96-102099 i4- /oz-09 9
• CITE' OF FEDERAL WAY PERMIT NO: BLD96-0264
33530 F i rs t Way South ':9001,„,.111 "rye;;. LEY 1 ilf lift! 9C'`"''fl '‘tI . .. T ISSUED: OB/08/96
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
ifr6`a;4000 EXPIRES: 02/04/97
ADDRESS :33515 10TH AVE S
NO. : 926925-0010
PROJECT DESCRI P T ION:TI - DENTAL OFFICE
p OWNER _.. _____.a__-.__-�- .= CONTRACTOR -- - -- LENDER
. .. __ = _ ._..-... xxxar. -aa-¢ ._ ._...__....-cxxs__..._...
DR. GARY DODOBARA ( D W SAFFLE COMPANY
33515 10TH PL SO. ' 7120 40TH ST W
FEDERAL WAY WA 98002 ( TACOMA WA 98466 t
839-5662 r 565-0654
1 DWSAFC*099LS
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE : 8.2% ***I
BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 I COMP PLAN 0 FEES:
TYPE OF WORK:TEN USE:COM 1ST.: 1845: 0:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS/ •' PLAN CHECK FEE $ 401.05
CENSUS CATEGORY •437 2ND.: 0: 0:sf HEIGHT • 000 ft ( HAZARD CLASS •' FINAL PLAN CHECK...* $ 0.00
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION ( REQUIRED SETBACKS FIRE FLOW • 0 gps BUILDING PERMIT....* $ 617.00
:B :? :? :? OTHR: 0: 0:sf EXIST..$: 0 €, FRONT • 0.00 ft PLCK-FIR corll only* $ 30.85
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 95000 SIDE • 0.00 ft WATER SERVICE..:? SBCC SURCHARGE * $ 4.50
:5-1HR:? :? :? DECK: 0: 0:sf REAR • 0.O0:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:07/10/96
: 18: 0: 0: 0: TOIL: 1845: 0:sf 1MPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
�_ --- -.____.__...._-.__aaaaaa..,__..r.._____ -------- -------- --- I as-- ... .__.. _-_aaaxx
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 1053.40
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
F RN<100K..: 0 DUCT WORK • 0 3-15 HP 0 SHOWERS • 0 SUMPS • 0
HWT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
V BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 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 ISS NCE NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFOR 1ION NISH D BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE C TY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT _--__ _- - _- DATE � 1 C>
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SETBACKS & FOOTINGS •
Date By
FOUNDATION,WALLS
Date By
PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH-IN
Date q/,�.o/9 By
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date zv �Jl Byr7 "Z
INSULATION
Date(, — By
GWB - 1ST LAYER//
Date /6/L�/9& By4›.15
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date 10-- By5 7
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
Naw
FIRE FINAL
Date //—//e— r 6 By C7
BUILDING INAL
Date //, (o//6,
/, (o //G, BYC� ✓
OTHE
Date By
OTHER
Date By
C D0193
0 • '
RECEIVED
City of Federal Way
JUL 101996 ,
v� L APPLICATION FOR BUILDING PERMITFYOFFEDERAL
BUILDING DEPT.
14.
PLEASE PRINT APPLICATION #: BLD9(Q— Dac..9
SITE LOCATION Address 357 ,'L i/mac, S'o, f �c- 6 `f ,�
i
Tenant (if known) Lot # -7 Assessor's Tax #
-
,N Building Owner Name Address
..S.A..-.\ tr. +Y'‘^ LC--
City 1.--1. _ ,,,J,q-� State `i- Zip i QC Phone 3'3.1 — 52F Cc Z
Nature of Work "7--c.--t,4,,,-7- -n,..i Pitelrlr"-.c--4 — -- 4.---- -.cr� C C
[APPLICANT
Name (F,M,L)
H&/i C— A - b.i c x
Address
rif
City iG i de_lC L r__}-ya State CA.),4- Zip ''P 7e%
Contact Person Day Phone Other Phone Fax
7_7>Llv ^if X 8 2 Y'c)3 5-5 z Z 7( (o
LUILDING CONTRACTOR
Company Name
ctiJ . cS.51F/=c c' CO
Address
7/Z0 1-o 57 - W
City T ra c-v--v ,a--_ State L,_i-,4- Zip q Cj ` (p
Contact Person Phone Fax
cP-a-ter <4r�t j&.5'- CvS'--
Contractor's #card must be presented Expiration Date Verified III Yes III No
7) J . ° Fc — 0cLS i
M CHITECT
Name 4 NAf.
Address 1. /f
fo ,4 vc _ � 0 _ S.—
City
City I� l /01.6 L is -----c State (,..J \/L Zip C7E() ,,
Contact Person Phone Fax
LEGAL DESCRIPTION
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Please Complete Reverse Side
CD0492(Rev 4/93)
STRUCTURE sting Use (1—Ty) 'posed Use
6
Permit includes: ❑ Building ❑ Plumbing ❑ Mechanical ❑ Other ,
Type of Work: ❑ Residential ❑ New i.,Remodel ❑ Number of Units ❑ Deck
' " Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor 1000 sq ft 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 ❑ K Project Valuation $ ei ..j
Zoning Lot Size Existing Bldg Valuation $
LENDER
Name Address
City\, State Zip
M . • NICAL CONTRACTOR
Contra .r Name Address /�
City State ip
Contact Phone Fax
License # Expiratio nate Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR .41 /
Contractor Name / Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets Sin • Ur •als Lawn Sprinklers
Bathtubs ► sh Washers Drinki • Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL UNIT C0 T MECHANICAL VALUATION ONLY $
Fuel Type (electric/ot • I Gas Dryer Air Handling < = 10,000 . M 15-30 Tons
a
Length of Gas Pipi-• Range Air Handling > = 10,000 CF 30-50 Tons
Furn <100K B' s Gas Log Unit Heater 50+ Tons
Furn >100 :Ills Fans Miscellaneous Fu• Tanks
Gas Hw Hood Boilers Ab.ve Ground
Cony E'urner Duct Work 0-3 Tons Under. ound
BB¢i's Wood Stoves 3-15 Tons Total Unit C. nt
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.
_ —_.._ ' - TT lv /C,Owner/Aa : � �LC • ` . Date: --
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