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Permit # q I - 30
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print —
BOX 1
TENANT NAME:
OWNER Dream Craft Hames MJF Hold.in s SITE LOCATION
OWNER'S ADDRESS 217 E. 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. fioldi_n s Inc. CONTRACTOR'S REG. # M JFHOI*092DA
Card MUST be presented
CONTRACTOR'S ADDRESS 217 E. Meeker _ CITy_Kent
PHONE 859-9697
EXPIRATION DATE March 1 19c!2_
OR—
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
I
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
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
BOX 6 PROPERTY TAX ACCOUNT NUMBER -
LEGALDESCRIPTION I.nt 15-Parklane_Fstates Div. 2
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7
BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 1 182 2ND
FLOOR / 453
3RD FLOOR / BASEMENT — DECK / 80
GARAGE
BOX 8
(X) SINGLE FAMILY �X) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAUINDUSTRIAL TOTAL AREA OF PROPERTY
6_0OQQSQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins) MECHANICAL APPLIANCES — BASIC FEE $
NO.---I_WATERCLOSETS GAS PIPING, FEET $
1 BATHTUBS NO.FURNACE, ELEC. GAS $ •'1 6
SHOWERS _GAS HOT WATER HEATER $ �• r
LAVATORIES CONVERSION BURNER $
4 SINKS BOILER, SIZE .. BTU $
_DISHWASHERS AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
_LAUNDRY WASHER OUTLET _UNIT HEATERS $
3 URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER _ $
DRAINS $
OTHER $
n TOTAL FIXTURES $
TOTAL MECHANICAL FEE $ Zcs' Gel
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 PERMITAPPLICATION 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 O FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE. OF THE CITY, INCLUDING.ITS
OFFICERS AND LLO , UqN TH A URACY O HE INFO TION SUPPLIED TO THE CITY�S A PART OF THIS APPLICATION.
OWNER/AGENTDATE: __&_ ,
ANP -OUB 3/90
HIM
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE)
ZONI��� SETBACKS: FRONT ��� SIDE f REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS: bC( U, 7-W
SEPA: EXEMPT. NOT EXEMPT
FIRE DEPARTMENT APPROVAL
REMARKS:
DATE
PUBLIC WORKS DEPARTMENT APPROVAL X?- DATE EZV�i 1
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 3 TYPE OF CONSTRUCTION _ �''�• STORES
BUILDING SQ. FT. „ YS'. 3 @ �,�; - ZS T
Z `~� BUILDING SQ. FT. $ -z- @
R BUILDING SQ. FT. L(17- @ `36 = 6 Z . _
IC- BUILDING SQ. FT. 0 @ _ t O = g Q o
BUILDING, SQ. FT. @
BUILDING SQ. FT. _ @ c3 f Ir' — (5-H
TOTAL SQ. FT. TOTAL VALUATION 1® 7 3-77-7 7_
BUILDING DEPARTMENT REMARKS:
RECEIVED
MAR 2 9 1991
CITY OF FEDERAL V
BUILDING DEPT.
RECEIVED
PERMIT FEE 66 a
PLAN CHECK FEE Y3 ct
PLUMBING FEE re > C'
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE ro
SEPA REVIEW
?.w. kcvl_e- . 30.00
S.B.C.C. FEE 'Sd
OTHER FEES
AMOUNT DUE ,00 < s`o two
ASSIGNED ADDRESS: 3"f YG 3 ! S • �.j
PARTIAL PLAN CHECK FEE RECEIVED
Amount 2-00 Date -1-2—F—fl� Receipt # Z� r
BUILDING DEPARTMENT APPROVAL
BY Is Z
ACCEPTED FOR FILING
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PLUMBING ROUGH IN WATERLINE O.K.DATE
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