Permit M96-0121 - WINNERS RESTAURANT

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Project Name/Tenant: 1, f / , 1l, 1S t' c • >y I', r - . - t , 1 ' Descriptio9,of work to be done: A -,(, e ( ( !m( 10 ) c%;,1 , ,,. 1 ii(c. ;«<! - <<; ;. , 1 - ; Value o Construction: ', /9 9 ?. Tax Parcel Number (DatD' - I' G1aO Site Address: City State /Zip: c 1 `(C %I - )c�I),cc,J - I , 7; i',cl,.;� .. j.ik�:„,liG , ,•4 cA -/6p ' Property Owner: I'll ((�,7fric. • Phone: . .3 O ')6 Street Address: City State /Zip: 1 S a % lc, 6 111..;1 fs/ tit( 1)L /1 se- wq si c') Fax #: Contact Person: PIIe <%C../ c.:�. Phone: �f.; (- / /1, L) Street Address: / _ City State /Zip: / 1 1. : ✓J 1! . j- — A, ,. Q__. A, (.�--. r ,- ; ,..„) Lv / {4 C ,: '� `l Fax #: r () i (c.,- -- ' � Contractor: / 6 r" 4,„ -00r /)UC., (-i.�� .F /— r-=-- � // /— Phone %�� ) -- ' - / ' t :j ' l / Zip: Street Ad � City State (I /• :'_.c ..: r rr 4 - , •. /v"'3 /:• . . ( c- t�'( Fax #: .1'" 7 L .. � Z y Architect: Phone: Street Address: City State /Zip: Fax #: Engineer: Phone: Street Address: City State /Zip: Fax #: _ MISCELLANEOUS_ PERMIT REVIEW AND APPROVAL (TO BE FILLED OUT BY APPLICANT) Descriptio9,of work to be done: A -,(, e ( ( !m( 10 ) c%;,1 , ,,. 1 ii(c. ;«<! - <<; ;. , 1 - ; Will there be storage of flammable /combustible hazardous material in the building? ❑ yes no Attach list of materials and stora • e location on se • arate 8 1/2 X 11 •a • er Indica :in • • uantities & Material Safe: Data Sheets ■ Above Ground Tanks ■ Antennas /Satellite Dishes ■ Bulkhead /Docks ■ Commercial Reroof ❑ Demolition ❑ Fence .0 Mechanical ❑ Manufactured Housing- Replacement only ❑ Parking Lots ❑ Retaining Walls ❑ Temporary Pedestrian Protection /Exit Systems in Temporary Facilities (71 Tree Cutting MONTHLY SERVICE BILLINGS TO: '. Name: Phone: Address: City /State /Zip: 0 Water 0 Sewer 0 Metro 0 Standby CITY OF ''UKWILA Permit Cente) 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 Miscellaneous Permit Application Application and plans must be complete In order to be accepted for plan review. Applications will not be accepted through the mail or facsimile. APPLl CANT•REQUEST;FOR'MISCELLANEOUS PUBLIC WORKS PERMITS ❑ Channelization/Striping ❑ Flood Control Zone ❑ Landscape Irrigation ❑ Storm Drainage ❑ Water Meter /Exempt # ❑ Water Meter /Permanent # ❑ Water Meter Temp # ❑ Miscellaneous ❑ Curb cut/Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s): ❑ Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 sq. ft.grading /clearing ❑ Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Private 0 Public ❑ Street Use ❑ Water Main Extension 0 Private 0 Public Size(s): 0 Deduct 0 Water Only Size(s): Size(s): Est. quantity gal Schedule: ❑ Moving Oversized Load/Hauling WATER METER DEPOSIT /REFUND BILLING: Name: Phone: Address: City /State /Zip: Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The building official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once. Date application accepted: MISCPMT.DOC 7/11/96 q Date application expires: Appllcatlo� (Initials)