98-1002619 g—/ood-GJ
CITY OF FEDERAL WAYPERMIT NO: BL_D98-0039
33530 F i rs t Way South ; ;`:: �.,� .,�,. ,,..,,.:; ;.r ::.M..: f �.::;;r ':;:,` fill." 111.'] ..,,1"" � / /
ISSUED. a� 2n 9E3
Federal Way, WA 98003 Building Inspection Requests 253--661-4140 BY: FC2
253-661-4000 EXPIRES: 02/16/99
ADDRESS:200 SW 292ND sT
NO.: 119600-4870
PROJECT DESCRIPTION:RESIDENTAL ADDITON- 125 SQUARE FEET
p= OWNER=_____..______________________________________===r= CONTRACTOR ==__________________________________________-= LENDER
MARK DRANGSHOLT RICK HAIGHT CONSTRUCTION OWNER IS LENDER
200 SOUTH 292ND
ST
FANS..........:
0 BOILERS/COMPRESSORS
GAS PIPING.:
PO BOX 589
HOOD..........:
0 0-3 TON.....: 0
FURN<100K..:
0
{ FEDERAL WAY WA
98023
GAS HWT.... :
0
WOOD STOVES...:
MAPLE VALLEY WA
98039
0
FURN>100K.....:
0 30-50 TON...: 0
BBQ.........
0
MISC...........
0 50+ TON...... 0
GAS DRYER
0
AIR HANDLING UNITS
FUEL TANKS ---------
E
253-839-4244
425-432-4512
RICKHC*121NE
CONTRACTORS,
PLEASE USE
LOCATION
CODE 1132 WHEN REPORTING
SALES TAX FOR PROJECTS
WITHIN
THE CITY OF FEDERAL NAY.
_____-__--____________________-__
BLD?:X MEC?:?
PLM?:?
FLR--EXIST--PROP---
DWELLING UNITS: 0
COMP PLAN .........
:MDSF
TYPE OF WORK:ADD
USE:RES
1ST.:
0:
O:sf
STORIES- 0
� REQUIRED PARKING..:
0
SPRINKLERS?........
CENSUS CATEGORY .....
:434
2ND,:
0:
O:sf
......:
HEIGHT.....: 0.00 ft
HAZARD CLASS...:?
OCCUPANCY GROUP----------
3RD.:
0:
O:Sf
VALUATION----------
REQUIRED SETBACKS-------
FIRE FLOW....: 0 gpm
•? •? •?
•?
OTHR:
0:
O:sf
EXIST..$: 0
FRONT.........:
0.00
ft
TYPE OF CONSTRUCTION-----
BSMT:
0:
O:Sf
PROP ...$: 8569
SIDE..........:
0.00
ft
WATER SERVICE..:?
:? :? :?
:? :
DECK:
0:
O:sf
REAR..........:
O.00:ft
SEWER SERVICE..:?
OCCUPANT LOAD------------
GAR.:
0:
O:sf
RECEIVED.:01/21/98
3 0: 0:
0: 0:
TOTL:
0:
O:Sf
IMPERV SURFACE:
0
sf
SENSITIVE AREAS?.:?
FUEL TYPES.:?
?
FANS..........:
0 BOILERS/COMPRESSORS
GAS PIPING.:
0 ft
HOOD..........:
0 0-3 TON.....: 0
FURN<100K..:
0
DUCT WORK.....:
0 3-15 TON....: 0
GAS HWT.... :
0
WOOD STOVES...:
0 15-30 TON...: 0
CONV BURNER:
0
FURN>100K.....:
0 30-50 TON...: 0
BBQ.........
0
MISC...........
0 50+ TON...... 0
GAS DRYER
0
AIR HANDLING UNITS
FUEL TANKS ---------
WATER CLOSETS......:
0
URINALS........: 0
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
TAX RATE : 8.6% Ut
FEES:
PLAN CHECK FEE $ 70.20
BUILDING PERMIT....* $ 108.00
SBCC SURCHARGE.....* $ 4.50
TOTAL FEES $ 182.70
RANGE......: 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS... : 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
t---------------------------------- ---- -----.....------------------------------- ------------ -__---------- -----------------
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 NAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT___---_---�-----------------DATE
----------- --------
FILE Z--C-�-' --`2-
---
COPY
Name (F,M,L)
Address 9�—v0
Cit
State
Contact Person
Day Phone Other Phone
tFa.
M
Company Name
Address
City
State
Zi
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
LEGAL DESCRIPTION 1 .
Please Complete Reverse Side
VV.
Fax Ly'z 5
Name
Address
O
i
Cit
Contact Pen�
/
LEGAL DESCRIPTION 1 .
Please Complete Reverse Side
VV.
Fax Ly'z 5
Contractor Name
Address
Existing Use
State
Pro posed Use
p S-►rm►�
Contact
Permit includes:
Fax
❑ Building
❑ Plumbing
❑ Mechanical ❑
Other
Type of Work:
*—Residential
❑ Commercial
❑ New
Addition
❑ Remodel
❑ Garage
❑ Number of Units _ ❑
❑ Shed ❑
Deck
Other
Enter 1 st Floor
Area Basement
ZS sq ft /kDDL.
s 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
Water Availability
❑ Sewer Availability
❑ On -Site Septic System Availability ❑
Project Valuation
iS�f,
Zoning
0-3 Tons
Lot Size
Existing Bldg Valuation
I $
3-15 Tons
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
Drains Total. Fixture.Count...::.::.:......::::::::
f i t' ;,,.:::::::::::::::::::..
MECHANICAL EVALUATION ONLY S
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 Unrt 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 perforin 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 ofthejohartpe of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of this application.
i
Date: —
8 -.-.Aa
RE -0 8/28/97
- •0BUILDINGDIVISIp9
"TYOF�� `2 33530 First Way South
f�Y Federal Way, WA 98003
(253) 661-4000
S g= I v EE E) Fax (253) 661-4129
JAN 2, 7 1998
APPLICATION FOR BUIL[; ,[JVCa__-f'F,.,,_13MIT
BUILDING DEPT.
PLEASE PR/NT
:....... r .:.:...:::::....:.. .
RUN,,'Tf;4Y:t h;?�W
Address 124;0124;0v✓►
TION
r JzG2-"t)
State
Tenant (if known)
Contact Person
Phone
Lot #
Ass ss is Tax #
Building Owner's Name
��vStaZip
�Nn
AM s
Ci a
Phone 13
Nature of Work
poL, TV p.4 /�I
2 _ 1 N 1
Name (F,M,L)
^fLv-- Dom:
AddressN p
vw r-- 1 1 State W— Zi
Contact Person Day Phone lb -4-z4441 I Other Phone Fax
Company Name
Address
City
State
Zi
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
Name
Address
Contact Pe n I�ione Fax _.C42•S'
G, y r—...— A A I I I ri', r7
LEGAL DESCRIPTION
P/ease Complete Rever Side
?'............................................::::::::::::::.::::::.
Address
tin Use
g S
I
posed Use
P `1'►'I �i
Contact
Permit includes:
Fax
❑ Building
❑ Plumbing
❑ Mechanical ❑
Other
Furn > 100 BTUs
Fans Miscellaneous Fuel Tanks
Gas Hwt
Hood Boilers Above Ground
Type of Work:
residential
❑ New
❑ Remodel
❑ Number of Units _ ❑
Deck
❑ Commercial
Addition
❑ Garage
❑ Shed ❑
Other
Enter 1st Floor
1245sq ft ADIPL,
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 Availability
❑ On -Site Septic System Availability ❑
Project Valuation
i5� '–
Zoning
Lot Size
Existing Bldg Valuation
$
DVVN-
Name M Pnz4L— D )e4k-ri (�t5
City
Address
State
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
WashingMachine
Drains 76tal;:Fixiure.Count..
::;::::<::>::>::>::>::>::>::»:::<:>::>::>::s>:;:::
iE�Ei�#.... SIN.: ':Citi!1T::::.::::::::::.::EM,
MECHANICAL EVALUATION ONLY 5
Fuel Type (electric/other)
Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping
Range Air Handlin > = 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 Totai lriiLotlnt'' ...
>`>:'::;..
DIS CLAIMER: 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 of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of thisapplication.
Ownerk6.nt: ��(_� Date:
Buanwc.A,
REvaEo 8126197
AdOJ 0'131� '
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