97-104015ql - MOK9 -
0
l"01 wl VLRHl I L
BUILDING FIERMI r
I' �il Vi lc� 9T1001-4 I d i ng I ri s pc`-,- f -i c,;o 1-1 (,�q ue s Us 2 5-1— 61 -414 0
-4000
1003 J()8 I thi
rwoju f)v I 1' I I ()N RES ALT REPAIR Of WAAlt DAMAGE
FOREST LAKE CONDO'S
"p, CONTRACTOR
IOLEM KOBIt 1 3 FARMAN COASIP9019"
1003 04 3"Iff Of 133 19004 4711" AVE s
FEDERAL WAY VA 98003 SCATAC WA 'Y.188
0 1.146-60,10 206-248-2003
(811witm Sal f OF f'lT Of [IRK MAY. E = 8.2%
It V:X Nt('- PLN?: f LR- AX 1�114�wp -
TYPE Or WOO US(:R(S IST.: 0 s itt BUILDING PERMIT.... S 54,00
SR 4.50
CENSUS (AltGORY—..:434 )R
cc SORCHAR�E .....
q44.0 VA' AT
OCCUPANCY
:R3 :? :? :?
TYPE OF CONSTRUCTION--- 1351ft-
:50
IT Opt At
Cwwl LOAD GAP,
0- 0: 0: 0: IJIVE AREAS?.
L TYPES.:? FANS., 0 URINALS......... 0 TOTAL FEES
PJPING.: 0 ft HOOD.....,,.. 0
0 DRINKING FOUNT.: 0
01R,mlook..: 0 tilf 1 0 ....... 0 sumps. ......... : 0
GAS 0 ;0 TOM—: 0 L' 0 VA( f9t[AXERS ... : 0
COXV BI#PH[R- 0 0-50 TON.... 0 SINKS. ........... -: 0 DRAINS.......... 0
BBQ........: 0 50f 0 DISH WASHLRS ...... 0 LAWN 991#tl.LRS- 0
GAS DRYER-. 0 e FUEL TANKS--------- ELEC NIR HEATER"...: 0 0HIR FIXTURES.: 0
R4KE ...... 0 s ANY( 6peuRD: 0 1AUN WSHR 01JILIS ... 0
0S LOGS.. 0 M. 0 UNDERGROUND.: 0
-'=' ... =,-1 V
PIMITS LXPIK 190 DAri Rf Ito aIt III) wRf IS StAR110. RlslefliflAt 01 W�Olm f4ft"lls LIPIRF ON! YEW Aflfl "Ir Of Issum.
I (L-1.1ify IN] jut Imoklifil dkki'AD py Nf Is ]Rot fto toRat(l to IN! RES( of MY (11011t[Ml. AP 101. AllniCiAl (ITY 1 fiDt'944. V0 MOIRENEVIS VILL K IK).
04HER OP. AG(3T DATE
FIELD COPY
CDO193 (Rev 4/97)
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CDO193 (Rev 4/97)
BUILDING DI'VISION
C"''OF G 33530 First Way South
Federal Way, WA 98003
(253) 661-4000
Fax (253) 661-4129
Mi
CITY OFI FEDERAL
DEPAY APPLICATION FOR BUILDING PERMIT
BUILPLEASE PR/NT APPLICATION #
»: Address
Tenant (if known) Lot # Assessor's Tax #
-�( e i-)
Buildin Ow is Name / Address
Z' tti>�G` • '�L c��lr=�i"�:� �. / %!1 C) )Fi r3-( -�// S,( �C>
Cit—?4j 24Z State Lt/
Nature of Work
Name (F,M,L)
'
I C & QCCi
Address
City
State (/,)
Cit
Contact Person
t` S k?a
hone
�� c_J 2 y 8-Z v v
State
Zi
Co tact Parse nCu
� r (t'L, l
Verified ❑ Yes ❑ No
Da�P`one
_ J
�o
Other Phone
Fax
I..:..:. NCS: CtIITFiTR
Comp anNam
'
Address
1 C) v S
State
City
State (/,)
Zip CIFY Fol
Contact Person
t` S k?a
hone
�� c_J 2 y 8-Z v v
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
R..: kf i G .....::.::::::.::::.::::::::.:::::::.::::::.::::::::::.
Name
Address
City
State
Zi
Contact Person
Phone
Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
........................
.......f...................:..................................
.:::::.:::::::.
::>:
......... ....
luting Use
State
posed se
Contact
Permit includes:
Fax
G1 Building
❑ Plumbing
❑ Mechanical
❑ Other
Type of Work:
•❑ Residential
❑ Commercial
❑ New
❑ Addition
❑ Remodel
❑ Garage
❑ Number of Units 1
❑ Shed
❑ Deck
❑ Other
Enter 1st Floor
Area Basement
sq ft
sq ft
2nd Floor
Decks
sq ft 3rd Floor sq ft
sq ft Garage sq ft
Existing Floor Area sq ft
Proposed Total Area > sq ft
Water Availability
❑ Sewer Availabilit
❑ On -Site Septic System Availability ❑
Project Valuation
$ Z l
Zonina
Conv Burner
Lot Size
0-3 Tons
Existing Bldg Valuation
S
Name I Address
Citv State
........................................................................................
...........................................................................................
............................................................................................
...........................................................................................
............................................................................................
N.
1D T
................................................. ...... .... .................
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
...........................................................................................
............................................................................................
...........................................................................................
............................................................................................
...........................................................................................
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
............................................................................................
.................................................................
............................................................................................
............................................................................................
............................................................................................
...........................................................................................
............................................................................................
...........................................................................................
............................................................................................
...........................................................................................
k1#IC'l)NI ('(J#
......................................:....:..............:................................
Water Closets
Sinks
Urinals Lawn Sprinklers
Fuel Type (electric/other)
Bathtubs
Dish Washers
Drinking Fountains Other
Showers
Electric Water Heaters
Sumps
30-50 Tons
Lavatories
Washing Machine
Drains Total Fiatture;C�iunt
Unit Heater
50+ Tons
...........................................................................................
............................................................................................
...........................................................................................
............................................................................................
...........................................................................................
k1#IC'l)NI ('(J#
......................................:....:..............:................................
MECHANICAL EVALUATION 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
Total. Unit C66.
DISCLAIMER: I certify under penalty of perjury that the information fumished 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 of the information supplied to the city as a part of this application.
Owner/Anent: `" tom I ZccX,�, Date: _ /(" / S C) / 9
BN DING. AP
Ren 6/26197
(-ITY OF FEDERAL. WAY � � y PERMIT NO: BLD97-0651
33530 Firs t Way South . ' �,..,� .»�.. !L... ,.; h .,,If,. II""� �., ;ai 11�;) w,. II"'�, 'w"' „N�. ,..u,.,. ISSUED: 10/8 Q/97
Federal Way, WA 98003 Building Inspectipn Requests 253-661-4140 BY: FC2
253-661-4000 EXPIRES: 04/28/98
ADDRESS:1003 S 308TH ST Unit: 33
NO.: 259550--0330
PROJECT DESCRIPT'ION:RES ALT - REPAIR OF WATER DAMAGE
FOREST LAKE CONDO'S
= OWNER ____________________:__________._________::___-__-=_= CONTRACTOR
HELEN KUBIK T J FARNAM CONSTRUCTION
1003 S 308TH ST #33 19004 47TH AVE S
FEDERAL WAY WA 98003 SEATAC WA 98188
46-6030
206-248-2003
TJFARC*178J6
LENDER
*** CONTRACTORS, PLEASE USE LOCATION CODE 2732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.2% ***
BLD?:X MEC?: PLM?:
TYPE OF WORK:ALT USE:RES
CENSUS CATEGORY ..... :434
OCCUPANCY GROUP ----------
:R3 :? :? :?
TYPE OF CONSTRUCTION -----
:5N :? :? :?
OCCUPANT LOAD ------------
0: 0: 0: 0:
FUEL TYPES.:? ?
0PIPING.: 0 ft
N<100K..: 0
GAS HWT....: 0
CONV BURNER: 0
BBQ......... 0
GAS DRYER..: 0
RANGE......: 0
GAS LOGS...: 0
FLR--EXIST--PROP---
1ST.:
0:
O:sf
2ND.:
0:
O:Sf
3RD.:
0:
630:sf
OTHR:
0:
O:Sf
BSMT:
0:
O:Sf
DECK:
0:
O:Sf
GAR.:
0:
O:Sf
TOIL:
0:
630:sf
FANS.........., 0
HOOD,,......... 0
DUCT WORK—'-: 0
WOOD STOVES...: 0
FURN>10OK.....: 0
MISC........... 0
AIR HANDLING UNITS
<:10,000 CFM: 0
> 10,000 CFM: 0
DWELLING UNITS: 0
STORIES......... 0
HEIGHT.....: 0.00 ft
VALUATION ----------
EXIST..$: 0
PROP ... $: 2878
RECEIVED.:10/30/97
BOILERS/COMPRESSORS
0-3 TON...... 0
3-15 TON....: 0
15-30 TON...: 0
30-50 TON...: 0
50+ TON...... 0
FUEL TANKS ---------
ABOVE GROUND: 0
UNDERGROUND.: 0
COMP PLAN.........:?
REQUIRED PARKING..: 0
REQUIRED SETBACKS -------
FRONT ... ...... . 0.00 ft
SIDE........... 0.00 ft
REAR........... O.00:ft
SPRINKLERS?....- :?
HAZARD CLASS...:?
FIRE FLOW....: 0 gPm
WATER SERVICE..:?
SEWER SERVICE..:?
IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
WATER CLOSETS......:
0
URINALS........: 0
BATH TUBS...........
0
DRINKING FOUNT.: 0
SHOWERS......... .
0
SUMPS........... 0
LAVATORIES.........;
0
UAC BREAKERS...: 0
SINKS ...............
0
DRAINS.......... 0
DISH WASHERS.......;
0
LAWN SPRINKLERS: 0
ELEC WTR HEATERS...:
0
OTHER FIXTURES.: 0
LAUN WSHR OUTLTS...:
0
FEES:
BUILDING PERMIT....*
SBCC SURCHARGE....,*
TOTAL FEES
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 ME /IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT `�^' ----� �%?!.1------------------ /
DATE
FILE COPY
$ 54.00
$ 4.50
$ 58.50