97-103497CITY OF FEDERAL WAY
...,,,.."....... ',.,'` ..,,. PERMIT NO: B D9
-C 59
33530 First Way South ISSUED:
09j1a/9/
Federal Way, WA 93003 Building Inspection Requests 2.53--661-4140 BY: FC2
253-661.-4000 EXPIRES: 00,/16/93
ADDRESS : 4712 SW 325T1-1 PL
NO.: 373219•-0070
PROJECT DESCRIPTION. RE -ROOFING
= OWNER =_______._____________________=_____-_-=____________=
CONTRACTOR -____::__::_______________= ___:________======T= LENDER =______
MARJORIE APPLEGATE
2ND.:
AM CONSTRUCTION
0:sf
4712 SW 325TH PL
0:
1211 SW 313TH ST.
OTHR:
WAY WA 98023
O:sf
FEDERAL WAY WA 98023
I
j6ERAL
DECK:
O:
O:Sf
874-5337
0:
(253)839-9138 (253)818-1814
k
0:
O:sf
AMCON$*064DM
##* CONTRACTORS,
PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR
PROJECTS WITHIN THE CITY OF FEDERAL BAY.
BLD?:X MEC?:? PLM?:?
TYPE OF WORK:REP USE:RES
CENSUS CATEGORY .... ,:434
OCCUPANCY GROUP----------
TYPE OF CONSTRUCTION-----
.
OCCUPANT LOAD ------------
0: 0: 0: 0:
FLR--EXIST--PROP---
1ST.:
0:
O:sf
2ND.:
0:
0:sf
3RD.:
0:
O:sf
OTHR:
0:
O:sf
BSMT:
0:
O:Sf
DECK:
O:
O:Sf
GAR.:
0:
O:sf
TOTL:
0:
O:sf
DWELLING UNITS: 0 COMP PLAN.....;...:?
STORIES........: 0 § REQUIRED PARKING..: 0 SPRINKLERS?......:?
HEIGHT.....: 0.00 ft HAZARD CLASS...:?
VALUATION---------- REQUIRED SETBACKS------- FIRE FLOW....: 0 gpm
EXIST..$: 0 g FRONT........,: 0.00 ft
PROP... $: 4000 # SIDE,.........: 0.00 ft WATER SERVICE..:?
REAR..........: 0.00:ft SEWER SERVICE..:?
RECEIVED.:09/17/97
IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
TAX RATE : 8.2% Ut
FEES:
BUILDING PERMIT.... $ 63.00
SBCC SURCHARGE.....* $ 4.50
__-------_.----__ _ ___-_...___..___r..__________________________________: ______ T=====__________________________:________-_:__________ _
---_----._____ __ ________-.___-_. __
EL TYPES.:? ? FANS..........: 0 BOILERS/COMPRESSORS WATER CLOSETS......: C URINALS........: 0 ' TOTAL FEES
SAS PIPING.: 0 ft HOOD..........: 0 0-3 TON.....: 0 BATH TUBS..........; 0 DRINKING FOUNT.: 0
FURN<IOOK..: 0 DUCT WORK.....: 0 3-15 TON....: 0 SHOWERS ............: 0 SUMPS.,.........: 0
GAS HWT.... : 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES.........: 0 UAC BREAKERS...: 0
CONV BURNER: 0 FURN>10OK.....: 0 30-50 TON...; 0 SINKS ..............: 0 DRAINS.....,...: 0
BBQ........: 0 MISC..........: 0 50+ TON.....: 0 # DISH WASHERS.......: 0 LAWN SPRINKLERS: 0
I GAS DRYER..: C AIR HANDLING UNITS FUEL TANKS--------- 3 ELEC WTR HEATERS...; 0 OTHER FIXTURES.: 0
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 DAYSTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER -DATE OF ISSUANCE.
T CERTIFY THAT THE INFO ATIONJURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE NET.
OWNER OR AGENT--------- ----------------- __-__-_--_----_------------- _ DATE
FILE COPY
$ 67.50
- - �4- I EMEIZFiL
uV (PPI -
ISE PR/NT
Tenant (if known) (1
Building Owner's Name
BUILDINGDmsioN
33530 First Way South-
Federal
outh
Federal Way, WA 98003
(253) 661-4000
Fax (253) 661-4129
APPLICATION FOR BUILDING PERMIT
APPLICATION #�,L .i_� —"Ci t
>: Address
Lot #
Address
Assessor's Tax #
1 V
Phone
Name (F,M,L)
Address � ----2
State
Zi
State -i J Zi T c�
rC,,.,.t-.Ctprso
Day Phone - /_
` (
�_ (
Other ` ne I ( , ! Fax
Verified ❑ Yes ❑ No
Company Name
Addres� ^
city
State
Zi
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
Name
Address
Cit
State
Zi
Contact Person
Phone
Fax
LEGAL DESCRIPTION
Please Complete Reverse Sid 0
»><s
.............................
Existing Use
9
Contractor Name
Proposed Use
P
City
Permit includes:
Zi
'Building
❑ Plumbing
❑ Mechanical
❑ Other
Type of Work:
Residential
❑ New
❑ Remodel
❑ Number of Units _
❑ . Deck
�K.Dther
Miscellaneous
❑ Commercial
❑ Addition
❑ Garage
❑ Shed
Above Ground
Enter 1st Floor
sq ft
2nd Floor
sq ft 3rd Floor sq ft
Existing Floor Area
sq ft
Area Basement
sq ft
Decks
sq ft Garage sq ft
Proposed Total Area
sq ft
Water Availability
❑ Sewer Availabili
❑ On -Site Septic System Availability ❑
Project Valuation
$ IDf-'1�—`
Zonin
Lot Size
Existing Bldg Valuation
$
»><s
.............................
Sinks
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
»><s
.............................
Sinks
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
X
..:.:..:.::....
::.:.:...:...:............................
Water Closets
Sinks
Urinals Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
Drains Total: Fixture Gaunt
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
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 onty
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.
i
Owner/Agent: C/ "' Date:
aur
RE—.
81 8/286
/97
MECHANICAL EVALUATION ONLY LY S
Fuel Type (electric/other)
Gas Dryer
Air Handlin < = 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;Un/t Cot#nt
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
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 onty
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.
i
Owner/Agent: C/ "' Date:
aur
RE—.
81 8/286
/97