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RECEIVED
AU6 2 0 1991
C;1_ I OF FEDERAL WAY
WILl7MIQ DEPS
BOX 1 TENANT NAME:
,ermit # /� ---
CITY
--CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION _ �' b�
— Please Print —
OWNER E); 6%,6,_ f ,4& let C. SITE LOCATION SW .1 rf�`r'' +- i�T" l.c.� S
OWNER'S ADDRESS CITY v r■ _ PHONE3'"��
DESCRIBE JOB e- _:5),A4e, �+e I)ee-
THE PROPERTY IS OWNED BY: SIN E/MARRIED PARTNERSHIP CORPORATION X
BOX 2 CONTRACTOR'S NAME s0- m e,
CONTRACTOR'S ADDRESS �0��✓✓r- r CITY
EXPIRATION DATE- (-
—OR—
CONTRACTOR'S REG.#_AEK,6',C UI- :31 i
Card MUST he presented
- PHONE
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 ?�n xiaC- 0-0--C- 11A e-- PHONE
BOX 4 SEWER DISTRICT FCW tA)O a WATER DISTRICT jfeW bOn-j
BOX 5 ESTIMATED PROJECT COST 496,7 Q EXISTING BUILDING VALUATION ZW
BOX 6 PROPERTY TAX ACCOUNT NUMBER 4 T 0 2t _X0
LEGAL DESCRIPTION L0+ ;0-2L a k-- Q a- G t
(If necessary, please submit a sep arate pa a with the legal description.)
K.C. Plat Recording # /� �9 %
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 2ND FLOOR /
3RD FLOOR / BASEMENT _I - DECK 12P 1 GARAGE--:��
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY 75�'S SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
NO. 'Z_ WATERCLOSETS
GAS PIPING, FEET -
$
7- BATHTUBS
NO, FURNACE, ELEC. . GAS_)L__
SHOWERS
I GAS HOT WATER HEATER
$
2- -LAVATORIES
CONVERSION BURNER
$
I SINKS
BOILER, SIZE 13TU
$
(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
$
/' �_06
TOTAL MECHANICAL FEE
$
CERTIFY
RTHER THAT II AM AUTHORIZED BY THE OWNER OF^THEION ABOVE PREMISES TO PFURNISHED BY MEIERFORM THE WORK FOR WHTRUE AND CORRECT TO IL}4t�1 RM T �tijST,O ,M�C� l
DGE
AND FURTHER
MADE. IFURTHER AGREE T0SAVE HARMLESS THE CITY OFFEDERAL WAY ASTOANY CLAIM (INCLUDING COSTS, EXPE{{��S,F,t ,AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAYBE MADE BY ANY PERSON, INCLUDI ' HE ONIAMIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE QF,TRE;Qlx .,' INLVDI �� lTS
OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIO,, PP ��JLATIQTfv
OWNER/AGENT:
__f DATE:
�'�®�
ANP -008 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) (];3V13*, -)3! s
ZONE, 4•L. SETBACKS: FRONT 20 SIDE 5' 92!e�REAR S ` HEIGHT LIMIT 4Q R 1 OA
PLANNING DEPART ENT APPROVAL ��fvl°i1
DER A A DI d r
: // ' -/ " ff '-& . 0/J 50_ lea, • _ _ _0 /-i �f
SEPA: EXEMPT_ NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS: _
DATE 214 ZZ/
PUBLIC WORKS DEPARTMENT APPROVAL 7TG DATE, ���p1
REMARKS: A1 c ,9.,4e 11. tlwf sf �s
*e -H A S A. f7OS o- ,,09 ■✓ . 5 ' S r¢� [ Ate' chow vae. c •9 i`z T �.� ✓cd �' 'ryr Jr � r
S i�NI I Aaf� ac c E i s//iT'Wr� .t/ -r+rrCla</
TYPE OF JOB: NEW RESIDENCE X RES.
ADD/ALT
NEW INDUSTRIAL IND. ADD/ALT
5! rfl
NEW COMMERCIAL
COMM. ADD/ALT
NEW MULTIFAMILY
/ 5�
(UN1T5 )
94,2 - 40
MULTIFAMILY ADD/ALT
—'TENANT IMP.
OTHER
OCCUPANCY
TYPE TYPE OF CONSTRUCTION
_j i3�
STORES
AMOUNT DUE'Lj
BUILDING SQ. FT.
Il 4,
@
�K
BUILDING SQ. FT.
@
_�10✓evr_�
BUILDING SQ. FT.
3`93
@
30
BUILDING SQ. FT.
@
_
BUILDING SQ. FT..
@
_
7C7 SLS
'
_BUILDING SQ. FT.
@—
TOTAL SQ. FT.
9Q -t"
TOTAL VALUATION
z94- 3 ' �3
BUILDING DEPARTMENT REMARKS:
RECEIVED
AN 2 0 '1991
g" OF DW WAY
RECEIVED
ASSIGNED ADDRESS: _ - -13 l -7
PERMIT FEE
!�� f2 -,r,
PLAN CHECK FEE T4
5! rfl
PLUMBING FEE
MECHANICAL FEE
/ 5�
TOTAL BLDG. FEES
94,2 - 40
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
zlSa
OTHER FEES
rl
AMOUNT DUE'Lj
wl
PARTIAL PLAN CHECK FEE RECEIVED
Amount Ste. 370 Date - a - 4 /Receipt #
BUILDING DEPARTMENT APPROVAL
BYDATE ZZZ
ACCEPTED FOR FILING