96-102042or- FTJ)DAL W(-)Y t,10-. M_V)96012�.I/
First Way ;otjf,h ►IT 71190266
h-,del`-�Al- Way, WA 9f.,30021 f3 LJ i]. d 13Y - 1': (, 2
4000 1.,XI[).fRL;" 01/22/97
111-700'-f-111. 0
rROMEX-1 ADDITION - ADD 195 SF -'ROOM RDDII,foil Tti. EXISTING - SIR . RESIDENCE.
OWNER (ON I RAMP LENDER
GILB19T ROTS. OWNER M CONTRACTOR
28243 281H AVE-S
FEDERAL WAY WA 900(Y3
529-4011
............
CONINKIORS. PLEASE 010CA110 CUK 10MM OLMIING SALES .16% FOR PROJECTS VIVNIN AE City oF FLKRAL WAY, IAX RAIL 8.2% sn
RLP'X NEC?, Ptm?:. 'Ex I ri - -ppop- - - boMitir, 110111,51 1 COMP PLAN FEES:
TYPE OF WOMADD M:RESISI... 195: lqs..Sf SIMIK, ...... : " PEOUIREDPARKIRG...: 2 SPRINKLERS?......:? PLAN CHECK FEE 99.45
CENSUS CATEGORY ...... :434 2ND.,, 855- 0: � f litJ01--, 11.00 It 11AZA0 CLASS BUILDING PERMIT.... 153.00
OCCUPANCY GROUP---------- 30D. 0: 0: sf VA1161 Al - X001MI J[8ALtS- I fjh . MTR_.: .0 om. SM SURCHARGE.-.-...* 1 4.50
13 :? :? 0 1 41'. 0. 4.0 t 1: 1171?
TYPE OF CONStRudlov f pf'�!P' st I FINAL PLAN cwt...'*' $ 0.00
:58 :? :? :? It, REAR �.061it SEWER
OCCUPANT LOAD---;-- 011. 4 iL'_ E I V0. :41/oull%
0: 0: 0: 0: 1 1! I_! 121w I 1110C.",V SURFACf.' 1540 Sf SC9S1TTVE-AR[AS?.:N
FUEL TYPES.:? ' ? thfis.— WATER CLOSETS......: 0 URINALS........: 0 TOTAL -FEES 1 256.15
GAS PIPING.: 0 fl: HOOD. 0 lip... 0 BATH Tugs .......... 0 DRIkING FOUNT.: 0
0 DOCT Aoki. 3=I5 0 sflokr ......... 0
)s HIT.... " 0 WOOD STOVES...: 0 15-30 up_.: 0 0 VAC fKAKIERS ... 6
1.11HY BURNER: 0 FURNMOK.....: 0 30-50 0 a 0PAMS 0
BOO......... 0 MISC..........: 0 54 HP.......: 0 DISH WASHERS........ 0 LAWN' SPRINKLE95: 0
GAS DRYER..: 0 AIR HANDLING UHIf5 FUEL TANKS------ ELIC AIR HEATERS—: b 6roco-Flyfuns.: 0
RANGE......: 0 <:10,000 CFO: 0 ABOVE Won: 0 LAUN WSHR OUILIS.... 0
GAS LOGS...: 0 > 10,000 CFO: 0 UNDERGROUND.: 0
KIMIIS EXPIRE 180 DAYS I#ILR MOAK[ IF NO VM IS STAKII[b. RESmItIAL AND mam I FwaslipmE ME YEAR Afm Mir of tssmw.
CFRIIFY fivif I K. IN 911115NED JY HE IS IRK AND CM[Cf 10 Iff KST OF- V XkktW UD FOE VEMAI. NAY REWIREKNIS HILL K 91.
I ONR OR mill
DATE ��'� �•--�
FIELD COPY
SETBACKS & FOOTINGS
Date By
FOUNDATION WALLS
Date G� By
7
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date O J % _q By Cj
SHEAR WALLS
Date By
7=
ROUGH -IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH -IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date — By
7INSULATION
Date By
GWB - 1 ST LAYER
Date Q — / ' % �P By
7
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
7
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
7
6UILDtNG FINAL
q
Date 3 B
7
OTHE
Date By
OTHER
Date By
CD0193
CITY OF FEDERAL WAY PERMIT NO. BLD96-0257
33530 Fi rst Way Soutr, �.,..I�",.».W'' W''t . "'•I'.. ISSUED: 07/26/96
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 01/22/97
ADDRESS:28243 28-H AVE 5
NO.: 111700-0110
PROJECT DESCRIPTION:SFR ADDITION - ADD 195 SF ROOM ADDITION TO EXISTING SFR RESIDENCE.
�= OWNERCONTRACTOR =_ ___ =__«-_ _=__ «»»»_�==wawa=��m LENDER
GILBERT ROTS OWNER IS CONTRACTOR
I28243 28TH AVE S
FEDERAL WAY WA 98003 j
( 529-4011 +
•_-___=_=a=ca=c=«=-==az�_�===a«»=«a»=`==a
to CONTRACTORS, PLEASE USE LOCATION CODE 1732 NNEN REPORTING SALES TAX FOR PROJECTS MITHIN THE CITY OF FEDERAL MAY. TAX RATE = 8.2% tts
BLD?:X MEC?: PLM?:
FLR--EXIST--PROP---
DWELLING UNITS: 1
TYPE OF WORK:ADD USE:RES
IST.:
985:
195:sf
STORIES..:.....: 2
CENSUS CATEGORY ..... :434
2ND.:
855:
O:sf
HEIGHT.....: 0.00 ft
OCCUPANCY GROUP----------
3RD.:
0:
O:sf
VALUATION----------
! A3 :? :? :?
OTHR:
0:
O:sf
EXIST..$: 93700
j_TYPE OF CONSTRUCTION-----
BSMT:
0:
O:sf
PROP...$: 13367
:5N :? :? :?
DECK:
0:
O:sf
¢ OCCUPANT LOAD------------
GAR.:
440:
O:sf
RECEIVED.:07/08/96
E 0: 0: 0: 0:
TOTL:
2280:
195:sf
FUEL TYPES.:? ?
FANS..........:
0
BOILERS/COMPRESSORS
GAS PIPING.: 0 ft
HOOD..........:
0
0-3 HP......: 0
1 FURN<100K..: 0
DUCT
WORK.....:
0
3-15 HP.....: 0
,1S HWT.... : 0
WOOD
STOVES...:
0
15-30 HP....: 0
COMP PLAN ......... :SFHD
REQUIRED PARKING..: 2 SPRINKLERS?......:?
HAZARD CLASS...:?
REQUIRED SETBACKS------- FIRE FLOW....: 0
FRONT.........: 20.00 ft
SIDE..........: 5.00 ft WATER SERVICE..:FED
REAR..........: 5.00:ft SEWER SERVICE..:FED
IMPERV SURFACE: 1540 sf SENSITIVE AREAS?.:N
WATER CLOSETS......:
BATH TUBS...........
SHOWERS .............
LAVATORIES..........
CONY BURNER: 0 FURN>100K..... : 0 30-50 HP....: 0 i SINKS ..............:
BBQ........ : 0 MISC..........: 0 5+ HP.......: 0 DISH WASHERS.......:
i GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ------- I ELEC WTR HEATERS...:
RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS... :
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
0
0
0
0
0
0
URINALS........:
DRINKING FOUNT.:
SUMPS...........
VAC BREAKERS...:
DRAINS..........
LAWN SPRINKLERS:
OTHER FIXTURES.:
0
0
0
0
0
FEES: 4
PLAN CHECK FEE
BUILDING PERMIT....*
gpu SBCC SURCHARGE.....*
FINAL PLAN CHECK...*
TOTAL FEES
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO NOR[ IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I -CERTIFY THAT THE IMF NISHED BY HE IS TRUE AND CORRECT TO THE REST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL NAY REQUIREMENTS HILL BE NET.
OWNER OR AGEN
-- -- ----------------------_. --..........- DATE .�
99.45
153.00
4.50
0.00
$ 256.95 1
1
eazsa--=�enn_�
0"Or G
Paw —
PLEASE PRINT
RECEIVE]
Cityof Federal Way �� �
3' ddaa_, � �
APPLICATION FOR BUILDING PERMIT cn-yot-Fi=ut�mAt-wAY'
SITE LOCATION AddressL1�j
Tenant (if known) C 1 y rb-�
. J�L,L. l.. J
Building Owner Name
d- dit.lvy�2� u �
City ,� State W
Nature of Work ItQ �yl.� t�`�:V
APPLICANT
su)Lia)N air.
APPLICATION #: Y-AD2(0— 0;57-
9 1 t-i AV- het Al Soc3
Lot # Assessor's Tax # 1 (700-0//0
Address
9 9,14 a 'TN AV M W41 VA
Zip C\ 9 0 m Phone ;; 1 4 a H
Name (F,M,L)
Address
�, q p-( mr, ,f
City r EVERA L Wy State VA Zip - 0c00�
Contact Person Day Phone r Other Phone Fax
CA QkH�- CO, 'Da) -14011
BUILDING CONTRACTOR
Company Name � 1 - - � `
Address lr IYWL
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT
Name J
nn a n
Address
City State Zip
Contact Person A C Phone I Fax
LEGAL DESCRIPTION
OA1iWi.M
1
'A �:IlI7T
ol�l►`l`��'tl+�
[I I�♦ii1:.^�y!
�1�I
`�
/]{Sl
r D, e,. A\ a �., nrr,C III' 4
A+
�� � I n
D (1 1 o�
l c W c�.�
J
�-
K 0, 1 &1 / oA4,_"
W
Please Complete_ _ReYsrse Side
CD0492 (Rev 41931
STRUCTURE
stingUse puen
oposed Use 1
Permit includes:
Building Plumbing
❑ Mechanical
V'Other
Type of Work: (Residential
❑ New ❑ Remodel
-Addition
❑ Number of Units
❑ Deck
❑ Commercial
iB ❑ Garage
❑ Shed
❑ Other
Enter 1st Floor sq ft
2nd Floor sq ft 3rd Floor sq ft
Existing Floor Area
4 sq ft
Area Basement sq ft
Decks sq ft Garage sq ft
Proposed Total Area
sq ft
Water Availability' 0"' Sewer-4vailability On Site Septic System Availability ❑
Project Valuation
$ (p @ o
Zoning < < s- ��.
Lot
Existing Bldg Valuation
$
LENDER
Lj /i G�if' 1011el,,
Name
Address
City
MECHANICAL CONTRACTOR
Contractor Name
IMA
City
Contact
License #
PLUMBING CONTRACTOR
Contractor Name
City
Contact
License #
PLUMBING FIXTURE COUNT
State
Address
State
Phone
Expiration Date
Address
State
Phone
Expiration Date
Zip
Zip
Fax
Verified ❑ Yes ❑ No
Zip
Fax
Verified ❑ Yes ❑ No
Water Closets
Sinks
Urinals
Lawn Sprinklers
Bathtubs
���
Dish Washers
Drinking Fountains -
Other
Showers
Electric Water Heaters
�—
Sumps
Lavatories
Washing Machine
,.0�
Drains Total Fixture Count
MECHANICAL UNIT COUNT
MECHANICAL VALUATION ONLY $
Fuel Type (electric/other)
Gas Dryer
Air Handling < = 10,000 CFM
15-30 Tons
Length of Gas Piping
Range
Air Handling > = 10,000 CFM
30-50 Tons
Furn <100K BTUs
Gas Log
Unit Heater
50+ Tons
Furn > 100 BTUs
Fans
Miscellaneous
Fuel Tanks
Gas Hwt
Hood
Boilers
Above Ground
Conv Burner
Duct Work
0-3 Tons
Underground
BBQ's
Wood Stoves
3-15 Tons
I Total Unit Count
DISCLAIMER: 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 undersigned, 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 employees, upon the accuracy of the information supplied to the City as a part of this
application.
Owner/Agent:
1")
�� V, p.5
51TE
SITE PLAN APPROVAL
-N 62S
Ap�--I-vcd By:
cal,mcnts:
Ll