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RECEIVED 2,q fu
yp�:IF_DFRAk' JUL 23 10 CITY OF FEDERAL WAY l ■'
�I�0140de� BUILDING PERMIT APPLICATION �2
— Please Print —
BOXII OWNER _ e[ u -k_ ` G wv%5 1+4C- JOB LOCATION` 4. Veit ali�
OWNER'S ADORE 1,5 CITY ave PHON ��< $
DESCRIBE JOB cs
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME - CONTRACTOR'S REG. # X 'C ' -
Card MUST be presented
CONTRACTOR'S ADDRESS
_ __ CITY -- _ PHONE
EXPIRATION DATE-
-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 te h-- e-
PHONE_
BOX 4 SEWER DISTRICT
WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST Cr
EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER i
O
LEGAL DESCRIPTION _-Z,.� !C
(If necessary, please submit a separate page with the legal description.)
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed)
1ST FLOOR j q 2 2ND FLOOR
3RD FLOOR / BASEMENT___
DECK_____j_ GARAGE
BOX 8 (K) SINGLE FAMILY
(xy NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS= j
( ) EXISTING STRUCTURE
6702-
( ) COMMERCIAL/INDUSTRIAL
TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —BASIC FEE $
NO.^ WATERCLOSETS
GAS PIPING, FEET $--
Z BATHTUBS
NO. FURNACE, ELEC. GAS $
SHOWERS
_GAS HOT WATER HEATER $
"7- LAVATORIES
CONVERSION BURNER $
i SINKS
BOILER, SIZE BTU $
I 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 _ $
DRAINS
$
OTHER—,
- $
TOTAL FIXTURES
$--r�—
X S : '%6 e`"
TOTAL MECHANICAL FEE $ Z6
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRI1CT 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 ICP -PER ICATION IS MADE.
7ZIA;
7-2- 3
OWNER/AGENT: __
_ DATE:
ANP -006 2190
_ OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE�7•2 SETBACKS: FRONT -201 SIZEREAR 5' HEIGHT LIMIT 0 /
PLANNING DEPARTMENT APPROVAL
-, -REMARKS: ►'he4.112d
SEPA: EXEMPT NOT EXEMPT �W 2C `�O • is
FIRE DEPARTMENT APPROVAL /DATE,/l II
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL _ DATE 400*PW 7 3tV. '?/
REMARKS: LG IPuttyIN4� uT4 5007- ✓eP 0*Wy1S.AND !�h'�lnlS Fi�F� rfCG �M!'�.r2y�yctJ
s'G�F.4C�S Such .�,� 5 P J'i a S 4nrO flr tyE wrri'S, SW,4 Z Z- I3E > i er-Alri „^lh�o
e V&d �.e lT -sTU M G.p r ! a�TG d_g r gwA }gyp i aYE r"e—. qN
TYPE OF JOB: NEW RESIDENCE_ X RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY K3/p / _ _ TYPE OF CONSTRUCTION VN STORES b'Af-'
f 5r BUILDING SQ. FT./M?,. @ 90 - gelQ
G.r� _ BUILDING SQ. FT. -C'.' _ @ 12
BUILDING SQ. FT. _ _ @ -
BUILDING SQ. FT. @ - !290 G43. 20
BUILDING SQ. FT. @
BUILDING SQ. FT. @ z2L c er -
TOTAL SQ. FT. 194& TOTAL VALUATION • Y
EBUILDING PERMIT L . P CK FEE REC'D4 �1�. 5Q
� RECEIPT N0.
PERMIT FEE _.2 PLAN CHECK FEE �PLUMBING FEE—` `�`— — MECH. FEE Zt�w'
TOTAL FEES 1f_ f,a SBCC SUR—CHARGE -sa ENERGY SURCHARGE -_.0 AMOUNT DUE /D .00
BUILDING DEPARTMENT APPROVAL— - 7r `"+5-- .-------- -- DATE_
REMARKS:
ASSIGNED ADDRESS: ( 7 ZI t.]a SWe
0110
vG� A"
ED
ACCEPTED FOR FILING
1_0T 2I "MOWERA WES-r"
PLA( OF LAKOTA TRAILS PHASE 1
SEC.7 TW P. 21 RGcE 4 E. W.M.
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SET BACKS AND FOOTINGS
DATE: /J/O- BY _ -7 ....
OX TO POUR FOUNDATION WALLS
DATE BY _
PLUMBING GROUNDWORK
DATE _BY
PLUMBING ROUGH IN
DATE . 3 ��
�_�--_1 BY _ C .
WATER LINE O.K.
GAS PIPING O,K._1
MECHANICAL INSPECTION
DATE
O.K. TO E'NJCLO E FRAMING
DATE .,!!7 _BY
INSULAT%ION
DATE _._BY ._ _
WALL BOARD AND FIRE WALL
DATE BY
FINAL O.K. TO OCCUPY
DATE �7��� BY _
DCD.PSD
FD
2- 3--91
1 -,ex ale �3
.......................