94-101967 ,i'J — jai gt'7
CITY
335300Firstt Way South F FEDERAL WAY BUILDING P PERMIT ISSUED:NO: 10/11/9490
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 04/09/95
ADDRESS:823 S MARINE HILLS WAY
NO. : 515293-0050
PROJECT DESCRIPTION:
4 OWNER — — CONTRACTOR — LENDER
TEDRICK ROOFING JINC TEDRICK'S ROOFING INC
29211 158TH AVE SE 29211 - 158TH AVE SE
KENT NA 98042 KENT NA 98042
824-3440 800-701-2606
TEDRIRI121NC
BLD?:X NEC?:? PLM?:? FIR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN .? FEES:
TYPE OF NORK:ADD USE:? 1ST.: 0: O:sf STORIES - 0 REQUIRED PARKING..: 0 SPRINKLERS/ •9 BUILDING PERMIT....* $ 63.00
CENSUS CATEGORY -434 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS ./ SBCC SURCHARGE * $ 4.50
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gps
:? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 3500 SIDE • 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: 0:sf REAR • O.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:10/11/94
. 0: 0: 0: 0: TOTL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:? ? FANS - 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS - 0 TOTAL FEES $ 67.50
GAS PIPING.: 0 ft HOOD - 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
4111 FURN<1O0K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
GAS HMT . 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV 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 NTR 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 ISSUANCE IF NO WORK IS STAR 1. ', IDENT •L AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE F ISSUANCE.
I CERTIFY THAT THE INFORMATI4 FURNISED BY N R 'ND COR' T TO BES, OF MY KNOWLEDGE AND THE APPLICABLE C TY OF ERERAL NAY REQUIREMENTS WILL BE NET.
OWNER OR AGE i.,_ rY 1, if_ DATE i
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4 yrs ,
«•� • Cityof Ali
w ��` � Federal Way
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT
APPLICATION#: ,g4a 9 q " c97
SITE LOCATION 1Address .-47;Z 3 C�j. Ma.vll 1elp (-h 1 is V ,i..
Tenant (if known) Lot # IAss`essor's Tax#
Building Owner Name %- • Address /
f1.,�U-/ / /J 7/1" -rJ%cfX
(4Z-3 J6.2'12R/71i/3' i /4 Gv /
City/1:,11 I State 4/4- Zip3 `, /r9
Nature of Work �'v�� �� Phone, _ 0
7
APPLICANT J
Name(F,M,L)
Address
City State
Zip
Contact Person Day Phone Other Phone
Fax
BUILDING CONTRACTOR . I
Company Narr /
/�fJX/L �/�D�A' :..1-4-i-c,
Address /> • /
City ic,�9�// 1,51 .4( -7•-//
„ — State Zip gie-z)/42
Con ..PersonFax
N/70)016' /C - 1 o y .3/K\ /1-) 'o-7�) a ,-� 3/
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
ARCHITECT.;;::><::::::::' ; >:::`<.1111:<::<:>:::>;:;:>
Name
Address
City State
Zip
Contact Person
Phone Fax
LEGAL DESCRIPTION /�
0 /� �i�ioaP/ b��il qtL 'Y7./Zel____rli
'
</ e./Y-i7,2ieDvi-- G[ir/� / "C4- '.•Ov(
A /)Jo4J c,2 Go2vr'
Please Complete Reverse Side
CD0492(Rev 4/93(
................................................... .
STRUCTURE Exia • Use P.ed Use
•
Permit includes: ❑ I ding ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: f S"Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor 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 Cl Sewer Availability ❑ On-Site Septic System Availability ❑ Proreat:l�eluabon S � r
Zoning Lot Size Existin?Bld aluation
LENDER
Name Address
City State Zip
...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
+e r tCA O ACmt R >
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR > :`
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
...........................................................................................
...........................................................................................
PLUM iNG IXTURR:.COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains
Tatal:Fixture;(✓ourit :::::::::.....
MECHANICAL UNIT COUNT
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
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit 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 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 Oa' ),whic 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 Cit luding i officers and employees,upon the accuracy of the infor tion supplied to the City as a part of this
application.
Ci
Owne7Agent: ;%� — s 2-C,A., Date:7.1;'. s e,/