97-103570CITY OF FEDERAL WAYdd ddpp d d
33530 F i rs t Way South
.h ����
Federal Way, WA 9300:3 Building Inspection Requests 253--661-4140
253--661--4000
ADDRESS:1116 S 237-FFI ST
NO.. 515296--0560
PROJECT DESCRIPTION : RERROF - TEAR OFF , REPLYWOOD, REPLACE WITH 40 YAER DEM.
OWNER_______________________________ :.__-_____._-__=====i= CONTRACTOR ______.-_____::_____:::______________________.:= LENDER
TAMS JENSEN ROOFING COMPANY INC
1116 S 287TH ST 17321 MILITARY RD S
FEDRAL WAY WA 98003 SEATAC WA 98188
4
253-839-8831 206-241-5774 ;
° JENSERCO53L8
F
9-7.163 sip
PERMIT NO: BLD97-0579
ISSUED: 09/23/9;
BY: FC2
EXPIRES: 03/22/98
*** CONTRACTORS, 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?:?
TYPE 0c WORK;ALT USE:RES
CENSUS CATEGORY ..... :434
OCCUPANCY GROUP ----------
:?
TYPE OF CONSTRUCTION -----
.,
OCCUPANT LOAD ------------
0: 0: 0: 0:
FLR--EXIST--PROP---
1ST.:
0:
O:sf
2ND.:
0:
O:Sf
3RD.:
0:
O:Sf
OTHR:
0:
O:Sf
BSMT:
0:
O:Sf
DECK:
0:
O:sf
GAR.:
0:
O:Sf
TOTL:
0:
O:sf
DWELLING UNITS: 0 a COMP PLAN.........:?
STORIES...,... . 0 ` REQUIRED PARKINS.,: 0 SPRINKLERS?......:'
HEIGHT.....: 0.00 ft HAZARD CLASS...:?
VALUATION---------- REQUIRED SETBACKS------- FIRE FLOW.,..: 0 gpm
EXIST..$: 0 FRONT.........: 0.00 ft
PROP ... $: 6441 SIDE....,.....: 0,00 ft WATER SERVICE..:?
REAR..........: 0,00;ft SEWER SERVICE..:?
RECEIVED.:09/23/97
IMPERV SURFACE. 0 Sf SCNSITIVE AREAS?.:?
FEES:
BUILDING PERMIT,...* $ 90.00
SBCC SURCHARGE,....* $ 4.50
FUEL TYPES.:?
?
FANS..........:
0
BOILERS/COMPRESSORS
WATER CLOSETS......;
0
URINALS........:
0
TOTAL FEES
GAS PIPING.:
0 ft
HOOD..........:
0
0-3 TON.....: 0
BATH TUBS..........:
0
DRINKING FOUNT.:
0
FURN<100K..:
0
DUCT WORK.....:
0
3-15 TON....: 0
SHOWERS ............:
0
SUMPS..........:
0
GAS HWT.... :
0
WOOD STOVES.,.:
0
15-30 TON...: 0 {
LAVATORIES.........:
0
VAC BREAKERS...;
0
CONV BURNER:
0
FURN>1OOK.....:
0
30-50 TON...: 0
SINKS ..............:
0
DRAINS.....,...:
0
BBQ........:
0
MISC.........,:
0
50+ TON.....: 0 !
DISH WASHERS.......:
0
LAWN SPRINKLERS:
0
GAS DRYER..:
0
AIR HANDLING UNITS
FUEL TANKS ---------
ELEC WTR HERTERS...:
0
OTHER FIXTURES.:
0
j
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 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
FILE COPY
DATE
$ 94.50
BUILDING DIVISION
Cf1OF G 33530 First Way South
�— O Federal Way, WA 98003
(253) 661-4000
Fax(253)661-4129
.SEP 2 3 1-91117
APPLICATION FOR 13MMUM"PERMIT
APPLICATION # ' > L r
Address (� 5 J ►�`
Lot # Assessor's Tax #
2
I SE PR/NT
fw`
maim
Tenant (if known)
Building Owner's Name
State
I Nature of Work -C
Address
Phone
-,N33 i
Name (F,M,L)
Address
City State
Zi
Contact Person
Day Phone Other Phone
Fax
Company Name- j
Address
Address
State
Zi
Contact Person
City
State
Zi
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
NET
Name
Address
City
State
Zi
Contact Person
Phone
Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
A
0
Name
Address
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
€t111t1'BEIGl'
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
I Expiration Date
Verified ❑ Yes ❑ No
0................
1 'p �.41
Water Closets
Sinks
Urinals Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains I Total Fixture G:i9unt
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 pemut 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 ofthis application.
Owner/Agent
EWI D -Am
HEV6E0 8/28/97
Date: f-_)3 (! 2
MECHANICAL EVALUATION ONLY $
...........................................................................
Fuel T pe (electric/other)
Gas DrVer
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 Grour
Conv Burner
Duct Work
0-3 Tons
i 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 which pemut 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 ofthis application.
Owner/Agent
EWI D -Am
HEV6E0 8/28/97
Date: f-_)3 (! 2
CITY'()F rcfx--r4<)t- PERM IT NO: ULD97-0579
73,35"10 First '14' -Ay S.-)uth B U T L .'D'I "T
F'ederal. Way,_WA 98003 md1ding Inspoction Reqo(,z-'.'Js 25,'.1-661-41410 By: FC 2
0 7
253- 661 �400(') LXPTf�E!�. I
W,').: 515296-05il,11
TIRCIJECT DC'SCF* IPTICON: 91IROF - ]EAR OFF , RWYNOOP, REPLACE KITH 40 YAER Kfl.
LENDER
S" (oromfoks, strAst vst LKATION (q'K- �"'mj ",*k -W 1 Ot 1! WAL 90. TAX PAT[ .- 8.2t ttit
ING SALES TAX FOR PROJECTS VITtly 1hi
BIV:X NEC?:? PLN?*? FLA -E!VI I 4ROP-Y e" A ! ....... FEES:
,ltEll,
CORP PLAN
TYPE Of WORK:ALT USE:RB. IST.: 0'; O:Sf v
S IRED panc.: 0 SPRIpjaps? ...... WILDING PERMIT.... 90.00
':
(INSUS CAIIGORY.....:43 2"DO:sf HAZARD CLASS... :? SW SURCHARGE.....
OW Ky P ------- -- 3RD.: AT I $I I
jP4 000 O-Sf V
?
FRONT,.,j,. ? 0*4 f
TYPE or S f PR(.
0, 00 ft',-"
:? :? :? ...... -0,60'-ft SEWER ovid
O"CUPANT LOAD-..--___...._
0: 0: 0-' 0: w0f RV SURFACE: 0 Sf I.SFISITIVE AREAS?.:?
TANS
FUEL TYPES.:? ? Ms
BOILERS/0"RESSORS WAIER CLOSETS......: JR NA S 0 .1 L� ....... 0 TOTAL FEES
.
(AS PIPING.: 0 ft NOW 0-3 100.... 0 BATH TUBS..........: 0 DR I NK I K f 01JR1. 0
F"Ro"'loon . 0 W1 IORK.....: 0 3-15 TON....: 0 SHOWS ............ 0 sfflp�S.. , ..... ..: 0
GAS NWT:...: 0 NOD STOVES..,: 0 15-30 TOM... 0 LAVATORIES.........: 0 VAC BREAKERS... 0
(ONV BURNER: 0 FUR#>1OOK ..... 0 30-50 TON...: 0 slots .............. 0 RAW...
Bm... 0 HISC ........... 0 Sol TOM.....: 0 DISH WASHERS.......: 0 LhNd SPRINKLERS: 0
CAS DRYER-: 0 AIR RAIDLItK UNITS FUEL TANKS--------- ELIC WTR HEATERS—: 0 OTHER FIXTURES.: 0
RANGE ....... 0 10,000 CFO: 0 ABOVE GROUND: 0 tAUN WSHR OUTLIS... *, 0
GAS LOGS...: 0 > 10,000 CFO: 0 UNDERWOOD.: 0
PENITS EVIII 180 DAYS 9 111 ISSUANCE It HO "ORK IS STAklift. RBINWITAI AND WOW PIRNITS EXPIRt ONE YEAR AFTER PATE Of ISSUANCE.
(11111Y 1141 (W, 1111-ORIIA110ft FURNISNE9 OY Of Is Tw at (WIL(I fig lilt OCST Of NY (WREpa As ILI( AMICARIE CITY Of' f[KRAi, WAY Itt'QUIRINITS Vitt Of NET,
OW#fp of Aami
�N
FIELD COPY