96-102660 56„ l0D6 ( O
CITY OF FEDERAL WAY PERMI1 NO: BLD96-0331
33530 First Way South . " i�,....M ,if, N,....:P.,� IP4 It''''',, "-Ph .I. „I.,,. ISSUED: 08/30/96
Federal Way , WA 98003 Building Inspection Requests 661- 4140 BY : KLC
661-4000 EXPIRES: 08/30/97
ADDRESS:315 S 331ST PL
NO. : 132140-0610
PROJECT DESCRIPTION:NSF W/PLUMBING AND MECHANICAL. **BASIC PLAN 95-1018-V94**
CAMPUS GLEN, LOT 161.
Fr- OWNER --. -- ___ _ 4 CONTRACTOR ---- ..-.--=----.- .... 7-- LENDER --.__.__ --____ __ _
CAMPUS GLEN LTD PARTNERSHIP 1 POLYGON NW COMPANY i SEATTLE MORTGAGE
4030 LK WASH BLVD NE, STE. 201 1 4030 LK WASH BLVD NE ! 229 QUEEN ANNE AVE N
KIRKLAND WA 98033 SUITE 1201 1 SEATTLE WA 98109
822-7700 1 KIRKLAND WA 98033 I
822-7700
101.. 1 POLYGNCO51D4 y
_ * CONTRACTORS, PLEASE USE LOCATION CODE 1132 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL MAY. TAX RATE = 8.2% at
BLD?:X MEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN •SFHD FEES:
TYPE OF WORK:NEW USE:RES 1ST.: 0: 658:sf STORIES • 2 REQUIRED PARKING..: 2 SPRINKLERS' . PLAN CHECK FEE $ 100.00
CENSUS CATEGORY •101 2ND.: 0: 666:sf HEIGHT • 0.00 ft HAZARD CLASS •9 PUB WKS PLCK(SF)..93 $ 40.00
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm PW INSP FEE DEPOSIT $ 110.00
:R3 :U1 :? :? : OTHR: 0: 0:sf EXIST..$: 0 FRONT • 20.00 ft BUILDING PERMIT....* $ 643.00
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 100627 SIDE • 5.00 ft WATER SERVICE..:FED ; Mechanical Permit* $ 90.00
:5N :5N :? :? DECK: 0: O:sf REAR • 15.00:ft SEWER SERVICE. :FED SBCC SURCHARGE * $ 4.50
OCCUPANT LOAD GAR.: 0: 572:sf RECEIVED.:08/09/96 SCH IMPACT (SFR) $ 1707.00
: 0: 0: 0: 0: TOTL: 0: 1896:sf IMPERV SURFACE: 1861 sf SENSITIVE AREAS?.:N y PLUMBING FIXT....93* $ 91.00
---. -_ __._..._-__ .. ._..,.._ ___.__»_==,,ccs=c=.c___..____._-..
FUEL TYPES.:GAS ? FANS • 4 BOILERS/COMPRESSORS WATER CLOSETS • 3 URINALS • 0 TOTAL FEES $ 2785.50
GAS PIPING.: 38 ft HOOD • 1 0-3 HP • 0 BATH TUBS • 2 DRINKING FOUNT.: 0
aN<100K..: 1 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 1 SUMPS • 0
HWT • 1 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 4 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 SINKS • 1 DRAINS • 0 I f
BBQ • 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 OUTLTS...: 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 B E IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT �' })0DATE �� 3 0 -y
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�.•� G 411 Cikx of Federal WI PI o,n 3 La
uv Fry' APPLICATION FOR B1ING PERMI1
IWC d 9 1996 9 5-lot&- V R`/
PLEASE PRINT CI BUILDING;DEPTY RA T AY APPLICATION #: f>L 1 V/` oZ1
STi'L' LOCATION Address 3 i n 3. 3.,) �}4) .
Tenant (if known) Lot X Assessor's Tax I
' 9c-4io I a
Building Owner Name Address
Campus Glen Limited Partnership 4030 Lake Washington Blvd NE #201
City Kirkland state WA Zip 98033 Phone 206-822-770C
Nature of Work Construct Single Family Residence
......................
A ' CAN
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
BUII.DING CONTRACTOR
CompanyName
Poygon Northwest Company
Address
4030 Lake Washington Blvd NE #201
CityKirkland state WA TP 98033
Contact Person Phone Fax
Lori Perkins 206-822-7700 206-827-4098
Contractor's I (card must be presented) Expiration Date Verified 0 Yes 0 l
POLYGNCO51D4 03/09/96
•
ARCHITECT
Name
Jay Middleton Design Group
Addrpus30 Lake Washington Blvd. NE #210
City Kirkland 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
3
STRUCTURE •1Use Vacant •PosedUse
S.F. Dwelling
Permit includes: g Building gi Plumbing 4 Mechanical 0 Other
Type of Work: IN Residential NJ New 0 Remodel 0 Number of Units_ ❑ Deck
❑QCommercial ❑ Addition 0 Garage ❑ Shed 0 Other
Enter 1st Floor l0✓U sq ft 2nd Floor fn(Q/p sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage 5.i.J. sq ft Proposed Total Area sq ft
Water Availability 4. Sewer Availability %ID On-Site Septic System Availability ❑ 'Project 17g1►18p4i1 4>
Zoning SR Lot Size j 005661.3 � Existing Bldg./..... p $ _
' D, b S t � �
i tr-
.
LENDER`
Name Address
Seattle Mortgage 229 Queen Anne Ave. N.
•
City Seattle State WA ZP 98109
1VtEECHANTCAL'CONTRACTOR Bidding
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
...........................................................................................
R.V.O.N.1001.0igg..N.7.44C1-.0•AfiigniMiMa, Bidding
Contractor Name Address
City State Zip
Contact Phone Fax
I License # Expiration Date Verified 0 Yes 0 No
PI UIFI. ........... GOU ]T
Water Closets -2, Sinks I Urinals Lawn Sprinklers
Bathtubs ' 1 Dish Washers ) Drinking Fountains Other
Showers Z- Electric Water Heaters Sumps
Lavatories 1-/ Washing Machine ( DrainsTotal Fixttrri>C.oi n"., «•••••••[< :>
........................
1KECaANICAL'UNi COUNT
Fuel Type (electric/other) C7as Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping jg / Range + Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs I Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans L- Miscellaneous Fuel Tanks
Gas Hwt I Hood / Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total>Unit Cant#sa .... ` ? >
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 lam authorized by the owner
of the above premises to perf rmthf 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 incurrelin'rive tlgation and defense of such claim),which may be made by any person,including the undersigned,and tiled against the City of Federal Way,
but only where such cl I , arises • t of the.r lience f the City, Including Its officers and employees,upon the accuracy of the Information supplied to the City as a part of this
application.
O /^` r
Owner/Agent: (/ V -J� Dec ?//17/6769
LID9(o 0331
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N 29'3301" w SITE PLAN REcEi ,
2.82SCALE: 1 ■ 20' ED
• LOT 81 , PLAT LAT OF CAMPUS GLEN AUG 0 9 1996
. ��, GI i Y OF FEDERAL WAY
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POLYGON NORTHWEST PROJ . 1 CAMPUS GLEN
4030 LAKE WASHINGTON BOULEVARD N. E . , SUITE 201 LOT NO . 61 PLAN NO .
KIRKLAND, WASHINGTON 98009 (206) 822-7700 BASIC NO .
CONT , REG . NO . P❑LYGNC088DP ADDRESS
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