96-10141394, -/o
CITY OF FEDERAL WAY PERMIT NO: BLD96-0191
385 0 First Way South'" �►a-!N' '' ' ;, ? �'�'C'Sk "I. ISSUED: 08/06/96
Federal Way, WA 98008 Buil.dirig Inspection Requests 661.--4140 BY: FC
661.--4000 EXPIRES: 08/06/97
ADDRESS:82.5 S :308 f ll S f
NO.: 082104--9066
PROJECT DESCRIP l'ION:NSF
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JUAN BERGRUD & PAULINE
2722 HIGHLINE PL HE
TACOMA WA 98421
W/PLUMBING AND MECHANICAL.
Waaaaaaa»aaa==aa»»aaxxga CONTRACTOR--aaaaa_a
SIGNATURE HOMES, INC
14040 NE 181ST ST'
WOODINVILLE WA 98072
206-486-1700
SIGNAHI053K2
LENDERa_a_-----_a_____a_aa»a»aaaaaa»:=aaaaxx»xxaaaax=T
BERGRUD
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US CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.2t t##
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BLD?:X MEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN ......... :SFHD ( FEES:
TYPE OF WORK:NEW USE:RES 1ST.: 0: 1200:sf STORIES........: 2 REQUIRED PARKING..: 2 SPRINKLERS?......:? PLAN CHECK FEE $ 499.85
CENSUS CATEGORY ..... :101 2ND.: 0: 689:sf HEIGHT.....: 0.00 ft HAZARD CLASS...:? ( BUILDING PERMIT.... $ 769.00
OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION---------- REQUIRED SETBACKS------- FIRE FLOW....: 0 gpm Mechanical Permit* $ 63.00
:R3 :U1 :? :? OTHR: 0: O:sf EXIST..$: 0 FRONT.........: 20.00 ft PUB WKS PLCK(SF)..93 $ 40.00
TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP ... $: 136391 SIDE..........: 5.00 ft WATER SERVICE..:FED SBCC SURCHARGE.....* $ 4.50
:5N :5N :? :?DECK: 0: O:sf REAR..........: 5.00:ft SEWER SERVICE..:FED { SCH IMPACT (SFR) $ 1707.00
f OCCUPANT LOAD------- - GAR.: 0: 400:sf RECEIVED.:05/23/96 PLUMBING FIXT.... 93* $ 98.00
0: 0: 0: 0: TOTL: 0: 2289:sf IMPERV SURFACE: 3923 sf SENSITIVE AREAS?.:N FINAL PLAN CHECK...* $ 0.00
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FUEL TYPES.:GAS FANS..........: 0 BOILERS/COMPRESSORS WATER CLOSETS......: 3 URINALS........: 0 TOTAL FEES $ 3181.35
GAS PIPING.: 99 ft HOOD..........: 1 0-3 HP......: 0 BATH TUBS..........: 1 DRINKING FOUNT.: 0
L RN<100K..: 1 DUCT WORK.....: 0 3-15 HP.....: 0 SHOWERS ............: 1 SUMPS..........: 0
HWT....: 1 WOOD STOVES...: 0 15-30 HP....: 0 LAVATORIES.........: 4 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K.....: 0 30-50 HP....: 0 SINKS ..............: 3 DRAINS.........: 0
BBQ........: 1 MISC..........: 0 5+ HP.......: 0 DISH WASHERS.......: 1 LAWN SPRINKLERS: 0
GAS DRYER..: 1 AIR HANDLING UNITS FUEL TANKS--------- ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
J RANGE......: 1 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 1
{ GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0 {gj
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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 TME BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE NET.
OWNER OR AGENT
DATE ^'
FILE COPY
G • City of Federal Way •
•
APPL IV/ BUILDING PERMIT
PLEASE PRINT A�d-i L WAY APPLICATION #: } p Q
87 V
SITE LOCATION Address-;;,..-
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Tenant (if known) Lot # Assessor's Tax #
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./ Building Owner Name Address
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City C State Zip Phone
Nature of Work 0--- i
Allo -Ml.
Name (F,M,L)
St J o 14 C
Address _
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City w 0 State zip C?gC;? `? Z
Contact Person Day Phone Other Phone Fax
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Company Name
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Address
/L C�
City Ccs ; h ie
Con act Person
j C
Contractor's ##lam (card must be presented)
State
Ph ne
Expiration Date
9X-
zip
Fax
_y 53 --,5 aK
Verified ❑ Yes ❑ No
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492 (Rev 419'
STRUCTURE
ting Use
15-30 Tons
Air Handling > = 10,000 CFM
posed Use
Unit Heater
50+ Tons
Miscellaneous
Fuel Tanks
Boilers
Above Ground
0-3 Tons
Underground
3-15 Tons
Total Unit Count
Permit includes:
A Building
❑ Plumbing
❑ Mechanical
❑
Other
Type of Work: K Residential
J1 New
❑ Remodel
❑ Number of Units
UQ
Deck
❑ Commercial
❑ Addition
❑ Garage
❑ Shed
❑
Other
Enter 1 st FloorlgQ(; sq ft
2nd Floor
sq ft
3rd Floor sq ft
Existing Floor Area Q
sq ft
Area Basement sq ft
Decks
sq ft
Garage Com; sq ft
Proposed Total Area
sq ft
Water Availability 0- Sewer Availability N On -Site Septic System Availability ❑
Project Valuation
$
Zoning 9 SLot
Size C
516
7
Existing Bldg Valuation
$
LENDER
Name
r
City
Address
State
Zip
Fax
PLUMBING CONTRACTOR
Contractor Name Address
r Z C. L G'._ / If i w< i
Cityo State (" Zip 1750 SF'
Contact Phone Fax
D -R ve— q 3 L Z� Os'J
License # M F j f J 4 A? n r) Expiration Date Verified ❑ Yes ❑ No
PLUMBING k'l
..............................
.............................
...............................
.................................
Water Closets
Bathtubs
Showers
Lavatories
MECHANICAL! UNIT 'C
Fuel Type (electric/other)
Length of Gas Piping
Furn < 100K BTUs
Furn > 100 BTUs
Gas Hwt
Conv Burner
BBQ's
Sinks 2—
Dish Washers %
Electric Water Heaters
Washing Machine
Gas Dryer t
Range L
Gas Log
Fans
Hood
Duct Work
Wood Stoves
Urinals 0
Drinking Fountains
Sumps
Drains r%
Lawn Sprinklers
Other
MECHANICAL VALUATION ONLY $
Air Handling < = 10,000 CFM
15-30 Tons
Air Handling > = 10,000 CFM
30-50 Tons
Unit Heater
50+ Tons
Miscellaneous
Fuel Tanks
Boilers
Above Ground
0-3 Tons
Underground
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 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 arise,,s 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
opplication. ! -
/Agent Date: r Date: �f
0144" t, 321� 3uEi 111 -,1
I)C�SCRIPIJOH'NSF NI, EMBING AND MECHANICAL.
OWNER.: ONTR6�CTtR
UNDER
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161,00
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0: V SURf k 1123 St SUSUIVE AREAS'
FUEL FYPU–GA� FA S , It r (om" ilk Sso WATER CLOUIS ...... 1! IjRIHAIS� ...... 0 TOM IM
GAS PIPING.: 99 tt HOOD. 0 - 3 TIP ...... 0 BAIN IUBS .......... I DRINKING HURT.: 0
Rom WoRr,—..: 3-15 HP ..... 0 SHOWUS–.— ....... I SUMPS .......... : 0
AT I WOOD SIMS ... 0 b -30 HP .... 0 LAVA ORM ......... 4 VA( lik[AMS—: 0
#tloNv Rup,11CF: 0 0 30.4 Hp—.: 0 141MI(5........ ......• DRAIK:1. , ....... : 0
BBOT......... t "IS( .......... 0 54 lip.. . .... : 0 IIISH WASHIRS .... -- I LAWN SPRINKLERS: 1)
GA. DRYER–: 1 AIR HANDLING101117' 1`141, IANVS ----------- ELY WIP HMERS...- 0 OTHO f IMIFES,: Q
10,000 (Fm LAUN
of LOGS.'': I lomoo M., 0
I-PICKIIIIIS EXPIRE IwJ DAVS Al 49 Iss"I 11 1110 Niw« is aAAM0. M110111141 AND GR, MOING PUNIIS EXPIM 0111, ib* 41CR Nit (it 15!MWI.
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FIELD COPY