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Permi'RECEIVED
AUG � � 1991 BUILDING
OF FEDERAL WAY a'`�
BUILDING PERMIT APPLICATION y*
C'N��� �� AY —Please Print — Cy
�-5
BOX 1 TENANT NAME:
OWNER x wA 95S f A C- SITE LOCATION 4- Tn W c
OWNER'S ADDRESS I -il-7 CITY PHONE 272- o 32
DESCRIBE JOB 1L e,-0 SP�'R. 1-L G-A-rAL+f —
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION Y
BOX 2 CONTRACTOR'S NAME CONTRACTOR'S REG.
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 _7-- N`C- k• C' -A 1 4 PHONE
BOX 4 SEWER DISTRICT F -el WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 92020 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER X. F)
LEGAL DESCRIPTION Lr f �L� _ f ��c .- e -
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR_ 2ND FLOOR 72/
3RD FLOOR / BASEMENT I DECK______j_ GARAGE 'S
BOX 8 (>C) SINGLE FAMILY (,w) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) { } EXISTING STRUCTURE /
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY 7 (o SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANI AL APPLIANCES — BASIC FEE $
N0. 7-WATERCLOSETS
GAS PIPING, FEET gy
$
BATHTUBS
NO.. i_ _FURNACE, ELEC. GASB
$ 1�o
SHOWERS
I GAS HOT WATER HEATER
$
LAVATORIES
CONVERSION BURNER
$
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
$
%e roc, r r .ro
TOTAL MECHANICAL FEE
$ r'=
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO TH9 BE—,MV O �DGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APOLICATIpN IS
MADE. I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM (INCLUDING COSTS, EXPM? S, AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MANE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FI LED AGAINST THE CITY OF FEDERAL_ WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF HE'dTY', INCLUDING ITS
OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: DATE:'^
ANP -008 3
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE �`'2 SETBACKS: FRONT �` SIDE 5 REAR S HEIGHT LIMIT aA r
PLANNING DEPARTMENT APPROVAL
REMARKS:-Tp�I
SEPA: EXEMPT ✓ NOT EXEMPT
FIRE DEPARTMENT APPROVAL .L DATE �I$'I9i
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE '7110111
REMARKS: LL 6L4rd,,A7ila.4N9:;' 43e-.9i"lS fz:eor+9
%36 Gt9NN�ci,9 rV 7t/5 f�J��i..2� ✓ ��2,�s.iE/►�r Sy-�i1�v1 .17i�2L��nf D�i'�-.�T
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 R j r m/ _ TYPE OF CONSTRUCTION (f Ai STORES
iUCI
BUILDING Std. FT.
@
�d `��
_ �,rS 7 a G�
ZIJ dG;ll r _ BUILDING SQ. FT.
@
-x? . w
so
BUILDING SQ. FT. ;3 ly
@
3®
ab
BUILDING SQ. FT.
BUILDING SQ. FT.
BUILDING SQ. FT,
TOTAL SQ. FT.
BUILDING DEPARTMENT REMARKS:
f;ECGI Y LV
AUG 2 9 1g91
, V []Ir j:EaEAAL WAY
BUILDING DEPT.
RECEIVED
f7S'5.5�
TOTAL VALUATION 2U 6� • �<('
PERMIT FEES
y
PLAN CHECK FEE
f D
PLUMBING FEE
GG
MECHANICAL FEE
so
TOTAL BLDG. FEES
loc7l. 476
PART P/C FEE
SEPA REVIEW
P -LI
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS: 317 0 3 LcA
PARTIAL PLAN CHECK FEE RECEIVED
Amount - Date — y'/ Receipt # 3 5_
BUILDING DEPARTMENT APPROVAL
BY��i± F�*—E .1 SIT �� OATE I 1
ACCEPTED FOR FILING
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DATE .:/ y� BY _. /73_ DATE .� .5=..�� .BY e,4DATE -BY - -
PLUMBING ROUGH Y9 WATER LINE O.K. MECHANICAL INSPECTION
DATE_���oI .BY �.L_ _`W.._ _ . GAS PIPING O.K.------ ` �� C7�._ DATE _. _� L_�� �Z ..-- --BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE... ..�Wy/Z BY DATE �`� i`y1... BY .... _.-- DATE BY
FINAL O.K. TO OCCUPY
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