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CO 6L LT, — I T rk i UJ -; u cN 1%2 O F-1 T 1I 71 0 s tj E Cj ?i D < j •p M x (; �j mH L ati �.a., i'1 z O 0 co q� .n fo t 1 N) Nj P- �-® ply 0 Ln N PLEASE PRINT BUILDING DIVM0N 33530 First Way South Federal Way, WA 98003 (253) 661-4000 �e A Fax (253) 661-4129 AN 19 149q APPLICATION FOR BUILDING PERMIT APPLICATION # Site address 7i () (�Alle Tenant name Lot # Assessor's Tax # Building Owner's Name I �J Address l 2(5k lP SVv City Fedeml LL4i� State zip Z PhoneDescription of Work 1 1-h ligI FA APPLICANT... - - Name (F,M,L) k Address /D U 12154 Ave SA/ Cit F State Zip3 Contact Person�/� T (w la S l Day Phone�3 �� _� Other Phone Fax J Ferieral Warm RiscinPcc Licence # Company Name Address O CityP�L State zip '1 0.2— Contact Person flevu � k Phone � tip) 8 38 —13�i 3 Fax h 64- Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No Name r, G a k-e-(� Address U -5' - Aw SW Cit ep cif State Zi v .7 Contact Person y Qi% M& Phon ?�'3) —l3� Fax LEGAL DESCRIPTION lease Com"I W Reverse Sid g Proposed Use �• Existing Use Permit includes: li� Building 17 Plumbing ❑ Mechanical ❑ Other Type of Work: Residential ❑ New Remodel ❑ of bedrooms ❑ Deck ❑ Commercial Addition ❑ Repair Ef Gara e ❑ Shed Enter 1st Floor sq ft 2nd Floor 4_ �' sq ft 3rd Floor sq ft Existing Floor Area 0 sq ft Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area ss ft Water Availabili Sewer Availability ❑ On -Site Septic System Availability 0' Project Valuation $ WOO Zoning Lot Size 16, (QC) S " _ Existing Bldg Valuation $ 02.1000 Contractor Name Address City State Zi Contact Phone Fax License # Ex -,ration Date Verified ❑ Yes ❑ No ---------------------- -------- 00'. Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No Water Closets Sinks, Urinals Lawn S rinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washin Machine Drains Total Fixture Count ;:�;.ryge• -.-='.. MECHANICAL EVALUATION ONLY $ Fuel Type (as/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 1 Above Ground Conv Burner Duct Work 0-3 Tons Under round BBQ's Wood Stoves 3-15 Tons 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 attomeys' 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 ofthe information supplied to the city as a part of this application. Owner/Agent: �� Date: GAOL. Bua Aw R[v 5ED 511 B199 SEA __AE-KING COUNTY DEPARTMENT OF PUBLIC H> �TH l ,, r,q ENVIRONMENTAL HEALTH 0 TOTAL FEE: 5125.00 APPLICATION FOR HEALTH DEPARTME APPROVAL OF BUTT DING PERAm. Submit application, route map, building permit plot plans, and other required documents in triplicate. The following must be completed and the fee must accompany this application: Note: If the property is located in unincomorated King County, make direct application to the King County Department of Development and Environmental Services. (DDES). i'roper:ies in incorporated cities apply to local building deparranerim o PROPERTY INFORMATION V**�House/Sumcture is served by an on -site sewage (septic) system Distance to the nearest public sewer 1,6 Fe -et Address of property 0 rb .2.1 S 7-1VdMt4F !;W Fe- PM -- Parcel Number (Tax Lot Account #)_ _. 26F,2 6 3 `J O 77 ' ]° Applicant's Name Afu M a Jr Day Phone a53� Applicant's mailing address Owner's Name Pe ch to i- Day Phone(4,75) .g -1 Age of house 4,q Number of existing bedrooms 3 Existing square footage of house 4170 Are additional bedrooms being constructed or. created? Description of proposed changes/remodeling (attach plot plans, showing existing structure, remodeling and septic system): Affa( hod" �'r r p�..�. v 'New square footage after construction Approximate dates septic tank was pumped (attach receipts) Additions or major landscape changes since house was constructed (examples: add family room, bedrooms, garage, patio, deck, pool, etc.; major or excavations done in landscaping): Additions or repairs to sewage system (give data and describe Other information which would be helpful in evaluating the sewage system (i.e. drainfield easements, covenants, etc. WATER SUPPLY INFORMATION Public system ( 2 or more connections) Name of public supply APPROVED �3 Date DISAPPROVED Date FOR HEALTH DEPARTMENT USE ONLY c SY: BY: Piny person aeaneved by any decision or Baal order of the Hcai i Utficer may maze written appacauon for appeal to the King County Board of Sewage Review if done so within 60 days of the above decision. Private (well, spring, etc.) Attach copies of well log, well covenants, chemical/bacterial sample reports. j Date Received Y F_ TG. 76 V III kA Yu L I IS-9.9 EASTGA, i -L ",,.,JCE CENTEV v rf-, � DEPT. C"OutqTY r- PU8L('C HEALTH ............ .............................................. ................. ............................ ENG 6X. -, L Public Health and Seattl '.ing County ` Application for Health Department Approval of Building Permit Thomas Guide Page/Loc. For houses or structures served by an on -site sewage (septic) system East Public Health Center 14350 SE Eastgate Way For DDES use Only (206) 296-4932 Application Fee: $210.00 D t R d Please submit al2plication and all support documents in triplicate The minimum support documents include: 1. detailed route map and directions to property 2. plot plan scaled at 1"=20' or 1"=30' 11 x 17 max. size, to include: ■ house footprint and any proposed changes to that footprint • location of septic tank and pump tank, drainfield and all tight sewer lines ■ location of reserve drainfield area (repair area) • all water lines and well sites, show 100ft radius around all well sites ■ location of all out buildings location of all driveways and parking areas ■ all property boundaries and easements • all streams and bodies of water 3. Floor plans of what is changing in the building 11 x 17 max. size. a e e V %1 Tracking No. Permit Tech HD Fee Collected: Yes No -H 0 j 0C Property Information Address of Prope-r0f21e�� &_ �W W _ W Lj}k Parcel No. �appficants Name VT Day Phone 3 — �� .p emts-Mafhq—Add ss X010 ?VP &SW . fll . 1,,IA- �50)3 _ Owners Name - Qeu ng Day Phone Age of House 40 t Distance to nearest public sewer Existing Square footage of house /4" f j _ - Number of existing bedrooms Square footage to be added c.2 0 . _ Number of bedrooms being added 0 Description of proposed changes _A da drzzQ Approximate dates septic tank was pumped (attach copy of receipts) Additions or repairs to sewage system (give dates and describe briefly) AX Describe or attach any drainfield easements or covenants which may impact the property WateESupplv Information Public water system (water supply with 2 of more connections) Private (well, spring, etc.) attach copies of well log, well covenants, chemical/bacteriological sample reports. For Health Department Use, Only ❑ Released Initials Date b+ - ! C Approved ? By ❑ Disapproved n;rlc y: " 'ETED ❑ Hold n:,re By: Comments/Conditions: rRR!rr*u MAR 2 3 2003 Eastgate r , Jjy 1­13ull aggi lute❑ ay ally ucL;naun or final uruer or me riezum vrncer may maze wnnen appncauon ror appeal to the &Ing county 25cwage [review Committee if done so within 60 days of the above decision date. Building Permit Application 12/99 version 4 APPROVED SEATTLE-KING COUNTY DEPT. OF PUBLIC IJEALTH EM zf;tl�v DAW Q Val 1p- .11p APPROVED SEATTLE-KING COUNTY DEFT. OF PUBLIC HEALTH DATE o!etV -1V m �° n n � Ao m -� mmo m Z r I-q �60 -6) - t} - _ � 1 4 I -W 61— —4 m it Ln i-W ig CD C= m Q CO OLI t= CD cz) =1 311, ry Ems! ys =X; YY 315 Le FF FT et Qj I FF C> 11 OD .0 cl, 7:5 70 m i, rm = . 4n O r, 72 � 4=1 it 9 rf t4 CD G t= cz, 1= r N W P C-- co ac 50 it cttP lw ac .1 171 •r-w n Lj r.7 CID xe it It ol O O p , ..0 j— r C� Cn r4- W Ln A I Lr' 1 5E:rSAGKS & FOOTINGS Date . �(j - By 34 i ;1 r �. t` u "i :1n t7 21 FOUNDATION WALLS 7 d� p `� J��Y]� ��} 1 hr" 1:7'� Date _ / By 'i�) 3 PLUMBING GROUNDWORK t"_ Date By 4 SLAB INSULATION Date By 5 FOOTING/DOWNSPOUT DRAINS Date By 6 UNDERFLOOR FRAMING Date By 7 SHEAR WALLS �j�.-i e .[ �� otrr� -G I mot,, �PLUMBING ROUGH -IN Date By =GAsING Date f.1 7-7,$Y 10 MECHANICAL. ROUGH -IN Date Z By 7MRAMING�y4 4.4 s Date(. BY rv•s, 12 INSULATION Date BY sS�u �� ' 1.tc 2 13 GWB _ 1ST LAYER e ! , LC.y ir Date �� By .S,S 14 GWB - 2ND LAYER Date By 15 SUSPENDED CEILING Date By 16 PLANNING FINAL Date By 17 PUBLIC WORKS FINAL Date By 18 FIRE FINAL Date By 19 BUILDING FINAL Date `02 7• 01 By..,4f"QC2_ 20 OTHER Date By CDO193 (Rev 4/97)