95-103340 .4400111116,
CITY OF FEDERAL WAY „w PERMIT MU : ULDJ..D -1006
23530 First Way South .N°;;�fi,,.,,,N ..,�,,. ,,..., ,�.,.,,h..,�,. "'' (..::'i .'°� "�,,.,. '�'� ”' ...�,,. �,.,. ISSUED: 06/ 2/ 6
Federal Way, WA 98003 Building inspection Requests 661--4140 BY: JTH
661-4000 EXPIRES: 12/09/96
ADDRESS: 319 S 330TH PL
NO. : 132140-0790
PROJECT DESCRI P PION:NSF W/PLUMBING AND MECHANICAL ***REVIEWED AS BASIC #95-1017-V94***
CAMPUS GLEN, LOT #79.
F= OWNER _ .- __ • CONTRACTOR -------- - - -_ ___ LENDER =_ ___ ----------__-_---_--.
I CAMPUS GLEN LTD PARTNERSHIP 1 POLYGON NW COMPANY SEATTLE MORTGAGE
1 4030 LK WASH BLVD NE, #201 4030 LK WASH BLVD NE 229 QUEEN ANNE AVE N •
•IRKLAND WA 98033 SUITE #201 SEATTLE WA 98109
KIRKLAND WA 98033
822-7700 I 822-7700 1
I POLYGNC051D4 ' I
--_.-----= 1 ----------- __...._...._
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RAPE = 8.2# ***
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BLD?:X MEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN SR FEES:
TYPE OF WORK:NEW USE:RES 1ST.: 0: 1187:sf STORIES • 2 REQUIRED PARKING..: 0 SPRINKLERS? ./ PLAN CHECK FEE $ 100.00
CENSUS CATEGORY •101 2ND.: 0: 992:sf HEIGHT 0.00 ft ; HAZARD CLASS '' FINAL PLAN CHECK...* $ 0.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm BUILDING PERMIT....* $ 856.50
:R3 :U1 :? :? OTHR: 0: 0:sf EXIST..$: 0 ' FRONT •'20.00 ft SBCC SURCHARGE * $ 4.50
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 161377 SIDE • 15.00 ft WATER SERVICE..:FED MEC APPLIANCE FEES.* $ 50.50
:5N :5N :? :? DECK: 0: 0:sf REAR • 15.O0:ft SEWER SERVICE..:FED PLUMBING FIXT....93* $ 105.00
OCCUPANT LOAD GAR.: 0: 696:sf RECEIVED.:12/06/95 PUB WKS PLCK(SF)..93 $ 40.00
: 0: 0: 0: 0: TOIL: 0: 2875:sf IMPERV SURFACE: 2769 sf SENSITIVE AREAS?.:N SCH IMPACT (SFR) $ 1707.00
MEL TYPES.:GAS ? FANS 4 BOILERS/COMPRESSORS WATER CLOSETS 3 URINALS • 0 TOTAL FEES $ 2863.50
GAS PIPING.: 22 ft HOOD • 1 0-3 HP • 0 BATH TUBS • 2 DRINKING FOUNT.: 0
FURN<100K..: 1 DUCT WORK.....: 0 3-15 HP • 0 R SHOWERS • 3 SUMPS • 0
GAS HWT • 1 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 4 VAC BREAKERS...: 0
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 1 DRAINS • 0 I e
( 880........: 0 MISC • 0 5+ HP • 0 DISH WASHERS • 1 LAWN SPRINKLERS: 0
GAS DRYER.,: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 1 <:10,000 CFM: • 0 ABOVE GROUND: 0 LAUN WSHR OUILTS...: 1
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAI THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT )) l
. lS.•....._.._...... __..-.._.._.___ ._._ DATE 677_/_Z"71..-(e;
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REVIEWEDUNP 4 niUDC • tPt
City of Federal Way ��
1 -11—» -44:19L rAPP
VV !�Y LICATION FOR BUILDING PERMIT
DEC O j 1995
PLEASE PRINT Ui i Y OF FEDERAL WAY APPLICATION #: V L-LYi " J UU
SITE LOCATION is 'G `j �3. tr D` ,
Tenant (if known) 1 Lot Assessor's Tex S
-761 131(-10-'01c10
7c1(
Building Owner Name Address
Campus Glen Limited Partnership 4030 Lake Washington Blvd NE #201
City Kirkland State WA Zip 98033 Phone
206-822-7700
Nature of work Construct Single Family Residence
A 'PLICANT
Name (F,M,L)
Campus Glen Limited Partnership
Address
4030 Lake Washington Blvd NE #201
cityKirkland State WA zip 98033
Contact Person Day Phone Other Phone Fax
Lori Perkins 206-822-7700 -- 206-827-4098
BUILUCNG CONTRACTOR;
Company Name
Polygon Northwest Company
Address
4030 Lake Washington Blvd NE #201
CityKirkland state WA Zip 98033
Contact Person Phone Fax
Lori Perkins 206-822-7700 206-827-4098
Contractor's S (card must be presented) Expiration Date Verified 0 Yes 0 No
POLYGNCO51D4 03/09/96
[RCIUTECT
Name '
Jay Middleton Design Group
Addrpus
4430 Lake Washington Blvd. NE #210
CityKirkland state WA zip 98033
Contact Person Phone Fax
Jay Middleton 827-4991 827-6405
LEGAL DESCRIPTION
Campus Glen Lot#
Please Complete Reverse Side
CD0492(Rev 4/931
:::::::::*:::: ::::::i*:::i:i*i*KI:*:]:::ii:!:::Wi:::i:Sii:iii: : :iii,i:*i:i:* . .
i
Use se
0 osed Use
fl Pr
11' I Vacant � p S.F. Dwellingermit includes: g Building J Plumbing gl Mechanical ❑ Other
ype of Work: IX Residential ® New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ AdditioCn� ❑ Garage El Shed ❑ Other
nter 1st Floor 1� 1 sq ft 2nd Floor I ' 2-aq ft 3rd Floor sq ft Existing Floor Area aq ft
• Area Basement sq ft Decks aq ft Garage, aq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ prof@pf VglflaI,jort $oning SR Lot Size 6137 gxiQtang...Irap Vt.luat.0n $ ...
........................................................................ ............ ..
..................................................................... .........
........... ......................................................... ............. ..
Name Address
Seattle Mortgage 229 Queen Anne Ave. N.
City Seattle State WA zip 98109
SIECIIANICAVCONTIaCTORaiiimiii. Bidding
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes El No
•
ptpl gi iCC1NTRAmo;. Bidding .
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING1' TUE COUNT :: ,?
Water Closets 3 Sinks ( Urinals Lawn Sprinklers
Bathtubs 2. Dish Washers I Drinking Fountains Other
Showers 3 Electric Water Heaters Sumps
Lavatories yWas Washing Machina
Drains ,`> :..><»;'. :« ' < <•»': si >>Total'Fixt�re.Count< <`a<
•
lYI CHANICAA UNI'`;eOUNT
Fuel Type (electric/other) 644:3
I Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range I Air Handling > = 10,000 CFM 30-50 Tons
Furn <10OK BTUs I Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fansa Miscellaneous Fuel Tanks
Gas Hwt Hood / Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
fi'Qtal.:U
BBQ's Wood Stoves 3-15 Tons nit Oaiint
DISCLAIMER: I certify under penalty of perjury that the Information furnished by me is true and correct to the beat of my knowledge and further that I am authorized by the owner
of the above premises to perform the wo • 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 Invests..tlo 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 cl im arises outibf t- -.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.
Owner/Agent: ( G Date: i 2--/Z/C6
• . . .
SITE PLAN
SCALE: 1" ■ 20'
LOT 79 . PLAT OF CAMPUS GLEN
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BSBL _ „ o3o49N APPROVE )`�a QQo�C
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�, �/ - / SUBJECT TO FIELD INSPECTION. b9&j .io •o ,y OVERSIGHT OR VIOLATIONS OF CITY ,?o� a o r
ORDINANCES ARE NOT INCLUDED IN dp •(2) wATr' tvii � ��ry THIS APPROVAL °o I °
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SITE PLAN APPROVA , re ISION DATE
Permit Number. I � - tIO /, /
Approved By: _,,;,e SEP i 7 1996 I
Date: • /' 1e;
Comments: o�j ,—.fes )0,,,z"-- • -10°
1r41°. T?d'.'✓- e
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POLYGON NORTHWEST PRUJ , 1 CAMPUS GLEN
4030 LAKE WASHINGTON BOULEVARD N . E . , SUITE 201 LUT NO , 79 PLAN NO ,
KIRKLAND, WASHINGTON 98009 (206) 822-7700
BASIC NO .
CONT . REG , NO , PULYGNC088DP
ADDRESS
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C T E IS G 1 N, E E Fi I N G MEMO 180 Nickerson ti
Suite 302
Z tC n S Seattle,WA
Date: "I
98109
To. L 616 �6L( S (206)285.751.2
AX:
From: !� E
Ai� n 206
((206)285.0618
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