99-102974 9940649-7 y
CITY OF FEDERAL WAY ��,,,. u llll uu,,,. r � PERMIT N : B D9 -0 87
33530 First Way South , I�,, II .,.11.,. N,.... .,ii,•.,,�..I1.. N �,'0 ,. ' yy p E O 9 4
�,: li i!' ��.li it .,.„. ..•:u,... ISSUED: 08/03/99
Federal Way, WA 98003 Building Inspection Requests 259-661-4140 BY: FC2
2.53--661-4000 EXPIRES: 01/30/00
ADDRESS:3OO5O 12TH LN SW
NO . : 515320.-.0220
PROJECT DESCRIPTION:RES ADD - REPLACE & SLIGHTLY ENLARGE SECOND STORY DECK
== OWNER --- -----. T- CONTRACTOR -- LENDER
JERRY ASHBY BERRYMAN CONSTRUCTION
30050 12TH LN SW ! 88 LAKE LOUISE DR SW
I
FEDERAL WAY WA 98023 ! LAKEWOOD WA 98498
4111/ !
;t
253/581-6614
_ 1 BERRYC*169C1
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN ROOMING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.6% ***
BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- EY,Ih0 UNITS. S COMP PLAN •? FEES:
TYPE OF WORK:ADD USE:RES 1ST.: 0: 0:Sf _TORIES... C RECUIRED PARKING..: 2 SPRINKLERS?... ...:? PLAN CHECK FEE $ 81.41
CENSUS CATEGORY •434 2ND.: 0: 0:sf _IGF' • 0.00 ftHAZARD CLASS.. .:? • BUILDING PERMIT....* $ 125.25
OCCUPANCY GROUP 3RD.:` 0: O:sf VALUATION. :EC.IRED:SETBACKS FIRS FLOW. ..: G .,),Ti.ySBCC SURCHARGE * $ 4.50
:' :? •? •? OTHR: 0: 0:sf EXTST..$ 3 rRONT.,,..
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 5280 SIDE • 5.00 ft WATER SERVICE..:?
l I
:? :? :? :? DECK: 0: 500:sf REAR • 5.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: O:sf RECEIVED.:08/03/99 I i
• 0: 0: 0: 0: TOIL: 0: 500:sf i IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
EL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 211.16
PIPING.: 0 ft HOOD • 0 0-3 TON • C BATH TUBS • 0 DRINKING FOUNT.: 0
RN<100K..: 0 DUCT WORK • 0 3-15 TON • 0 SHOWERS • 0 SUMPS • 0
, GAS HWT • 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K • 0 30-50 TON...: 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 50+ TON • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
i GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS j ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
i 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 TN[ TR 0RrpTTO? PIRM?S"ED BY ME IS TRUE AND CORRECT TO THE BEST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGEN- -_1;4 -_ DATE 61 /91_,____.-_
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•
Date `,/9/y'7 By
2
Date By
13 PLUMBING=ORO�IJNDWORK
Date By
...::::....
Date By
5 FOOTt1!I f i7Q RtNSPO DR/�1NS``
Date By
6
Date By
Date By
8 PLUMBING Rt�IJGH IN
Date By
9
Date By
10
Date By
Date By
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12 .................................................................................. .. . ..
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Date By
13
Date By
14
Date By
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15 • USFBNDEO CEl JNO
Date By
16 PLANNING'FINAL::
Date By
17 PUBLIC WORKS FINAL
Date By
18
Date By
•
19 BU[LOIML31=tNA[.
Date /z/f/ql' By
20 1 ....`. :::::::::....._.......
Date By
CD0193(Rev 4/97)
CITYOF 33530 Fust Way South
nom— Federal Way,WA 98003
ruV F3Y
RECEIVED (253)661-4000
RECEIVED Fax(253)661-4129
AUG 0 3 1999
APPLICATIOIy,KIFIREBUMLDING PERMIT
BUILDPLEASE PRINT APPLICATION # h - O CI 1
#itiOCOO » > <> :>> .s< > > >;> » Site e address L )
Tenantnames 2� �1 Lot # Assessor's Tax #
Building Owner's NameAddress
City ("I-2i20,-1V,
n�� State Zip Phone
Description of Work `( ,0 �tiv1 �{r
Name (F,M,L)
S i b 2 L, GE212`l iAA 1)1-4
Address
6-1 i--O GA
44 /5i= .�6✓
City ( ''c<-"ddO State Zip = i ,
Contact Person Day Phone Other Phone Fax
Gt z Lt 1-1'1 5.x"- /�
������.............................. Federal Way Business License #
Company Na
.1;312-2-11/4•1#55-4Address
c�
City l�'1Z�G:...C-tV3 State(44A Zip Celgy CU
Contact Person � Phone Fax 25-3
Contrac is # (card must byy presented) Expiration.Date Verified 0 Yes 0 No
AFgHtifECTMEMEMEMEMM
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
P/ease Complete Reverse Side
¶roposed xistin9 Use Use
Permit includes: �Buildin. ❑ Plumbin. ❑ Mechanical 0 Other
Type of Work: ,Residential ❑ New ❑ Remodel ❑ #of bedrooms ❑ Deck
❑ Commercial Addition ❑ Repair 0 Garage 0 Shed
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks C;t;t sq ft Garage sq ft Proposed Total Area sq ft
Water Availability 0 Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation $
Zoning f-J - ) c Lot Size 7,,7,G{ ^, Existing Bldg Valuation $
•
E10ER > > > '< ><< « <is>< <<> > For new residential only selling cost:
$
Name Address
City State Zip
...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
EMM
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
.....................................................................................
............................................................................. . ...
.....................................................................................
............................................. .............................. . ...
::PLUMBINOV. 1NT OTOIV >' > <;< ;<
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
..........................................................................................
PLUMBINaifiXTURe
..........................................................................................
............................................................................................
..........................................................................................
iMEMEM
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Tutsf 1=lxttfreGflunt,.
............................................. ................. ........................
.................... .. ................ . ..................... .................
.......................................... ..........................................
MECkAN........................................... ............................................
MECHANICAL EVALUATION ONLY $
Fuel Type (gas/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:{ht€t Ootitt
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.
Owner/Agent: G , _. , z - i _W Date: ..?./.:.39
BUiLoirq.Aw Or
REVISED 5/18/99