00-105908 J.
of Federal Way
Community Development Services Building - Single Family Permit #:00 - 105908 - 00 - SF
33530 1st Way S
Federal Way,WA 98003-6210 Inspection request line: 253.661.4140
Ph:253.661.4000 Fax:253.661.4129
(3:30pm cut-off for next day inspections)
Project Name: CARLSON
Project Address: 31702 5TH AVE S Parcel Number: 794170 0240
Project Description: DEMO-DEMOLITION ONLY prior to fire damage repair.
Owner Applicant Contractor Lender
Family Trust Carlson NONE NONE NONE
283 MISTYWOOD DR
COUPEVILLE WA
98239-3610 NONE NONE
Includes:
Census category: 434-Reside #1 #2 #3 #4
Occupancy Group: R-1
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.):
Census Category 434-Residential alt/add-no Mechanical No
Occupancy Group#1 R-1 Plumbing No
PERMIT EXPIRES June 4,2001,IF NO WORK IS STARTED.
Permit issued on December 6,2000
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy a•• the e will be in accordance with the laws,rules and regulations of the State of Washington and
the City of F,9 eral Way. /
Owner or agent: / Date: 42-/A)
POS IS CARD ON THE FRONT OF BUILDIO
= L BUILDING DIVISION
uv FI)' INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-661-4140
Request must be received by 3:30 PM for next day inspection
PERMIT #: 00-105908-00-SF
OWNER'S NAME: Family Trust Carlson
SITE ADDRESS: 31702 5TH S
() FOOTINGS/SETBACKS () FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
DO NOT'Potii SLAB UNTIL'11-1E ABOVE IS APPROVED
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
() ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof Floor
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS
ALL THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTIONr
() FRAMING/FIRESTOPPING
THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCKING
( ) INSULATION: Floors Walls Attic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROCK 441kAl 1
, '''
O WALLBOARD NAILING () SUSPENDED CEILING
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
() ELECTRICAL FINAL
( ) PLANNING FINAL
() PUBLIC WORKS FINAL
( ) FIRE FINAL
THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL
() BUILDING FINAL
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
—,,� • CONDUCTION PERMIT APPLICATIC
� APPLICATION NUMBER: C)0 _ / 0 Y 0 f-,$±
APPLICATION NUMBER: _ _ _ _ _- _ _
APPLICATION NUMBER: _ -._ _ _ ._
**The following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION •.
,j �y
SITE ADDRESS: Z/ 7�� !" /gl),�' ��•
ASSESSOR'S TAX/PARCEL#: 7.9 7 l 7 `- o�G 6
ONO
LEGAL DESCRIPTIaoc if.ON O SUBJE ROPER WfACH SEPARATE DESCRIPTION IF LENGTHY): 4./.2 f� f L�R'T 7,
- :.4^--f- . :.;a:PROJECT INFORMATION • _ _ .. . :
TYPE OF PROJECT(This application): 0-BUILDINGPLUMBING aftECHANICAL WDEMOLITION
L 'EtECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM /�,, �
/✓fi ,4S-J_ ,4,S"tom .aI7fr9c- s
PROJECT DESCRIPTION(Provide detailed description): F� �"
jc-iI 96e,s L) LM,b O7N (..-1 .
PROJECT NAME:
' ; , _ _ '..71 4EOPLE INFORMATION - • .
DAYTIME PHONE:
PROPERTY OWNER: NAME:
- fq/ / 4/ (i.9---/0,c) (26r) oY -9/(0-
MAILING
9/ -MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): -
NAME: / DAYTIME PHONE:
_ CONTRACTOR: / `i y�d LI_�''e---} � e / DJj)94/1
MAILING ADDRESS(STREET ADDR ,CITY,� /STATE,ZIP): /,/ EVENING PHONE:
/ y�1 ,f/ / KJ•t- 9,49e/ (AX NUMBER:)
- -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: ( ) -
CONTRACTOR'S REGISZRATLON NUMBER: EXPIRATION DATE:
1 /
l
NAME: / DAYTIME PHONE:
APPLICANT: j fit/ C S }��/� /�U (2SD) , 3f ��
MAILING ADDRESS(STRE DRESS;CITY,STATE,ZIP): EVENING PHONE:
/S/c<5'2 s ,t/u..) ,rky 4/1,„(4 £4 Roo/ ( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:G
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): (?2) `2 ki/
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
• ■ DETAILED BUILDING INFORMATION . /�•
J
EXISTING USE: i
/-��(L/ �� EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ /03' fir •
019
///' �� �Q
/n/� / PROPOSED VALUATION FOR IMPROVEMENTS: $ l(cL K/fry
PROPOSED USE: / �fJ
SPRINKLERED BUILDING? (J/YES KNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES '.2
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUUON ONLY**
NUMBER OF BEDROOM�� ESTIMATED SELLItORICE- $
• ■ PRO3ECT FLOOR AREAS -
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST 7D 7(�r�
SECOND �
THIRD
`19—
FOURTH
• OTHER FLOORS(DESCRIBE)
DECK /o }((-
GARAGE
HOW MANY FLOORS? LP///1 f
TOTAL: GGGGGG```�"
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.(
COMPRESSOR(S) FURNACE(S)
DUCTS) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLETS) SINK(S) WATER CLOSET(S) MISC.(
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,an,
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
further agree to hold harmless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees incurred in th
Investigation and defense of such daim),which may be made by any person,including the undersigned,and filed against the City o
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accurac•
of the inform :ons•.p . to the city as.a I•• : : is appli tion.
NAME TITLE: f���� � DATE: !Wee
❑ PROPERTY OWNER ❑ APPLICANT ) 1CONTRACTOR
ORYJFUCE'U.S..E,ONI (s .
i=iTNEvfmqtziti,ADDITION 1LTERJIiION 2REP„AiR A -INANTAM RROVEMENTFREEt
_CENSUSC30DE _._�_-_�._t _ _ -___ __:__ f.X0TSIZE .---:=-_....__ �-._._5_ .-..:_._. :....__ ._ :
ONII4G )ESIGNATXONIMV 2 1 -4*- i DING$HELL�ONLY CFS ANO j
=00MP.tPLAN DESIGNATIONwcgailooxiiga,-ilcqf fl-YES -- ri0
SECTION
w: 0:
R/\NGE = EW DDRESS REQUIFRED�. z�; ES x _ VO .:
k ❑ CES ANO -
�
::.. . . -_.:
WU1TrED l.OT7._ �"_!(ES NO C
fl �_ _- • i1ANGE aDF�/SE? 3
OOMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063.9718•253-661-4000•FAX:253-661-4129
4 -
Construction Permit Fe Iation Sheet
•
*******PLEASE NOTE LL FEES MUST BE VERIFIES, is 'CITY STAFF PRIOR TO ACCEPTANCE OF PAYME
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building,mechanical,and fire prevention system fees are based on the following schedule.
TABLE A
TOTAL VALUATION FEE FACTOR
(1)$1.00 to$500.00 (1)$23.50
(2)$501.00 to$2,000.00 (2)$23.50 for the first$500.00 plus$3.05 for each ad i6onal$100.00 or fraction thereof,to and Including$2,000.00
(3)$2,001.00 to$25,000.00 (3)$69.25 for the first$2,000.00 plus$14.00 for each additional$1.000.00 or fraction thereof,to and including
$25,000.00
(4)$25,001.00 to$50,000.00 (4)$391.25 for the first$25,000.00 plus$10.10 for each aorditipnaf$1,000.00or fraction thereof,to and including
$50,000.00.
(5)$50,001.00 to$100,000.00 (5)$643.75 for the first$50,000.00 plus$Z00 fix-each additional$1,000.00 or fraction thereof,to and including
$100,000.00.
. (6)$100,001.00 to$500,000.00 (6)$993.75 for the first$100,000.00 plus$5.60 for cad,additional$1.000.00 or fraction thereof,to and including
$500,000.00
(7)$500,001.00 to$1,000,000.00 (7)$3,233.75 for the fist$500,000.00 plus$4.75 for each additional$7,000.000r fraction thereof,to and including
$1,000,000.00.
(8)$1,000,001.00 and up (8)$5,608.75 for the first$1,000,000.00 plus$3.65 for each additional$1,000.00 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized,underlined number Is the fee per additional spec Pied Increment
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fire District#39 surcharge,commercial only.
Add$4.50 for WA State Building Code Council,plus$2.00 per unit for duplex&above.
**Electrical,plumbing,and mechanical fees are calculated separately**
a-BUILDING �. r
PROPOSED VALUATION: � a - d' / 2 ,S-/-C
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(OOf4MERCIAL ONLY)
/ MECHANICAL, .
PROPOSED VALUATION: f it V'
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5)
._ ./ FIRE PREVENTION SYSTEM
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
•
• - ■'PLUMBING . . .
Base Fee Number of fixtures
$21.00+{ X$7.00/fixture}= (8)Estimated Permit Fee
Estimated Permit Fee
X .65= (9)Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
Sub Total(Pageone): tine(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)= (11)