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Permit #
Ay
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1 TENANT NAME:
MECHANICAL APPLIANCES — BASIC FEE $
OWNERr _ q�:F H�ldin SITE LOCATION
GAS PIPING, FEET
NO. _FURNACE, ELEC.. GAS
OWNER'SADDRESS��_iia. Meeker CITY Kent
PHONE -859-9697
DESCRIBE JOB ,New homes
$
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP. _
CORPORATION XX
BOX 2 CONTRACTOR'S NAME M.J.F. Holdinas . Inc. CONTRACTOR'S REG. # MJFHOI*092DA
4 SINKS
Card MUST be presented
CONTRACTOR'S ADDRESS 217 E. Meeker CITY Kent _ _
PHONE 8599697
EXPIRATION DATE March 1. 1992
$
—OR—
—IIEAT PUMPS, SIZE _
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. ,
UNIT HEATERS
BOX 3 CONTACT PERSON Michael j. Feuerborn
PHONE 859-9697
BOX 4 SEWER DISTRICT Federal Way - WATER DISTRICT Federal Way
BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
DRINKING FOUNTAINS
*BOX 6 PROPERTY TAX ACCOUNT NUMBER_ %G6Yq—Q / Sa — /
$
LEGAL DESCRIPTION lot 17 aarklane Estates Div.
_ _—OTHER ..
(If necessary, please submit a separate page with the legal description.)
DRAINS
K.C. Plat Recording # -
$
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 985 2ND
FLOOR 830
GARAGE l—
3RD FLOOR / BASEMENT / DECK-----/—
i_! .TOTAL FIXTURES
BOX 8 (X� SINGLE FAMILY �X) NEW CONSTRUCTION
$
( ) MULTIFAMILY (NO. OF UNITS = } ( ) EXISTING STRUCTURE
TOTAL MECHANICAL FEE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY
SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES — BASIC FEE $
NO. 3WATERCLOSETS
BATHTUBS
GAS PIPING, FEET
NO. _FURNACE, ELEC.. GAS
$ 2 C-1
$ lrj.
SHOWERS
GAS HOT WATER HEATER
$
—LAVATORIES
CONVERSION BURNER
$
4 SINKS
BOILER, SIZE BTU
$
1 DISHWASHERS
AIR HANDLING UNITS
$
ELECTRIC HOT WATER HEATER
—IIEAT PUMPS, SIZE _
$
1 LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
—COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
_ _—OTHER ..
$
DRAINS
_ _
$
OTHER
$
i_! .TOTAL FIXTURES
$
y
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 UNDERsidNED,
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 E PLOYEES, SON TH CURACY F THE INF • R ATION SUPPLIED TO TH CITY AS A PART OF THIS'APPLICATION.
40
OWNER/AGENT: DATE: ,
ANP -006 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONE 77 SETBACKS: FRONT=
PLANNING DEPARTMENT APPROVAL
REMARKS: 0,9je:i(2-
SEPA: EXEMPT_ NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:.
SIDES REAR -!5 ' HEIGHT LIMIT
DATE r- 3—
PUBLIC
—
PUBLIC WORKS DEPARTMENT APPROVAL ►� o�Nt-1 DATE 5/7/2 !
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 1�3 TYPE OF CONSTRUCTION VA/ STORES
ry �T BUILDING SQ. FT. � 3
@
__ _ L
7', L7
2," BUILDING SQ. FT. a
@
rr
_
S 7 Z 7 0
BUILDING SQ. FT. b'{
@
PART P/C FEE u�
11 072,
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
TOTAL SQ. FT.
TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
RECEIVED
MAR 2 9 1991
CiTy euOF FEDERAL EDEPT.
PERMIT FEE -7 .)
PLAN CHECK FEE V-,' Z
PLUMBING FEE -
MECHANICAL FEE 2
TOTAL BLDG. FEES /2-77
PART P/C FEE u�
SEPA REVIEW
Pw . R d 30.0 0
S.B.C.C. FEE -} 6
OTHER FEES
AMOUNT DUE Zo Aa
e
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount w— Date I ` 3-q `a ( Receipt #
BUILDING DEPARTMENT APPROVAL
BY _ DATE r _
ACCEPTED FOR FILING
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