97-102576CITY OF FEDERAL RAL WAY PERMIT NO:7BLD9�O4ls
33530 First Way South .;":,.»,�:,:....,„;r ,..'�,�°,+� ,..,�' �µ� .,. ,.�,•,. ISSUED: 07/16/97
Federal Way, WA 98003 Building Inspection Requests 561--4140 BY. FC
661-400.10 EXPIRES: 01./12/98
ADDRESS:30610 4TH AVE S
NO.: 241..330-0480
PROJECT DESCRIPTION. REROOFING PERMIT.
r= OWNER
CHARLES BRADFORD
30618 4TH AVE S
FEDERAL WAY WA 98003
CONTRACTOR =________
A G ULRIGG ROOFING
35002 28TH AVE SW
FEDERAL WAY WA 98023
874-9429 874-2917
AGULRR*055KH
LENDER
x** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.2% sts
BLD?:X MEC?: PLM?:
TYPE OF WORK:? USE:RES
CENSUS CATEGORY.. ...:555
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
IL TYPES.:? ? FANS.......... 0
9 PIPING.: 0 ft HOOD.. 0
FURN<100K..:
0
DUCT WORK.....: 0
GAS HWT....:
0
WOOD STOVES...: 0
CONV BURNER:
0
FURN>10OK.....: 0
BBQ.........
0
MISC........... 0
GAS DRYER..:
0
AIR HANDLING UNITS
RANGE......:
0
<:10,000 CFM: 0
GAS LOGS...:
0
> 10,000 CFM: 0
DWELLING UNITS: 0
STORIES......... 0
HEIGHT.....: 0.00 ft
VALUATION ----------
EXIST..$: 0
PROP ... $: 4600
RECEIVED.:07/16/97
BOILERS/COMPRESSORS
0-3 HP....... 0
3-15 HP...... 0
15-30 HP....: 0
30-50 HP....: 0
5+ HP........ 0
FUEL TANKS ---------
ABOVE GROUND: 0
UNDERGROUND.: 0
COMP PLAN.........:?
REQUIRED PARKING..: 0
REQUIRED SETBACKS -------
FRONT ...... ,... 0.00 ft
SIDE........... 0.00 ft
REAR........... O.00:ft
SPRINKLERS?......:?
HAZARD CLASS...:?
FIRE FLOW....: 0 gpm
WATER SERVICE..:?
SEWER SERVICE..:?
IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
WATER CLOSETS......:
BATH TUBS...........
SHOWERS .............
LAVATORIES..........
SINKS ...............
DISH WASHERS.......:
ELEC WTR HEATERS...:
LAUN WSHR OUTLTS...:
0 URINALS........: 0
0 DRINKING FOUNT.: 0
0 SUMPS........... 0
0 VAC BREAKERS...: 0
0 DRAINS.......... 0
0 LAWN SPRINKLERS: 0
0 OTHER FIXTURES.: 0
0
FEES:
BUILDING PERMIT .... $ $ 72.00
SBCC SURCHARGE.....* $ 4.50
TOTAL FEES $ 76.50
PERMITS EXPIRE 180 INNS 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
Bun.DING DmsioiN
33530 Fust Way South
Federal Way, WA 98003
(206) 661-4000
Fax (206) 661-4129c
Lot ff Assessor's Tax #
Building Owner's Name n n Address /� ,t ,
C--V\-C, lz n s• v, r , � J (y � / � 4 �"t.r S
Ci State �. Zi a Phone — 3
Nature of Work f.`�— �hL
Name (F,M,L)
Address
Citv
Contact Person
Company Namg�
Address
Cit e -
Contact Person
Contractor's # (card must be presented)
Name
Address
Day Phone
W
Other Phone I Fax
State J,, zip l/v,
Phone Fax
fly �yZ r
Expiration JDatg, Verified ❑ Yes ❑ No
State I r
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Como/ete Rev rse Side
ism'E'�3i1��sting Use Zroposed Use
Permit includes:
Address
❑ Building
❑ Plumbing
❑ Mechanical
❑ Other
' Type of Work:
/R–Residential
❑ New
❑ Remodel
❑ Number of Units _
❑ Deck
❑ Commercial
❑ Addition
❑ Garage
❑ Shed
❑ Other
Enter 1st Floor
sq ft
2nd Floor jv 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
1 $ U
Zoning
I Lot Size
Existing Bldg Valuation
Is
Name
Address
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Contractor Name
Address
City
State
Zi
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Water Closets
Sinks
Urinals Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washing Machine
:7iiaal?:F1%tF2C8':.G`D fAt. :�:�3 .....-
Drains .:........
DIS CLAIM ER: 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 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.
kner/Agent: Date: �— l Z, 9,7
411
BEYMED 12/11/98
I I f,)[,- 1,Q n L, wiw
I twa 0 tit, h
I way, wri 1),8o03
ADPV Ill.- Ss.- 3061.8 4111 AVE
NO.: 24lnO-0480
1'Fwo,,.t i ,c 171'-53CPlPT1()N:R1R0QFI#6 PERMIT
OWNER
CHARLES I,RANORD
30618 41H AVE S
fEbtRAL WAY NA 98003
BI V?A ME(?, Pt"?: F[R--EXW
,,F,�
40'* OP - - -
R17
TYPI Of WORK:? USF:Rfs IST., 0.-sf
CENSUS CATEGORY ..... :S55 2N�a
f
OCCUPANCY Go(op *4
TYPE Of COHSTRUCIIOm---- 0-�,-11,ll-,,lll-),,ll-,ll,Sf
l7m,
O(CUPAOI LOAD -----------
0: 0: 0: 0: 1OT(It"I'll-,1161-1
VERM I I NO:
.`"}UIQ V:
1, 14 11
ul�l Lli r1ell 13 Y:
A, G ARIGG ROOFING
3%02 281" AVE sw
FEDERAL WAY WA 48023
374-8429 874-2917
AGULRR*O55KH
L TYPES..,' ? FARS—...
:� .....BOILERS/COMPRESSORS
9
PIPING.: ' 0 ft HOOD.,.. 0 0-3 op ...... : 0
FURN< IJOK.
0
DUCT WORK...,..
0
3-15 HP.....:
0
GAS Wt. —:
0
WOOD STOVES—:
0
15-39 OP.—:
0
(OOV BURNER:
0
fURN,,100k .... .:
0
30 50 up. –.:
0
880 ........ :
0
MISC..........:
0
'St HP ....... :
0
GAS OPYEA..:
0
AIR HANDLING ONTIS
FUEL YANKS ---------
RANGE .......
0
<:10,000 CfA*
0
ABOVE GROUND;
0
GAS LOGS—:
0
> 10,000 CFM:
0
UNDERGROUND.:
0
SATES fix f" PROJFCIS vfIvIl THE city of FIEWAL NAY. TAX BATF : e.A nt
OMP P4AM .......... ? FEE).
lik,191D PARKING,.: 0 SPRINKLERS?......:? BUILDING PERMIT....72.00
Sort SURCHARGE.....* S 4.50
SIK .......... : 0.00 ft WATER SIRVICE..:'
......... : 0.00:ft SEWER SIRVICL.-:?
INPERV SURFACE: 0 sf SENSITIVE AREAS'.:?
WATER CLOSETS ......
0
ORINALS ..... –.: 0
BATH TUBS.....,...,;
0
l*IRrIv, FOUNT.: 0
SOONERS .... – ......
0
SUMPS........ : 0
LAVA10RfES– .......
0
VA( BREAKERS...: 0
SINKS ..............
0
DRAINS ......... : 0
DISK WASHERS.......:
0
LAWN SPRINKLERS: 0
[I,[( WIN HEATERS,..:
0
OTHER fIXIURES.: 0
LhUR WSW OUILIS ...
0
JOIAL 11ES $ 76.50
PERMITS EXPINI 190 DAYS Atitt ISSUANCE If NO WORK IS SIARILD. l[SlOtIllit AMP PERNIIS EXPIRE QK nN Alfillt tiff Of ISW,'IKI
I CERT11Y THAT THE INFOMIJON FINNISK0 BY ME Pi 101 NO COAKU TO lK, KSI Of fl?' fWKEDGE AND 101 W11(4101 �--IIY OF FEDERAL Wtf R[ot9lotoltNis W111 It' MET
OWNER OR gm
7
FIELD COPY F; , &:Ll t
CDO193 (Rev 4/97)
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