05-104205�ICIa
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Federal Way '��p
gtio PERMIT
COMMUNITY DEVELOPMENT SERVICES
33325 87H AVENUE SOUTH • 63 BOX 9718
FEDERAL WAY, WA 98063-97]8
253-835-2607• FAX 253-835-2609 O� FOG
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The following is reauired i6o% ation - an incomplete avnlication will not be
SITE ADDRESS 3290140TH AVE S, Federal Way, WA 98001
ASSESSOR'S TAX/PARCEL # 6 1 8 1 4 1- 0 4 2 0
SF MF CO ME EL PL DE EN FP
LEGAL DESCRIPTION (e.g. Acme Estates, Lot i) Northlake Ridge, Division 2, Lot #42
(Attach separate page for lengthy legal desenpnon)
Please
TYPE OF PERMIT ♦ BUILDING ❑ PLUMBING ❑ MECHANICAL
or
SUITE/UNIT # N/A
LOT SIZE (s,) 5,056
❑ 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 2221 C.
Lot 42 of Northlake Ridge, Division 2
City of Federal Way Registered Basic Plan Number 05-102568-00.
PROJECT NAME (Name of Business or Owner Last Name) Quadrant Homes
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
NAME
PRIMARY PHONE
Quadrant Homes
1 ( 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 0 1 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 0 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
Glen M. Lyons 425 646 - 8360 glen.lyons@quadranthomes.com
,per RCW 19.27.09$~: Lender informanon is
NAME
required if Project value aVceees $5,000
Quadrant Homes
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 $ 83.842.00
SPRINKLERED BUILDING? ❑ YES ♦ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ♦ NO
WATER SERVICE PROVIDER ♦ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ♦ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
PROPOSED
TOTAL
GAS LOGS
S . FT.
SQ. FT.
SQ. FT.
BASEMENT
FANS
0
HOODS(co-al)
0
0
0
0
FIRST
1
RANGES
0
MISC (Describe)
0
910
910
SECOND
GAS WATER HEATERS
1
VACUUM BREAKERS
DUCTS
0
1,356
1,356
THIRD
0
0
0
FOURTH
0
0
0
ADDITIONAL FLOORS (DESCRIBE)
0
0
0
DECK(COVERED?)
0
85
85
GARAGE ® CARPORT ❑
0
452
452
&XIE7IDG
PROPOSED
TOTAL
TOTAL EXWMG sr
TOTAL PROP09M XF
TOTAL W
NUMBER OF FLOORS
0
2
2
0
zsd3
2,803
**NEW HOMES ONLY** NUMBER OF BEDROOMS 4 ESTIMATED SELLING PRICE $ 292,800.00
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 $ 3.738.90
AIR HANDLING UNITS
0
EVAPORATIVE COOLERS
2
GAS LOGS
0
REFRIG. SYSTEMS
BBQS
7
FANS
0
HOODS(co-al)
0
WOODSTOVES
BOILERS
0
FIREPLACE INSERTS
1
RANGES
0
MISC (Describe)
COMPRESSORS
1
FURNACES
1
GAS WATER HEATERS
1
VACUUM BREAKERS
DUCTS
8
GAS PIPE OUTLETS
PLUMBING
3 BATHTUBS (or Tub/shower combo)
0
SHOWERS
4
WATER CLOSETS (Totiet) 0 MISC (Describe)
1 DISHWASHERS
2
SINKS
0
DRINKING FOUNTAINS
0 GAS PIPE OUTLETS
0
SUMPS
0
RAINWATER SYST
2 WASHING MACHINES
0
URINALS
4
HOSE BIBBS
5 LAVS (Bathroom sinks)
1
VACUUM BREAKERS
0
ELECTRIC WATER HEATERS
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 filed against the City of Federal Way, but only where such claim
arises out of the reliance of�he� ty, }µciuding its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application. k/ � ��
NAME/TITLE
RELATIONSHIP' O PROJEAV ❑ Owner ♦ Agent ❑ Contractor
ladrant Homes DATE 8/15/2005
(Title)
❑ Architect ❑ Other
FOR OFFICE USE ONLY- _
o NEW a ADDITION
o ALTERATION
a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
a YES ONO
BASIC PLAN?
o YES
a NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 — August 19, 2004 Page 2 of 4 k\Eandouts\Pennit Application
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