96-102771go. ,.
CIT-Y OF FEDERAL WAY PERMIT NO: BLD96-0352
33530 First Way South -E".r L. D I He f" CM Pf IT ISSUED: 08/20/96
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 02/16/97
ADDRESS:29009 am AVE S
NO.: 515292-0220
PROJECT DESCRIPTION :RE-ROOF - CHANGE FFROM SHAKE TO LIGHT-WEIGHT TILE
f= OWNER CONTRACTOR LENDER
WILLIAM BEURSKINS JENSEN ROOFING COMPANY INC
20009 8TH AVE SO. 23641 7TH AVE S 118
FEDERAL WAY WA 98003 DES MOINEES WA 98198
-1652
824-6210
JENSERC053L8
Sts CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY Of FEDERAL WAY. TAX RATE :: 8.2% s**
BLD?:X NEC?: PLM?:
TYPE OF WORK:ALT USE:RES
CENSUS CATEGORY ..... :555
OCCUPANCY GROUP----------
:?
TYPE OF CONSTRUCTION--- --
:?
OCCUPANT LOAD----------- -
0: 0: 0: 0:
FLR--EXIST--PROP---
1ST.:
0:
O:Sf
2ND.:
0:
O:Sf
3RD.:
0:
0: Sf
OTHR:
0:
O:Sf
BSMT:
0:
O:Sf
DECK:
0:
O:Sf
GAR.:
0:
O:Sf
TOTL:
0:
O:Sf
DWELLING UNITS: 0
STORIES......... 0
HEIGHT.....: 0.00 ft
VALUATION ----------
EXISTA: 0
PROP ... $: 15000
RECEIVED.:08/20/96
COMP PLAN.........:?
REQUIRED PARKING..: 0
REQUIRED SETBACKS------ -
FRONT.......... 0.00 ft
SIDE........... 0.00 ft
REAR........... 0.00:ft
SPRINKLERS ?......:?
HAZARD CLASS...:?
FIRE FLOW....: 0 gpi
WATER SERVICE_:?
SEWER SERVICE..:?
IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FEES:
BUILDING PERMIT....*
SBCC SURCHARGE.....*
$ 162.00
$ 4.50
f= FUEL = TYPES.:? ===== ? FANS..........: 0 BOILERS/C=OMPRESSORS WATER = CLOSETS ...... 0 URINALS........:_
RINALS ........ 0 ----- TOTAL FEES $ 166.50
'U
AS PIPING.: 0 ft HOOD..........: 0 0-3 HP......: 0 BATH TUBS..........: 0 DRINKING FOUNT.: 0
RN<IOOK..: 0 DUCT WORK...... 0 3-15 HP...... 0 SHOWERS ............ 0 SUMPS........... 0
AS HWT .... : 0 WOOD STOVES...: 0 15-30 HP....: 0 LAVATORIES.........: 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K ..... 0 30-50 HP.... 0 SINKS .............. 0 DRAINS.........: 0
BBQ ........ • 0 MISC .......... 0 5+ HP.. 0 DISH WASHERS.. 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS-- - - - - - -- ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE......: 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS ... 0
GAS LOGS...; 0 > 10,000 CFM• 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY HE IS TRUE AND CORRECT TO THE MST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS MILL BE NET.
OWNER OR AGENT / It <_ DATE -
_4�,�JL --- L ---- ---- — ------------------------ ---
FILE COPY
YG- ia377y
CITY "I IIERM11 N0: BL 1)96--0351
335,30 Fimt Way !�(.,,)tith I HICS f1% 1,,)() 1 e)6,
Federal Way. W(I Mtkl�4 13uilcjinq IA-1SPG1Cti0() e--161 41, 4 (. i Vc 2
661-4000
AI)i*ESS:2190L)9 811-1 AVI-I'
P F� 0 3 C'. C. T 00G[fFROP
OWNER,let—g .........
WILLIAM REUPSr]Ncv
20009 8f0 AVE SO.
f[REPAL WAY WA 98003
1p
OLD":Y ME('!: PLM?., I,LP--EX1Sf--PROP--
fypf Of WORK:Alf US(:R1S 1ST.: 0a0
CENSUS CATEGORY ..... :555 2m1 + 0-sol
OCCUPANCY GROUP -- ------
TYPE or (ONSIRUCII('N-
?
OfflIPANI LOAD——— --- ..........
0: 0: 0, 0:
SNAKE 10 LIGH] -WEIGOI TILL
CORTRA(IOP LENDER
JENSEN ROOFING COMPANY 10(
23641 Ifff AVE S 118
KS MOINICS #A '18198
824-6210
JINSER053LB
wilpo&INC SUES Im FOR koilc),
S flITNIM 11L CIIY 01 FIDEWU MAY. IAX RAII. 8.2% tit
GHI
HOILEFS/00fl)PLSSORS
0-3 HP....... 0
3-15 11P.....: 0
15-30 OP—.: 0
30-SO NP..... 0
54 HP.......: 0
1`01L TANKS-- ___.___
ABOVE GROUND: 0
UNDERGROUND.: 0
�COMPIRUD PARKING. 0 PP I K L I Pli? ...... IRUILDIK PERMIT.... 162.00
S 'UR( "ARGE.
0(( 4.50
f ROH
k ?.,....... 0.00:ft SEWco I
MPLEV SURFACE: 0 sf SENSITIVE AREAS?.:?
WAILk (LOIAIS ...... 0 URINALS........: 0 16fAt fftl, 166. 51)
BA(H TUh .......... 0 DRINKING FOU"f.: 0
SHOWERS.. 0 SUMPS. 0
LAVATORIES .... .... 0 VAC EkArERQ ... 0
slus .............. 0 DRAINS.......... 0
DISH WASHERS.......: 0 LAWW:SPR.IHfi1RS: 0
LLI( WIR-O[AfIRS...: 0 01"(9 FIXIURCS.� o
LAUN WSHP OUILfS... 0
PERMITS EXPIRE, 1tw DAYS Atilt ISSUANCE It Mij K*1 IS SIAIRII-D. R1.5101.111AI. AND GRADING P11111IS EXPIRE OK YEAR Atilt DAIS Of ISSUAW-t.
I (1111fy [RAI THE 111ft"I10ll iURNISH11 By HE Is IRUI, AND (ORRECI (0 IN[ BESI Of NY KMEBU AND I111. APPI.I(ABLf (11Y I* FtDUAt MAY RtOUIRIMLVIS 4111. vt Mf1
<
OWNER OR AGENT
FIELD COPY
PIPING.:
0 ft
HOOD ..........
0
H (I Uot.
0
W.1
0
GAS HW1*....
0
WOOD STOVES...:
0
COW BURNER:
0
FUR" 1110 .....
0
800........•
0
MIS(..........;
0
GAS DRYER..:
0
AIR HANDLING UNITS
RANGE.......
0
"40.000 (Fm:
0
GAS 0GIS.. _:
0
, 10.000 (FM:
0
SNAKE 10 LIGH] -WEIGOI TILL
CORTRA(IOP LENDER
JENSEN ROOFING COMPANY 10(
23641 Ifff AVE S 118
KS MOINICS #A '18198
824-6210
JINSER053LB
wilpo&INC SUES Im FOR koilc),
S flITNIM 11L CIIY 01 FIDEWU MAY. IAX RAII. 8.2% tit
GHI
HOILEFS/00fl)PLSSORS
0-3 HP....... 0
3-15 11P.....: 0
15-30 OP—.: 0
30-SO NP..... 0
54 HP.......: 0
1`01L TANKS-- ___.___
ABOVE GROUND: 0
UNDERGROUND.: 0
�COMPIRUD PARKING. 0 PP I K L I Pli? ...... IRUILDIK PERMIT.... 162.00
S 'UR( "ARGE.
0(( 4.50
f ROH
k ?.,....... 0.00:ft SEWco I
MPLEV SURFACE: 0 sf SENSITIVE AREAS?.:?
WAILk (LOIAIS ...... 0 URINALS........: 0 16fAt fftl, 166. 51)
BA(H TUh .......... 0 DRINKING FOU"f.: 0
SHOWERS.. 0 SUMPS. 0
LAVATORIES .... .... 0 VAC EkArERQ ... 0
slus .............. 0 DRAINS.......... 0
DISH WASHERS.......: 0 LAWW:SPR.IHfi1RS: 0
LLI( WIR-O[AfIRS...: 0 01"(9 FIXIURCS.� o
LAUN WSHP OUILfS... 0
PERMITS EXPIRE, 1tw DAYS Atilt ISSUANCE It Mij K*1 IS SIAIRII-D. R1.5101.111AI. AND GRADING P11111IS EXPIRE OK YEAR Atilt DAIS Of ISSUAW-t.
I (1111fy [RAI THE 111ft"I10ll iURNISH11 By HE Is IRUI, AND (ORRECI (0 IN[ BESI Of NY KMEBU AND I111. APPI.I(ABLf (11Y I* FtDUAt MAY RtOUIRIMLVIS 4111. vt Mf1
<
OWNER OR AGENT
FIELD COPY
RALfS & FOOTTrNQs,::
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Date
By
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FOUNDATION.. llfU.$
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Date
By
f LL 1:IlIILLNG ;3RpuNt�rvltaa
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By
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UNDERFLOOR I=RAMING
Date
By
HEpR VIFALL.$
Date
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PLUMBING: ROUGIR -IN .
Date
By
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xAS PIPIK�s
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MECHANICAL. ROUGH aN
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By
(MECHANICAL (OTHeRj'
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FRAMING
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INSULATION
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GWB - 1 ST LAYER
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GWB - 2ND LAYER
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.su EWE. MV . Ell LINQ
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PLANNING::
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ENGINEER1111Is FMiAL
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By
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F..IRE 1=1NAL:
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BUILDING FINAL
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OTHER
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CDO193
PLEASE PR /NT
Name (F,M,
Address
City
Contact Per
Company Name
Address
City
is
Contact Person .
L
• P .
City of Federal Way • RECEIVE
APPLICATION FOR BUILDING PERMIT AUG 2 ^ 1996 r
yA AY
BUILDING DEPT.
APPLICATION #. v J
Address
.................
Lot # Assessor's Tax #
J
Address
0166q S 14^
State W' A Zip Phone
State Zip `% Y
Day Phone Other Phone Fax
Contractor's # (card must be presented)
State
Phone
Expiration Date
Zip
Fax
Verified ❑ Yes ❑ No
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492 (Rev 4183)
STRUCTURE
E 'ling Use —.
City
State
Zip
Permit includes: wilding ❑ Plumbing
Phone
Type of Work: W— Residential ❑ New ❑ Remodel
License #
❑ Commercial El Addition ❑ Garage
Verified ❑ Yes ❑ No
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft
Lavatories
Area Basement sq ft Decks sq ft Garage sq ft
Drains
ns
Water Availability ❑ Sewer Availability ❑ On -Site Septic System Availability ❑
Gas Hwt
Zoning I
Lot Size
Name
N
dw�nnqp.d Use
Mechanical ❑ Other
❑ Number of Units _ ❑ Deck
❑ Shed ❑ Other��E
Existing Floor Area sq ft
Proposed Total Area sq ft
Address
City r I State I Zip
Contractor Name ' n
/�—
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
P W1Nq CQNTRACTOR ...........
............ ...............................
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
KI I A-- ,
...................
Water Closets
Sinks I
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains
Other
Showers
Electric Water Heaters
Sumps
50+ Tons
Lavatories
Washing achine
Drains
ns
Fuel Tanks
M CID
Fuel Type (electric /other)
Gas Dry 4r
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
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. 1 further agree to save harmless the City of Federal Way as to any claim lincluding 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: �vt � /�,�L.f L r - Date: �/�