95-103336 MIL
-CITY OF FEDERAL WAY yp ` PERMIT NO: BLD95-0989
33530 . F i rs t. Way South 11 ; �,,,.,� .,•�,,. L..,�,,,,h.,,�,,. U"''li�,.,,ii ii;;;;u :;,.�'.' , ' .,�. ,,,�,,, ISSUED: 12/19/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KLC
661-4000 EXPIRES: 12/19/96
ADDRESS:33027 4TH PL S
N0. : 132140--0630
PROJECT DESCRIPTION:NSF - W/ PLUMBING & MECHANICAL ***APPROVED BASIC NO. 95-1016-V94***.
CAMPUS GLEN, LOT 1163.
E= OWNER ==_... ___.._._.. .. __T.. CONTRACTOR ____... __::_____.. ___-. __ LENDER =------- T
CAMPUS GLEN LTD PARTNERSHIP 1 POLYGON NW COMPANY I SEATTLE MORTGAGE
4030 LAKE WASHINGTON BLVD #201 I 4030 LK WASH BLVD NE 1 229 QUEEN ANNE AVE N
I IRKLAND WA 98033 1 KIRKLAND WA 98033 1 SEATTLE WA 98109
822-7700 ' 822-7700 i
POLYGNC051D4 {
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL NAY. TAX RATE : 8.2% ***
BLD?:X MEC?:X PLM?:X FLA--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN •SR ► FEES:
TYPE OF WORK:NEW USE:RES 1ST.: 0: 1187:sf STORIES • 2 REQUIRED PARKING..: 2 SPRINKLERS' •' PLAN CHECK FEE $ 100.00
CENSUS CATEGORY •101 2ND.: 0: 992:sf HEIGHT • 0.00 ft HAZARD CLASS •' PUB WKS PLCK(SF)..93 $ 40.00
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION s REQUIRED SETBACKS FIRE FLOW • 0 gpm BUILDING PERMIT....* $ 856.50
:? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 ! FRONT • 20.00 ft SBCC SURCHARGE * $ 4.50 @@
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 161274 s SIDE • 5.00 ft WATER SERVICE..:FED MEC APPLIANCE FEES.* $ 50.50
:? :? :? :? DECK: 0: 0:sf REAR • 5.00:ft SEWER SERVICE..:FED PLUMBING FIXT....93* $ 105.00
OCCUPANT LOAD GAR.: 0: 690:sf RECEIVED.:12/06/95
: 0: 0: 0: 0: TOTL: 0: 2869:sf IMPERV SURFACE: 2551 sf SENSITIVE AREAS?.:N
L OKTYPES.:GAS ELE FANS • 4 BOILERS/COMPRESSORS WATER CLOSETS • 3 URINALS • 0 1 TOTAL FEES $ 1156.50
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 SHOWERS • 3 SUMPS • 0
GAS NWT • 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
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 THAT THE INF MATIQN FUR IS1ED 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 k•�--- DATE 1-2---2—d-915-
FILE COPY
CITY OF F=EDERAL. WAY PERMIT NO: E3LD95 -0989
. 3533O First Way South DU .I L DI NG P ERM I. T ISSULD: 12/1/95
Federal Way, WA 9E3003 Building Inspection Requests 661"-47.40 BY: KLC
1. 661 -40010 EXPIRES: 12/19/96
ADDRESS:33027 4TH PL S
* NO. : 132140-0630
PROJECT DESCRIPTION:NSF - N/ PLUMBING 4 MECHANICAL ***APPROVED BASIC NO. 95-1016-V94***.
CAMPUS GLEN. LOT 163.
f> ONNER : arraa,a: ����,&���mn::� :�Ra* �:a as m.a:m..:,�a axt r,c ,:a�a,.z-,�, CONTRACTOR ,n,r zxrrn n m.a,�aa:,�•: _.a:� aar a,_ :Quo ���ra .= LENDER r .t=nava,.,crawrfl .nS zt..st su_�a,�. .:„tea :a aa=saa r=a=
I CAMPUS GIfN LTD PARTNERSHIP I POLYGON NW COMPANY SEATTLE MORTG4GE
4030 LAKE WASHINGTON BLVD 1201 I 4030 LK WASH BLVD NE 229 QUEEN ANNE AVE N I
K.IRKLAHD WA 9803:1 KIRKIAWD WA 98033 SEATTLE WA ‘8109
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822-7700 822-7700 .
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*** COtIKACT , I� A 00.1041� 3 , DIG SALES TAX T0R PEOJECIS t1T11IN"FUE CITY 01 FEDERAL WAY. TAX RAKE = 8 % stt
ai. 5 '� � w°" ,y z' .�J (�a A. -..,:.'.:n�.cscxr.-r a�n.ax:nrn:nsr..^.^s.:-::.uxxca:a,eca:..;.rnc.:a..x'sarn^.r-„_r.::ec..:saaec..:r.::%anns��vmrc.:.anaxmrsrsra�asxmwnaala,e.�krw:.^
':{t'tC.aat13Ma:'i-.'�IaCMACYIYR� 3SLSG.CAR�Ii:�'a:ILA fi•C:FRPR EYa:.T:rynZ n6 ClK'. lA?T "" k:C..�J
BLD?:X MEC?;X PLM?:1i FLR -E OP ,T` ”- � . t PLAN 5R j FEES:
TYPE OF WORE:NEW USE:RES 1ST.: 1187 s1 IE� � . �r,_ ,, r,R mer ` 4 ym PLAN CHECK FEE 100.00
CENSUS CATEGORY •101 : �r 1° IGH e°rI 1 i 2M 1e �, . �;HA : 'SSA PUB WKS PLCK(SF)..93 $ 40.00
OCCUPANCY GROUP � '� " , s r` ,LUA1 , KEQU(R� ',.`` - 3FIRE . .. .. i g 1 N PERMIT....# $ 856.50
1 . .IST . ...... �: . < `HARGE $ 4.50
TYPE OF CONSTRUCTION `;'' ' '` I ' ' a OP 5.00 ft MAZER SERVICI..:FED MEC APPLIANCE FEES.* $ 50.50
:? :? :? :? r g�"� ";Ammimem °` A� �, ,wAR • 5.00:ft SEWER SERVICE..:FED PLUMBING FIXT....93+ $ 105.00
I OCCUPANT LOAD I 6 E R„ ED 12 # 95 rn, =
0: 0: 0: 0: TOIL' . . IMPERY SURFACE: 2551 sf SENSITIVE AREAS?.:N
r,,6
�n1'.a9R 4%G:f3Y1iISDr1n1S.::C`.:Fty%eaaL"ar:TitmRat[FECtSBAa4 "t CCC¢0R4d Ra:eRAR'9C'Y*C3.n3.n3,s3.s 3..'.:aC.i:Cr r ICA:S::ST=qMAYR:WnzSflflS3.UCC3YJt.A'n•JI3:f3tSSlr•%MRSW3.Oi0i%L9'.fl3.fOS3.:t3.'::::.'Vis
SEL TYPES.:GAS LIE FANS • 4 BOILERS/COMPRESSORS WATER CLOSETS • 3 URINALS...... 0 TOTAL FEES $ 1156.50
S 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 SHOWERS • 3 SUMPS • 0
GAS HWT • 1 WOOD STOVES...: 0 15.30 HP • 0 I LAVATORIES • 4 VAC BREA RS..•: 0 I
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0 I SINKS • 1 DRAINS • 0
B80 • 0 MISC • 0 5+ HP • 0 I DISH WASHERS • 1 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS .- ELEC WIR HEATERS...: 0 OTHER FIXTURES.: 0 I
MANGE • 1 <_10,000 CFM: 0 ABOVE GROUND: 0 I IAUN WSW OUTLTS...: 1
GAS LOGS...: 0 ? 10.000 CFM: 0 UNDERGROUND.: 0
L:CKaltQitl MELL'iYR2".Ll Z'='.:.1.««.,3 S3..:%RQtn=CAL'niSt.'a[a.SVU3. 3'SDCRn@v3M:'.. w'3.ttfl ,93.S3L;HMtotFi:;R>L'.RAKL4=6Atmaa5*3.t 3. 3.SSY:%.t'3.3.3.ftkO.i1 S3S�
PUNITS EXPIRE 1:1 DAYS ATTt-R 1SSUA ;E if NO WORK IS STARTED. RESIDENTIAL AND GRADIN PERNITS EXPIRE ONE YEAR AREA BATE OF ISSUANCE.
I CERTIFY THAT TNF INTORMAIIOW FURNISHED BY NE IS IROS AND CORRECT TO TIE BEST 01 KY ENOWI EIDE AYD TIE APPLICAOLL CITY OF FEBFRAL WAY REQUIRENLKIS WILL NE NET.
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«r.aCity of Federal Way
--4y—mit=rziari__
RECAPPI.IQATION FOR BUILDING PERMIT
DEC 051995
PLEASE PRINT GU Y OF Fes❑ APPLICATION #: I s ^ bqg
SITELOCATIo : .4.Pn o fig, t` -_ 4
Tenant (if known) Lot # Assessor's Tax
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
APPLICANT
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
UII.UING CQNTRA;ditt
CompanyName
Poygon 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 # (card must be presented) Expiration Date Verified ❑ Yea 0 No
POLYGNCO51D4 03/09/96
•
CHITEC '..::
Name
Jay Middleton Design Group
Addr 4
4U30 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 4/931
•
—
STRUCT•• lkisting Use Vacant Proposed Use S.F. Dwelling
hermit includes: Q Building g Plumbing gi Mechanical ❑ Other
Type of Work: IX Residential El New ❑ Remodel ❑ Number of Units_ ❑ Deck
CI Commercial ❑ Addition CIGarage CIShed ElOther
Enter 1st Floor 1 k V t-1 sq ft 2nd Floor`119l--sq ft 3rd Floor sq ft Existing Floor Area sq ft
• Area Basement sq ft Decks sq ft Garage i, i f k' sq ft Proposed Total Area sq ft
Water Availability 12f Sewer Availability 0 On-Site Septic System Availability LIK.Wi: t Valyafagn
Zoning -2 Lot Size
(SR) S- 7. 11., /'") O•4;ing Bldg Vefu441 $.. ,'
........................... ... ....................... ..... ....... .. .......
............................ ... ....................... ...... ........ ... .....
:LE
Name Address
Seattle Mortgage 229 Queen Anne Ave. N.
City Seattle State WA Zip 98109
i GAY• G4� 1'44:: .k0 .•.... Bidding
Contractor Name • Address
City State Zip
Contact Phone Fax
•
License # Expiration Date Verified ❑ Yes ❑ No
>pY.. acoca rQR Bidding .
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
VLU
...........................................................................................
Water Closets 3 Sinks ( Urinals Lawn Sprinklers
Bathtubs ' - Dish Washers 1 Drinking Fountains Other
3r�
Showers Electric Water Heaters Sumps
Lavatories Ll Washing Machine I Drains TotalFixlJro:Count 1
1 Cii0.4.04t UNI`i`eiOti
1St
Fuel Type (electric/other) (—Yx5 Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping r/,3, Range 1 Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans ""1 Miscellaneous Fuel Tanks
Gas Hwt I Hood 1 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 beet 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 a h 'IsI 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 pert of this
application.
Owner/Agsnt:� 1✓" Date:
r tUb Pi-098_ ._
SITE PLAN -
SCALE: 1 is ®20' E 1 519 5
LOT 63, PLAT OF CAMPUS GLEN clry ,,FF:DBp:<. AY
B ILDI G 0
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64 ' . _.
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•
SOUTH 331ST PLACE
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11111•1111111111NM= MUM1/11111114
SITE PLAN APPROVAL
Permit Number. Z.,-,096 - D9�`
Approved By: _% n.:,
Date: /Z f 9d-
Comments:
s Comments: ..9-e--- L'o,,,-/Q/7 "-' S
POLYGON NORTHWEST PROJ.
4040 LAKE WASHINGTON BOULEVARD N.E., SUITE 201 LOT NO. 63 PLAN NO. g
KIRKLAND, WASHINGTON 98009 (206) 822-7700 BASIC NO.
CONT. REG. NO. POLYGNC088DF ADDRESS
ti
Le)-7- Size: 7, 6-73 Sf Lok CoVr'ruoe, n S I -(,. +