19-100555RECEIVED PERMIT APPLICATION
CITY OF vo�k
FEB 01 2019 PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal WayFEB+ FAX 253-835-2609 + nerniitcentertacitvoffederal�vay.com
CITY OF FEDERAL. WAY
CO/MIMUNCTY DEVELOPMENTV
' PERMIT NUMBER _ ' `� .55,5 _ (� F TARGET DATE
SITE ADDRESS
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SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$
— —(a—> -I —+ 3 L
TYPE OF PERMITDUILDING
❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
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PROJECT DESCRIPTION
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Detailed description of work to
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be included on this permit only
NAME
JGO�4 [_.,A ti ,, l Gil U iC
PRIMARY PHONE
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PROPERTY OWNER
MAILING ADDRESS
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E-MAIL
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ZIP
8 041
NAME T Or ^1��`�
PHONE
MAILING ADDRESS
0�0
CONTRACTOR
CITY
STATE
fW' If `T
ZIP I
FAX
WA STATE CONTRACTOR'S LICEN E #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME '['`� {
t� AS ?? () CPU P � ■ ow N G?
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
APPLICANT
CITY
STATE ZIP
FAX
PROJECT CONTACT
NAME {� `�
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PRIMARY PHONE 7 7 {y 5 y
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MAILING ADDRESS
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E-MAIL
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(The individual to receive and
respond to all correspondence
CITY
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STATE
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FAX
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concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $5,000 or more
(RCW 19.2ZO95)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
(] Q
.-� DATE
SIGNATURE: IL
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PRINT NAME:
Bulletin # 100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
$ C DDID
Indicate how many 9f each type of
>rture to be installed or relocated as
art of this proLect. Do not include existingfixtures.to remain.
AIR HANDLING UNITS
10 FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
I FIREPLACE INSERTS
HOODS (Commercial)
BOILERS
I FURNACES
HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$ 0.1000
Indicate how of each type gffazure
to be installed or relocated as art
of thisproject. Do not include existi res to remain.
,_ -!X- BATHTUBS (or Tub/Shower Combo)
±h
LAVS ([sand sus)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER escnbbc)
DRAINS
Z
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
_
WATER HEATERS (Electrie)
yL HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
t Vo
0
$
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
&K K7 LOT-
l � (ZQ �)
❑ Yes No
)Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
O
0
0
J 2—+
Q
Z t32-14
.._...................................... _......... _.—......... _
_............_._................... _.._� ._
COVERED ENTRY
p
O
O
DECK
0
GARAGE>( CARPORT ❑
0
�J 1
L69
OTHER (describe)
Totals
EXISTING
0
Ti) IF/0,Area
PROPOSED
0Te)
"AI E��W��fHOMES ONLY**
ESTIMATED SELLING PRICE $ 6� 00co 1
# OF BEDROOMS 3
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
S uare Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin # 100 - January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application
BILE
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Lakeli�-,-,,�*�)lr,,�c,�--,-,oi� plt)tz�
4 WATER & SEWER DISTRICT
;Jd1LQAUW,kCATE OF AVAIVKWLFTl
Lakehaven Water & Sewer District - Development Engineering Section
31623 - 1st Ave S * PO Box 4249 * Federal Way, WA 98063-4249
Telephone: 253-945-1581 or 253-945-1580 * Email: DE@Lakehaven.org
This certificate is intended to provide the applicant, land use agencies &/or public health departments with
information necessary to evaluate development proposals. Lakehaven Water & Sewer District, at its sole
discretion, reserves the right to delay, or deny, sewer service based upon capacity &/or supply limitations
in Lakehaven's or Other Purveyor's system facilities.
Proposed Land Use: ® Building Permit-SFR ❑ Building Permit-MFR ❑ Building Permit -Other
❑ Subdivision ® Short Subdivision ❑ Binding Site Plan
❑ Rezone ❑ Boundary Line Adjustment
❑ Other (specify/describe)
Tax Parcel Number(s): 6143600440 Site Address: 3605 S 334t' St Lakehaven GIs Grid: M-10
Ex. Bldg. Area to Remain: 4738 sf New Bldg. Area Proposed: 4500 sf (9.238 total)
Applicant's Name: Igor Afichuk
SEWER SYSTEM INFORMATION
1. ® Sewer service can be provided by the existing shared service connection (SSCP #27037) located on the site and the sewer
system has the capacity to serve the proposed land use.
2. ❑ Sewer service for the site will require an improvement to Lakehaven's sanitary sewer system of:
❑ a. _ feet of " diameter sewer main or trunk to reach the site; and/or
❑ b. The construction of a sanitary sewer collection system on the site; and/or
❑ c. A major portion of Lakehaven's comprehensive wastewater system plan would need to be implemented and/or
constructed; and/or
❑ d. Other (describe):
3. ® a. The existing sewer system. is in conformance with Lakehaven's Comprehensive Wastewater System Plan.
❑ b. The existing sewer system is not in conformance with Lakehaven's Comprehensive Wastewater System Plan and an
Amendment to this Plan will be required. This may cause a delay in issuance of land use approvals or permits.
4. ® a. The proposed site land use is within the corporate limits of Lakehaven Water & Sewer District, or has been granted
Boundary Review Board approval for extension of sewer service outside of Lakehaven's sewer service area.
❑ b. Annexation or Boundary Review Board approval will be necessary to provide service.
S. Sewer service is subject to:
® a. Payment of connection charges (to be determined by Lakehaven);
® b. Proof or reservation of easement(s) as required by Lakehaven;
• ® c. Other: Sewer Service Connection Permit required, for any new/modified service connection(s).
Private Grinder Pump Agreement required.
• Comments/special conditions: The property does have an existing service (SSCP #27037). Shared service connection KCAF
20140407001127.
I hereby certify that the above sewer system information is true. This certification shall be valid for one (1) year from the date of
signature.
Name: BRIAN ASBURY
Signature:
Title: DEVELOPMENT ENGINEERING SUPERVISOR
6143600440 CoA-Sewer-2017 (Form Update 1/3/17)
PERMIT #: 19-100555-00-S
ADDRESS: 3609 S 334th ST
PROJECT: New Constructio
Date: << Z:F% Zx/1,
FEB 01 2019
CITY OF FEMRAL WAY
MMMUNIN CFWP914NT
AFICHUK
DATE: 02/01 /2019
6143600440 CoA-Sewer-2017 (Form Update 1/3/17) Page 2 of 2
Lakehaven
WATER & SEWER DISTRICT FILE
Lakehaven Water & Sewer District — Development Engineering Section
31623 — 1st Ave S * PO Box 4249 * Federal Way, WA 98063-4249
Telephone: 253-945-1581 or 253-945-1580 * Email: DE@Lakehaven.org
This certificate is intended to provide the applicant, land use agencies &/or public health departments with
information necessary to evaluate development proposals. Lakehaven Water & Sewer District, at its sole
discretion, reserves the right to delay, or deny, water service based upon capacity &/or supply limitations
in Lakehaven's or Other Purveyor's system facilities.
Proposed Land Use: ® Building Permit-SFR ❑ Building Permit-MFR ❑ Building Permit -Other
❑ Subdivision ® Short Subdivision ❑ Binding Site Plan
❑ Rezone ❑ Boundary Line Adjustment
❑ Other (specify/describe)
Tax Parcel Number(s): 6143600440 Site Address: 3605 S 334t' St Lakehaven GIS Grid: M-10
Ex. Bldg. Area to Remain: 4.738 sF New Bldg. Area Proposed: 4500 sf 238 total)
Applicant's Name: Igor Afichuk
WATER SYSTEM INFORMATION
1. ® Water service can be provided via the existing 12" diameter water main that is approximately 17 feet from the site with an
existing 1" water service #37157.
2. ❑ Water service for the site will require an improvement to Lakehaven's water distribution system of:
❑ a. feet of " diameter water main to reach the site; and/or
❑ b. The construction of a water distribution system on the site; and/or
❑ c. A major portion of Lakehaven's comprehensive water system plan would need to be implemented and/or
constructed; and/or
❑ d. Other (describe):
3. ® a. The existing water system is in conformance with Lakehaven's Comprehensive Water System Plan.
❑ b. The existing water system is not in conformance with Lakehaven's Comprehensive Water System Plan and an
Amendment to this Plan:wili be required. This may cause a delay in issuance of land use approvals or permits.
4. ® a. The subject property is within the corporate limits of Lakehaven Water & Sewer District, or has been granted
Boundary Review Board approval for extension of water service outside of Lakehaven's water service area.
❑ b. Annexation or Boundary Review Board approval will be necessary to provide service.
S. Water service is subject to:
® a. Payment of connection charges (to be determined by Lakehaven);
® b. Proof or reservation of easement(s) as required by Lakehaven;
® c. Other: Water Service Connection application required, for any new/modified service connection(s).
• Comments/special conditions: The property does have 2 existing service connections.
The nearest fire hydrant is approximately 1+ - feet from the Property (as marked on map on the back of this page).
System hydraulic model results (FF #90.1), at no less than 20 psi, indicate that Lakehaven's standard maximum allowable liquid
velocity of 10 ft/s is exceeded at a fire flow rate above 4200 GPM. This flow figure depicts the theoretical performance of the water
distribution system under high demand conditions. Fire flow rates greater than this may be accommodated through water
distribution system improvements, contact Lakehaven for additional information.
578 Pressure Zone Est. Meter Elevations)-GIS: High 414+/-, Low 410+/- Est. Pressure Range at Meter(s) (psi): Min. 68, Max. 78
I hereby certify that the above water system information is true. This certification shall be valid for one (1) year from the date of
signature.
Name: BRIAN ASB RY Title: DEVELOPMENT ENGTNEERTNG SUPERVISOR
< J
Signature: F Date:
PERMIT #: 19-100555-00 F
ADDRESS: 3609 S 334th ST FEB G 1 2019
PROJECT: New Construction
6143600440 CoA-Water-2018 (Form Update 10/24/18) AFICHUK CITY OF FECEli�lf WAY
COMMUNITY DEVELOPMENT
DATE: 02/01 /2019
6143600440 CoA-Water-2018 (Form Update 10/24/18) Page 2 of 2
LAKE HAVEN UTILITY DISTRICT
Hydraulic Model Fire Flow Estimate
Request/Reporting Form
Requested By:
KRB
Dale:
11/3/1998
Location to be Modeled: S 334th St & 3 8th Ave S
Lakehaveu'/, Section Grid:
M-10
Intersection:
S 334th St & 38th Ave S
Add. Description:
See attached map PressureZone: 578
Results By:
JCB (form update by BIA)
Date:
11/9/1998 (3/28/2013)
Model Run No.:
Master Water System Model 2007.net
Fri #90.1
Condition
Pressure (psi)
Flow (gpm)
Static
79
0
Fire Flow
20
5500
NOTES:
". Lakehaven's adopted level of service goals for fire flow rates are 1000 gpm within single
family residential areas (including duplexes) and 2500 gpm for multi -family, commercial,
industrial areas.
Model results depict the theoretical performance of the water system under high demand
conditions and are not guaranteed to represent actual system performance. A design
professional should be consulted for site specific design purposes.
The calculated fire flow capacity in the above table is based on a currently available residual
system pressure of 20 psi at the location modeled. The model indicates that Lakehaven's
standard maximum allowable velocity of 10 ftls is exceeded at a fire flow rate above 4200
gpm. Fire flow capacities greater than 4200 g1)m may be accommodated through water
system improvements.
Form Rev. 5/30/08
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