O
0
m
ro n
N
o
Z
a
z ti
z
G)
m
*
m
ZD
m
� O
v
m
3
r
O a
cn m
m
D
X
O D 3
D
co
O
cn
z
-1
r n
x
D
r
~ �
Cn C�7
m
m
3
z
m
m
mO
m
m m
v
cn
z
v
D
z
m
x
a
z
O>
D
�P
r_
D
z
n
�
z
m
m
O
r-
m
m
r
a
a
0 W
O
>
D
v
p
n
3
n
8
{
7m0
D
x
m
z
W iA
M C)
n
m m
o
m
O*
y z
H
m
v
T 0
a 37
K -A
z
M
W
=
O
co
=
m
N
c D
K
Cl)
0
m
Z
o
m
r
O Fy'
D
r
c
Z
z
m
m
m
o
I
W
n
m (p
D
10
LTJ
<
'
1O
O
v
O
c
CD
v
a
o
O
W
-n0
v =i
aon
r
.ti
13
m
3
_C
r
v
cc /Z�
L /Y d
LL
cn
y O
U' m w
n W
Z
BOX 1 TENANT NAME:
F
CITY OF FEIDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
OWNER AtvM•eson &C4 n r3 E22yfl?) 51 It: LUUA I IUN -y 7 wq&je 0 w
OWNER'S ADDRESS adr_ CITY _Fnc &4e PHONE 6 y7 - 9S -33
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP— 1C CORPORATION
BOX 2 CONTRACTOR'S NAME ClMi i `11 " c CONTRACTOR'S REG. #, rgn r•r P-1 16iloA
Car MUST be presented
CONTRACTOR'S ADDRESS
EXPIRATION DATE
.57r&bO CITY PHONE�97 41.rC'Og--3
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
BOX 9 PLUMBING FIXTURES (including rough -ins)
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. .
BOX 3
CONTACT PERSON S �r�TJ��-
_ _ _ PHONE 67Y-Y12�
BOX 4 SEWER DISTRICT
WATER DISTRICT
BOX 5
ESTIMATED PROJECT COST _
EXISTING BUILDING VALUATION
BOX 6
PROPERTY TAX ACCOUNT NUMBER
— -
AIR HANDLING UNITS $
LEGAL DESCRIPTION
- —
LAUNDRY WASHER OUTLET
(If necessary, please submi a eparate page with the legal description.)
URINALS
K.C. Plat Recording # &00
DRINKING FOUNTAINS
BOX 7
BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST FLOOR / 2ND FLOOR /_
_ DRAINS
3RD FLOOR / BASEMENT _
1 DECK / GARAGE /
BOX 8
(N SINGLE FAMILY
NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = )
( ) EXISTING STRUCTURE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
( ) COMMERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY _ SO FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
NO. —.-3 _WATERCLOSETS
GAS PIPING, FEET $
'I BATHTUBS
N0. FURNACE, ELEC. GAS $ —
SHOWERS
GAS HOT WATER HEATER $ .._
LAVATORIES
CONVERSION BURNER $
SINKS
BOILER, SIZE BTU $
l 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 $
_ SLUMPS, SPRINKLER VACUUM BREAKERS
OTHER $
_ DRAINS
$
OTHER
$
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 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 EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: 1 " t--
DATE:
ANP -009 3/90
OFFICE USE ONLY (PLE=ASE DOINOT WRITE BELOW THIS LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL _
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL
DATE T
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:
RECEIVED
. ............ . ......... .
ASSIGNED ADDRESS: .
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date _ __- -- Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE
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
°
m
�
2
\
>
>
m
>
G
R
m
>
® §
$
>
»
r-
CO
)
/
#
$
)
§
§
M
«
\
=
w
c
_
=
z<
o
a>
c
w
z
*
F=
z
z=
e m
r
e=.
P
a
m
w
m
a#_
o
>
2
A t¥
3
m
=
m
A
-)§
7
c m
a
_]
z
n=__
»
n
g
e
»
o
m=
;
o
o
c
o=>
I
e-
m
a
m
m-�
z
z=
o
®
m
3=
n
z
o
R
m
e
z
o
m�
«
2
m
m
m
a
=
s°
0
9
f
§
$
z
$
§
®
\
o
@
~
§
\
)
I
m w
m®
�<»
m
m®
m
7
_
®
w>
z
z
>
z=
cn
n
o
m
m
e
m
)
/
§
m
®
p
q
/�
m
7
m
m
m
z
w
:E -4
9
K
Fm
z
)
mk
k
°
�
(
K0
7a
/
w
■
k
1
]
§ 2
\
\
-
§
/
m_
>
i
/
§
/
§
2
>
°
=
c
z®
2
5
§
z
2
k
(
_°
\
::E
)
m
§
z
m
>
>
g
G
9
CO
k
,.S
»
°
®
£
^_
\$
m
m
m
m
m
%
t
!
°
2
g
z
>
a
c
y
c
w
o
z=
o
c
_
k
§
\
§
>
r
k
2
(
/
}
2
/
}
§
c
k
W\
j
M
0
\
/
(
(
4
$
z
2 3
G
i
`
j
■
>
_ ®
(7
w
z
K
q
CD
°
)
\
§ /
k
/
U
\
`
\
9
E
)
g
\
@
)
k
m
§
_
mM
>
E
m
a
z
)
E
2/
7
§
m )
m
>
\
§
D
o
D
m
cn
S
K
AZ
z
)
)
»
§
§
k
z
k
m
>�
b
k
§
/
§
/
/
>
m
/
m 4*
3
=
v
A
o
_
/
kFn
m
§
/
§
>
(
)
o
\
m
R
°
m
K$
m
/
>
>
z
k
/
n
r
®
>
>
§
k
E
\
g
m
k
\
m
§
\
m
z
M
-n
2
m
E
0
U)
\
\
m
/
m
J
§
m
E
\
\
(
z
§
w
B
m
§>
z
K
G
2
m
§
R
(
(
R
L
Q
�
�
m
�
�
�
==I
�
_C
�
O
SET BACKS AND FOOTINGS OX TO POUR FOUNDATION WALLS
DATE- _______ BY T DATE _ _BY
PLUMBING ROUGH IN WATERLINE O.K. _
DATE _"`.BYGAS PIPING O.K.-
O.K. TO ENCLOSE FRAMING INSULATION
DATE BY _ _ DATE __. -BY
FINAL O.K. TO OC UPY
DCD PSD.
DATE�BY_
PLUMBING GROUNDWORK
DATE BY
MECHANICAL INSPECTION
DATE _BY
WALL BOARD AND FIRE WALL
DATE BY
FD