00-105326 !� •
City of
Way
Services Building - Single Family Permit #:00 - 105326 - 00 - SF
33530 1st Way S
Federal Way,WA 98003-6210 Inspection request line: 253.661.4140
Ph:253.661.4000 Fax:253.661.4129
— — (3:30pm cut-off for next day inspections)
Project Name: JONES
Project Address: 30019 21ST AVE SW Parcel Number: 012103 9119
Project Description: NSF-This permit is to final off the original permit#BLD97-0614
Owner Applicant Contractor Lender
Jonathan S Jones JONATHAN S JONES COMPLETE SITE SERVICES INC M AND T MORTAGE
1602 SW DASH POINT RD 31113 24TH AVE S
FEDERAL WAY WA FEDERAL WAY WA 98003 1717-341ST PL
98023-4530 FEDERAL WAY WA 98003
Includes:
Census category: 999-Unkno #1 #2 #3 #4
Occupancy Group: R-3
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.):
Basic Plan No Census Category 999-Unknown
Mechanical No Occupancy Group#1 R-3
Plumbing No
PERMIT EXPIRES April 23,2001,IF NO WORK IS STARTED.
Permit issued on October 25,2000
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accord. , e with the laws,rules and regulations of the State of Washington and
the City of Federal Way. i�/ � /IF
0_SC.Ifre Owner or agent: %`f Date: C
4111111✓
FINAL inspection: /p — Z — 0 p G— \`
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• CONSTRUIVON PERMIT APPLICATION
C4110.
Fr i-- APPLICATION Nl7MER: - L 0 ?jZ(o- - -
uV F=LY - - - - - - - - -
APPLICATION NUMBER:
APPLICATION NUMBER: - -
**The following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
1 ■ PROPERTY INFORMATION
SITE ADDRESS: E--C 4 9 c21Ai/e 5. 111 ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROTECT INFORMATION •
TYPE OF PROJECT(This application): oggicUILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL L❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 1--r Al(AI-- _ Ai ci ,
, , (-,4 -7.4.9.-r
___LEr ccrnt p-ec6& q tZ4fka-i 141,13-e_L- -717,_)--) ,
PROJECT NAME:
■ PEOPLE INFORMATION
PROPERTY OWNER: NAMEL._-. Vr�/ DAPHONE:
VOA / - �/rV , � �
iv-
- 99/0MAILINI% sSoo 9
CONTRACTOR: NAME: /n� DAYTIME PHONE:
060 i/476 ZI-6- C&V ,Li✓e_ (Zo® S49
)- /0
MAILING ADDRESS(STREET AD ;s�; ITY CSTATE,ZIPS EVENING PHONE:
0 EDERAL AY BUSINESS LICENSE NUMBER: FAX NUMBER:
- -
( )
ONTRACTORS REGISTRATION NUMBER EXPIRATION DATE:
- 4:24 Le/1/ 7/7 e kL.1" , 1 1
APPLICANT: NAM V O -
DAYTIME PHONE:
Sli � 7k ; � . (ae) O -
?c7(0/ /O
8 /7:
ADDRESS( S.Si iP,,O% `7/ A / EVENING PHONE:
( ) -
NSHIP
FAX NUMBER
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): - ( ) -
�/ E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: J PROPERTY OWNER 0 APPLICANT �$CONTRACTOR
/'�■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: • PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
{
**NEW RESIDENTIAL CONSTRUCTIDONLY** • ; £
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
• FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) _ EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
• • DISCLAIMER/SIGNATURE BLOCK
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 the permit application is made. I
further agree to hold harmless the City of Federal Way as to any daim(inducting costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such d•' •rises o • the relianceof the dty,induding its officers and employees,upon the accuracy
of the information supplied t!/..,)101.
�o . •s a part application.
NAME/TITLE: `m( DATE: ..•g5f1(6 .7% 24r3e3®
❑ PROPERTY OWN ' I APPLICANT ❑ CONTRACTOR
OR OFI CE'USE ONL'1f: I
HE IU . �.: ADDITION ❑ ALTERATION `. '.. PAIR ❑ "ENANT MPROVEMENT ;_'. .
ENSUS CODE.s Y�4 s SLOT E
ON�I IG)ESIGt ATION• � ILOIPCG{SHELL�IG Y? YES NO
�COMPPLAN DESIGNATION BASIN? `❑ACES 1O.
SECTION N TOWNSHIP RANGE mak.=. „'IE11 1bDR SS REf7UIRED?.._' _ Sr fl•
. O ,.....;
PLAT1 ED,LOT? ❑ YES NO ,;.C(. G:01 USE? ❑PES O
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253-661-4129