97-1035189,7- io N 5'18
CITY OF FEDERAL_ WAY uu q . .,. PERMIT NO: B ag C 62
h 33530 First Way South SJED:
12/03/97
Federal Way, WA 93003 Building Inspection Requests 253--661.-.41.40 BY: FC2
250-661.-4000 EXPIW
ADDRESS:35726 4T11 AVE SW
NO.: 3021.04-.9127
PROJECT DESCRIPTIO!
F= OWNER
LANE BERGMAN
35726 4TH AVE SW
5
FEDERAL WAY WA 98023
)661-5514
Building shop at 28' x 48
CONTRACTOR
OWNER, IS CONTRACTOR
LENDER
US CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.6% US
BLD?:X MEC?:? PLM?:?
TYPE OF WORK:ADD USE:RES
CENSUS CATEGORY ..... :434
OCCUPANCY GROUP ----------
:?
TYPE OF CONSTRUCTION-----
:?
OCCUPANT LOAD ------------
0 D: 0: 0:
FLR--EXIST--PROP---
1ST.. 0: 1344:sf
2ND.:
0:
O:sf
3RD.:
0:
O:sf
OI HR:
0:
O:sf
BSMT:
0;
O:sf
DECK:
0:
O:sf
GAR.:
0:
O:sf
TOTL:
0:
1344:sf
DWELLING UNITS: 0
STORIES........: 1
HEIGHT.....:
0.00 ft
VALUATION ----------
EXIST,.$:
0
PROP ... $:
6000
RECEIVED.:09/18/97
COMP PLAN...........
REQUIRED PARKING..:
FEES:
0 SPRINKLERS?- ....:? PLAN CHECK FEE
HAZARD CLASS...:? PUB WKS PLCK(SF)..93
REQUIRED SETBACKS------- FIRE FLOW....: 0 gpm BUILDING PERMIT....*
FRONT.,,......: 0,00 ft SBCC SURCHARGE.,...*
SIDE.....,,...: 0.00 ft WATER SERVICE..:? �
REAR..,,,.,.... 0.00:ft SEWER SERVICE..:?
IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:? ? FANS.....,....: 0 BOILERS/COMPRESSORS WATER CLOSETS......: 0 URINALS....,...: 0 ` TOTAL FEES
S PIPING.: 0 ft HOOD..........: 0 0-3 TON..,..: 0 g BATH TUBS..........: 0 DRINKING FOUNT.: 0
JRN<100K,., 0 DUCT WORK...,.. 0 3-15 TON..... 0 3 SHOWERS., .......... 0 SUMPS.....,.,,., 0 s
GAS NWT,,..; 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES...,.,...: 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K.... .: 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 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 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE I ORMATION F SHE 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 RGEN -------- DATE
______,ll��._'''j'Zz---- _ DATE �;'�
l/ ------------------------------------_---_--__ --_ ___________.__
FILE COPY
$ 52.65
$ 80.00
$ 81.00
$ 4.50
$ 218.15
BUILDING DIVISION
JVOF G 33530 First Way South
RECEIVED Federal Way, WA 98003
(253)661-4000
1997 Fax (253) 661-4129
1 Y OF FEDERAL WAY
APPLId TITOR BUILDING PERMIT
PLEASE PR/NT n nn1 1^ — A— kb r l r 6�
Name (F&,L) ] 1 "T l/1 `CP Llr "H t+ j
Address 73 7 -)L- e . w
`i
Address
State t4i r .
Tenant (if known)�1Z
1
Lot #
H
Assessor's Tax #
102,i0(4411,2 I
Other Phone
s✓t �►�
Building Owner's Name
Address
Verified ❑ Yes ❑ No
Cit t' o - State i..J �+ .
Zip Phone (a(0 ( S
Nature of Work 1,kop
Name (F&,L) ] 1 "T l/1 `CP Llr "H t+ j
Address 73 7 -)L- e . w
`i
Ci 1::e 0 i -%C\ &;
State t4i r .
Zi
Contact Person
5-r-�
Day Phone
s f1
Other Phone
s✓t �►�
Fax
Company Name
Address
City
State
Zi
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
Name
Address
city
State
Zi
Contact Person
Phone
Fax
LEGAL DESCRIPTION
Please Complete Reyerse Side •
Name
[MEC"141"14
Address
State
Contractor Name
Address
City
state
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified 0 Yes 0 No
................
. .............
......... ..
a J XTRI., ...........
............
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified 0 Yes 0 No
............. .......
3.
.0 . ... .. TU ..... ..' ................ ...... ......
Water Closets
Sinks
Urinals Lawn Sprinklers
Bathtubs
Dish Washers
Drinkin Fountains Other
Showers
Electric Water Heaters
Sumps
Lavatories
I Washing Machine
.............
................... .
1 Drains Total Fixture. Cunt
CHAN
MECHANICAL EVALUATION ONLY
Fuel T pe (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
..........
Tata( Unit Caunf':
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 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.
Date: ate: —9
I If
RE -ED 8/26/97
� It -4
CITY OF I EbEki)L W(�Y
3'3530 F,,i rsi , Way BUILI)ING
WAY, WI) 13kiildinq Inspection F�eque,tls, 25,.-4-661,4140
4 It-) OVt' �)W
P10. -,902104-.912!
I '1p 0J E, (,- I' 1)17'50 1 P I 10 ti: hi Iding shop at 28' x 48'.
OWN
tAHE BERGMAN
35726 4TH AVE SN
fERFAt, WAY WA 980"L3
)641-5514
ns CONINCIO", "LASE al LOCATIOO
RLD?:X NEC::? !ALM?:? FLP-49M-4PR0,44`i
TYPE QF WORK:ADD USI:RtS 15I.: 1344:sf
CENSUS CATEGORY. ,.414 20
O:sf
OCYIPANCY 3RD'. j"HU
Orsi
TYPE or CONSIRU0160-
st
:? :? :?
K(Uf'AKT
FUEL TYPES.:? ? FANS
GASPIPING.: 0 It "fit
N(100r..: 0
HWT—.:
COOV BURNER: 0
RECO......... 0
GAS K!Y[R..: 0 All'
RANGE....... 0
GAS LOGS—: 0 nw: 0
•
CONTRACTOR I rote
0WHIR IS CONTRACTOf. . A
A"r-P
,f) TON...: 0
0
4., T . .
.,0 50 0
504 TON..... _O
FUEL TANKS__._-__-.
A8OVE
ANKS---------
68OVE GROUND: 0
UNDERGROUND.: 0
#4
I
ul, If Km MAY. TAX RATE : 8.6A Ut
FEES
pt RED t I I V I t 41 f'L PtAN "NICK FEE 52.65
fli,,'hPD l' L PUB WKS P1(I((SF),,93 80.00
WILDIN, PERMIT ...11 81.00
SOCC SQRCWiRGE ..... 4.50
PERMI I NO:
U1 -1r97--0562
t,IIPFAO
061011410
ul, If Km MAY. TAX RATE : 8.6A Ut
FEES
pt RED t I I V I t 41 f'L PtAN "NICK FEE 52.65
fli,,'hPD l' L PUB WKS P1(I((SF),,93 80.00
WILDIN, PERMIT ...11 81.00
SOCC SQRCWiRGE ..... 4.50
fOIAL FJS
Prwis upw iso mr fif If If NO W1 IS SIART11. RESIKIIIAL AS WAKIK KNITS EXPIRE ON[ YIM AFTER BATE Of IS LE.
I CuRlIFY THAT Ilk, INt, 1'0414SLA IV III IS 19% An CORRECT TO 1K )ZEST Of NY KIWI%[ AND 1111. ARLICABLI (11Y Of FIKKAI. NAY RIQUIKLALNTS NIL K NET.
OWNER (w, AGENT
FIELD COPY
t,IIPFAO
AREAS?.:?
1
0
01mi3Ls .......... 0
0010196 FOUNT.: 0
0
SUMPS........... 0
0
VA( PREAkIRS ... : 0
0
RAIIIS .......... 0
DISH
NA,HL ....... :
0
LAWN SPRINKLERS: 0
t[EC
WIR HEATERS...:
0
OTHER FIXTURES.: 0
LAOR
WSHR OUILTS ... :
0
fOIAL FJS
Prwis upw iso mr fif If If NO W1 IS SIART11. RESIKIIIAL AS WAKIK KNITS EXPIRE ON[ YIM AFTER BATE Of IS LE.
I CuRlIFY THAT Ilk, INt, 1'0414SLA IV III IS 19% An CORRECT TO 1K )ZEST Of NY KIWI%[ AND 1111. ARLICABLI (11Y Of FIKKAI. NAY RIQUIKLALNTS NIL K NET.
OWNER (w, AGENT
FIELD COPY