96-1006709 6,
OF W( -)Y "R T PCRN.11' Nul.. - (JOB 1
First, W�ly South 13U I L D I NG L. I . 't1;S(JED: 03/1.3196
'Feciet-at Way, Wri 98003 BUildiric; Requ,,tll1 , 6 140 BY: FC
661 L-Xl-)IltE3: 09/09/96
AVDFtESS: 1023 S 961 tl PL_
NO.: 5151,60-0980
PROJP-Cl' DESCR If) V ION: resovinq old cedar shakes, installing new roof sheithinq and comp roof
OWNERCONTRACTOR LENDER::z.. ......... .........
ANN MAJORS DAVIS CONSTRUCTION
7518 HERMOSA BEACH ROAD 23620 63RD AVE SW
MARYSVILLE WA 88271 VASHON ISLAND WA 98010
0,658.5050
JEFFD(1101NT
RG SUES TAX TOR PROJEas vil"Im 14t CITY of ftKKK MAY. TAX RATE = 8.2t Ot
-- — ----------
BtD?-X NEC?:? PLO?:? FLR--1XISI_, -PROP--- ;,"Sw OP PLAN..........? FEES:
TIRED PARKING..: 0 S
BUILDING PERMIT.... 63-00
" wm""
TYPE Of WORK:ALI USE:R[c IST.: N 0 Rw er ...... :?
" 74--
434 2110. 4.50
0 fn
CENSUS CATEGORY.....:434
Ns-
�R
OCCUPANCY GROUP-.--_- UAI
ON
m.
4"!
:?
"'IpL.
ATCO SE
TYPE Of t0HSIpUCTI0m__
0 10. SEWER SERVICE
ft
........ 0.00:ft SEWER SERVICE—:?
:? :? :?
O(CUPANI LOAD ------
0: 0: 0: VMPERV SURFACE: 0 sf SENSITIVE AREAS?,:?
FUEL TYPES.:? ? FANS . OF BOILER'S/COMPRESSORS WATER CLOSETS....... 0 URINALS........: 0 IOTAL FEES 67.50
AS PIPING.: 0 it HOOD........... 0-3 HP....... 0 BATH TUBS........... 0 DRINKING FOUNT.:.: 0
FURN(looK..: 0 Duff WORK.: 0 3-15 HP...... 0 S004LRS ............. 0 SUMPS........... 0
GAS HWf .... : 0 400D STOVES.... 0 15-30 HP..... 0 LAVATORIES.......... 0 VAC BREAKERS.... 0
(Oxv BURNER: 0 FURH>IOOK ..... 0 30-50 HP..... 0 SINKS ............... 0 DRAINS_._..: 0
880 ........ 0 MIS(........... 0 5f HP.......: 0 DISH WASHERS.......: 0 LAWN SPRINKLERS: 0
GAS DRYER—: 0 AIR HANDLING UNITS FOCI. TANKS ---------- Et[( WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE......: 0 <:10,000 CF": 0 ABOVE GROUND: 0 LAVH WSHP QUILTS...: 0
GAS LOGS...: 0 > 10,000 j": 0 UNDERGROUND.: 0
RESIDENTIAL AND GRADING PERNIIS EXPIRE ONE YWW Af-10 DATE Of ISS' L.
PERMITS EXPIRE 180 DAYS AFTER IssmiKE f NO NMI Is uw
I CERTIFY Iffil Off IWI-ORMAIJON TUR SH D io OF is Ull CORRECT TO (K REST Of MY INOREW AND IRE APPLICABLE (11Y Of FEDERAL VAY RMIRIN(NIS WILL at MET.
L/ V'
OWNER OR AGENJ DATE
FIELD COPY
0
CDO193
. Ili ' t
arrO G
� NO)
City of Federal Way
APPLICATION FOR BUILDING PERMIT
PLEASE PR/NT
SITE LOCATION Address /02
Tenant (if known)
Building Owner Name
&-) NO M ,:cOQS
City f yyrl� \) � State
Nature of Work 6 CjtdC,i(-
...................
........ ..........
......................
....................
'PLICANT
APPLICATION #:
2sG4-1,) 10(- FLJ Cj x4 5TCO
Lot # Assessor's Tax #
Addr ?,51
Zip clvZ / Phone 360
pkj -Cly) C66 /_-� IF68 0 .
Name (F,M,L) At,�) &�) M ) ; -3
Address 1)11 10
City �( f� State c, f Zip Z I
Co0aNPergon � �, ` Day -o`nb — 6 �--5o� � Other Phone Fax
kk"� -
6s d' jrj-o
Company Na b ^` ,;S
j v
Address 11 — 63
r�
City J State Zip 5 %
Contact Person; Phone Fax
S �b-
Contractor's # c d must be presented) Expiration Date Verified El Yes E:1 No
+o) �jr
LEGAL DESCRIPTION
0 Please Complete Reverse Side 0
CD0492 (Rev 4/93)
STRUCTURE
Existing Use
Address
Proposed Use
City
Permit includes:
Zip
❑ Building
❑ Plumbing
❑ Mechanical
❑
Other
Type of Work: ❑
❑
Residential
Commercial
❑ New
❑ Addition
❑ Remodel
❑ Garage
❑ Number of Units _
❑ 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
Proposed Total Area
sq ft
sq ft
License #
Water Availability ❑
Sewer Availability ❑ On -Site Septic System Availability ❑
Project Valuation
$
,idx%
UMBING OONTRACTOR
Zoning
Lot Size
Contractor Name
Existing Bldg Valuation
$
Address
NDER
Name
Address
City
State
Zip
;CHANICAL CONTRACTOR
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
UMBING OONTRACTOR
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
.
__._....._.......... ...
UMBIi�iG FII�TIJItE COUNT
Water Closets
Sinks
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains
Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains
Total fly arare .CQUJ1t
CHAIICAL UNIT COUNT <_
>
MECHANICAL VALUATION 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 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 whi tpermit application is ace. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenses,
and attorneys' fees incurred in investigation nd efense of such claim , hich 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 th elia ce of the City, incl g its officers and employees, upon the accuracy of the information supplied to the City as a part of this
application. {zr fb 1. /� V
Owner/Agent: Date
ADDRESS:1023 S 296TF] PL
NO.: 51-51.60--0380
PROJECT DESCRIPTION: removing old cedar shakes, installing new roof sheathing and comp roof
: OWNER CONTRACTOR LENDER
ANN MAJORS r DAVIS CONSTRUCTION
7518 HERMOSA BEACH ROAD 1 23620 63RD AVE SW
MARYSVILLE WA 98271 1 VASHON ISLAND WA 98070 [
?
0 ft
FANS..........:
HOOD...........
e
BOILERS/COMPRESSORS
0-3 HP....... 0
N<100K..;
0
DUCT WORK.....:
CITY OF FEDERAL
WAYPERr1IT
NO.
BLD96-008
33530 F a. r5 t W 4i y
South
�; � �,,,,,.� ..,�,.. �,,,,., ..�.,.h ..,�,,, �° � �,,, r �,, � �; ,. �' `�„ �� � .,,�.. ,. �... ISSUED:
0- 9 3
Federal Way, WA
98003
Buildir)q Irispectzori Requests 661.-41.40 BY:
FC
661-4000
0
EXPIRES:
09/09/96
ADDRESS:1023 S 296TF] PL
NO.: 51-51.60--0380
PROJECT DESCRIPTION: removing old cedar shakes, installing new roof sheathing and comp roof
: OWNER CONTRACTOR LENDER
ANN MAJORS r DAVIS CONSTRUCTION
7518 HERMOSA BEACH ROAD 1 23620 63RD AVE SW
MARYSVILLE WA 98271 1 VASHON ISLAND WA 98070 [
' FUEL TYPES.:?
PIPING.:
?
0 ft
FANS..........:
HOOD...........
0
0
BOILERS/COMPRESSORS
0-3 HP....... 0
N<100K..;
0
DUCT WORK.....:
0
3-15 HP.....: 0
P60.658.5050
0
WOOD STOVES...:
0
? 463.1975
CONV BURNER:
0
FURN>lOOK.....:
0
30-50 HP....: 0
BBQ.........
0
MISC....,......
0
JEFFDC 101NT
GAS DRYER..:
0
AIR HANDLING UNITS
FUEL TANKS ---------
--------RANGE..,...:
RANGE.. ....
0
<:10,000 CFM:
0
ABOVE GROUND: 0
GAS LOGS...:
0
>-10,000 CFM:
*** CONTRACTORS,
UNDERGROUND.: 0
PLEASE USE
LOCATION
CODE 1732 WHEN REPORTING
SALES TAX FOR PROJECTS
WITHIN
THE CITY OF FEDERAL NAY.
TAX RATE = 8.2% ***
BLD?:X MEC?:? PLM?:?
FLR--EXIST--PROP---
DWELLING UNITS: 0
COMP PLAN.........:?
FEES: 1
TYPE OF WORK:ALT USE:RES
1ST.:
0:
O:sf
STORIES.......,: 0
REQUIRED PARKING..:
0
SPRINKLERS?— ...:?
►
BUILDING PERMIT....* $ 63.00 �
CENSUS CATEGORY ..... :434
2ND.:
0:
O:sf
HEIGHT.....: 0.00 ft
HAZARD CLASS—:?
SBCC SURCHARGE.....* $ 4.50
OCCUPANCY GROUP----------
3RD.:
0:
O:sf
VALUATION----------
f REQUIRED SETBACKS--------
FIRE FLOW....: O gpm
i
:? :? :? :?
OTHR:
0:
O:sf
EXIST..$: 0
t FRONT... .
0.00
ft
TYPE OF CONSTRUCTION-----
BSMT:
0:
O:sf
PROP -3: 4000
STDF..........:
0.00
ft
WATER SERVICE..:?
:? :? :? :?
DECK:
0:
O:sf
! REAR...........
O.00:ft
SEWER SERVICE..:?
OCCUPANT LOAD------------
GAR.:
0:
O:sf
RECEIVED.:03/13/96
s
0: 0: 0: 0:
TOTL:
0:
O:sf
IMPERV SURFACE:
0
sf
SENSITIVE AREAS?.:?
' FUEL TYPES.:?
PIPING.:
?
0 ft
FANS..........:
HOOD...........
0
0
BOILERS/COMPRESSORS
0-3 HP....... 0
N<100K..;
0
DUCT WORK.....:
0
3-15 HP.....: 0
e
;GAS HWT.... :
0
WOOD STOVES...:
0
15-30 HP....: 0
CONV BURNER:
0
FURN>lOOK.....:
0
30-50 HP....: 0
BBQ.........
0
MISC....,......
0
5+ HP........ 0
GAS DRYER..:
0
AIR HANDLING UNITS
FUEL TANKS ---------
--------RANGE..,...:
RANGE.. ....
0
<:10,000 CFM:
0
ABOVE GROUND: 0
GAS LOGS...:
0
>-10,000 CFM:
0
UNDERGROUND.: 0
WATER CLOSETS ...... :T-0URINALS ........ :-10 -_M-� TOTAL FEES
BATH TUBS........... 0 DRINKING FOUNT.: 0
SHOWERS. ........... 0 SUMPS........... 0
LAVATORIES.........: 0 VAC BREAKERS...: 0
SINKS ............... 0 DRAINS.......... 0 ±
DISH WASHERS.......: 0 LAWN SPRINKLERS: 0
ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
LAUN WSHR OUTLTS...: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUA E F NO WORK IS RTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURdSHiD BY ME IS T AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL NAY REQUIREMENTS WILL BE NET.
OWNER OR AGENTDATE �✓ �-Fj
_ _. _. __.... _ ....... _ .._.._._._.._._____._____._..._.__.._........._..___......_.__...__
r -
FILE COPY
$ 67.50