05-101308cffy or A RECEWD
Federal Way MAR 2 3 2005 P E RWT
COMMUNITY DEVELOPMENT SERVICES
33325 8TH AVENUE OTH9R3BOX 97]
8
FEDEALWAYW8063978
35-- 4) I C AT I O N
253-835-2607•F253-80T
F FEDE
uv— ntto;lcdemlwau mm. BUILDING DEPT AY
1�4 'S6S
SF F CO ME EL PL DE EN FP
ASSESSOR'S TAX/ PARCEL M 6 1 8 1 4 1 - 0 7 1 0 LOT SIZE (sp 4,068
LEGAL DESCRIPTION (e.g. Acme Estates, Lot i) North lake Ridge, Division 2, Lot #71
(Attach separate page for lengthy legal descnpt—)
PROJECT INFORMATION
TYPE OF PERMIT ♦ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only
Construction of Single Family Residence, Quadrant Homes Plan Number 2611 C.
Lot 71 of Northlake Ridge, Division 2
City of Federal Way Registered Basic Plan Number 05-100891-00.
PROJECT NAME (Name of Business or Owner Last Name) Quadrant Homes
PEOPLE•• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
NAME PRIMARY PHONE
Quadrant Homes ( 425) 455 - 2900
MAILING ADDRESS CITY, STATE, ZIP
PO Box 130 Bellevue, WA 98009
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Quadrant Homes
Quadrant Homes
Quadrant Homes
( 425) 455 -
2900
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
( 425) 864 - 9771
PO Box 130
Bellevue, WA 98009
( 425) 864 -
9771
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
1 —9- 9 —0- —1 11 9 1 4 - B L
12 / 31 / 2005
( 425) 455 -
2900
CONTRACTORS REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION DATE
Q U A D R C * 2 2 1 Q F
09 / 10
/ 2005
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Quadrant Homes
Quadrant Homes
( 425) 455 - 2900
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
PO Box 130
Bellevue, WA 98009
( 425) 864 - 9771
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ♦ Agent ❑ Other (Describe),
( 425) 646 - 8363
NAME PRIMARY PHONE E-MAIL ADDRESS
lack Britton 425 688 - 3708 jack.britton@quadranthomes.com
PerRCW�- -927.095:.Lender �ir&rrnaKon is
NAME
Quadrant Homes
,*"#*#Vp, Valla* sxeseds $5�000
MAILING ADDRESS
CITY, STATE, ZIP
PO Box 130
Bellevue, WA 98009
EXISTING USE N/A PROPOSED USE Single Family Residence
EXISTING ASSESSED/APPRAISED VALUE $ N/A VALUE OF PROPOSED WORK $ 98,050.00
SPRINKLERED BUILDING? ❑ YES ♦ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ♦ NO
WATER SERVICE PROVIDER ♦ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE (WELL)
PROJECTI nAS
AREA DESCRIPTION
EXISTING
PROPOSED
TOTAL
0 HOODS )co oro— el)
SQ. FT.
SQ. FT.
SQ. FT.
BASEMENT
I FURNACES
I GAS WATER HEATERS
0 DUCTS
9 GAS PIPE OUTLETS
0
0
0
FIRST
3 BATHTUBS (or Tub/shower combo)
0 SHOWERS
4 WATER CLOSETS (roikt)
1 DISHWASHERS
0
1,126
1 126
SECOND
0 RAINWATER SYST
2 WASHING MACHINES
_0 URINALS
4 HOSE BIBBS
0
1,524
1,524
THIRD
0
0
0
FOURTH
0
0
0
ADDITIONAL FLOORS (DESCRIBE)
0
0
0
DECK(COVERED?)
0
142
142
GARAGE ® CARPORT ❑
0
407
407
stGsrmG
rRorosso
TOTAL
TOTAL XXOMG BY
Toru TRorOsw sr
IoMsr
NUMBER OF FLOORS
0
2
2
0
3,199
3,199
**NEW HOMES ONLY** NUMBER OF BEDROOMS 4 ESTIMATED SELLING PRICE $ 293 200.00
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $ 4,372.50
1 AIR HANDLING UNITS
0 EVAPORATIVE COOLERS 3 GAS LOGS
0 BBQS
6 FANS
0 HOODS )co oro— el)
0 BOILERS
0 FIREPLACE INSERTS
1 RANGES
0 COMPRESSORS
I FURNACES
I GAS WATER HEATERS
0 DUCTS
9 GAS PIPE OUTLETS
0 NO
PLUMBING
CHANGE OF USE?
3 BATHTUBS (or Tub/shower combo)
0 SHOWERS
4 WATER CLOSETS (roikt)
1 DISHWASHERS
2 SINKS
0 DRINKING FOUNTAINS
0 GAS PIPE OUTLETS
0 SUMPS
0 RAINWATER SYST
2 WASHING MACHINES
_0 URINALS
4 HOSE BIBBS
0 REFRIG. SYSTEMS
0 WOODSTOVES
0 MISC (Describe)
0 MISC (Describe)
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 the permit application is made. I further agree to hold
harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of
such claim, which may be made by any person, including the undersigned, and flied 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.
NAME/TITLE
Al
Zy' (Signature)
RELATIONSHIP TO PROJECT ❑ Owner ♦ Agent ❑ Contractor
luadrant Homes DATE 3/14/2005
(Title)
❑ Architect ❑ Other
• iH"OR Oh`�'I4"E��-�tltleY : ; , ' . -.
0 NEW o ADDITION
o ALTERATION
a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
0 YES 0 NO
BASIC PLAN?
0 YES
0 NO
ZONING DESIGNATION
CHANGE OF USE?
0 YES
a NO
NEW ADDRESS REQUIRED?
a YES 0 NO
UP/SEPA/SU?
a YES
a NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 - August 19, 2004 Page 2 of 4 k\Handouts\Pennit Application
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