94-102120 9y, /Dt)J.2.0
CITY
335300FirstF EWay RAL Sout�, BUILDING PERMIT PER ISSUED: 11/28/94MIT NO: 47
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 05/27/95
ADDRESS:613 S 331ST PL.
NO. : 132140-0330
PROJECT DESCRIPTION:NSF - W/ PLUM & MECH. APPROVED BASIC 194-1029-V91.
CAMPUS GLEN, LOT 133. PLAN 3483.
OWNER ' - CONTRACTOR r- LENDER
If
CAMPUS GLEN LTD PARTNERSHIP POLYGON NW COMPANY t SEATTLE MORTGAGE
4030 LK WASHINGTON BLVD NE 201 4030 LK WASH BLVD NE 229 QUEEN ANNE AVE N
KIRKLAND NA 98033 KIRKLAND NA 98033 SEATTLE WA 98109
822-7700 822-7700
POLYGNC088DP
BLD?:X MEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN -SR FEES:
TYPE Of WORK:NEW USE:RES 1ST.: 0: 967:sf STORIES • 2 REQUIRED PARKING..: 2 SPRINKLERS? 0 PLAN CHECK DEPOSIT.* $ 100.00
CENSUS CATEGORY •101 2ND.: 0: 140:sf HEIGHT • 0.00 ft HAZARD CLASS •1 PUB WKS PLCK(SF)..93 $ 40.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW 0 gpi BUILDING PERMIT....# $ 639.50
•R3 •M1 - OTHR: 0: 0:sf EXIST..$: 0 FRONT • 20.00 ft SBCC SURCHARGE * $ 4.50
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 99184 SIDE • 5.00 ft WATER SERVICE..:FED MEC APPLIANCE FEES.* $ 68.00
•5N •5N DECK: 0: 0:sf REAR • 5.00:ft SEWER SERVICE..:FED PLUMBING FIXT....93* $ 91.00
OCCUPANT LOAD GAR.: 0: 103:sf RECEIVED.:11/03/94 RADON KIT 93 $ 20.00
0: 0: 0: 0: TOIL: 0: 2410:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
• FUEL TYPES.:GAS ELE FANS - 5 BOILERS/COMPRESSORS WATER CLOSETS • 3 URINALS . 0 TOTAL FEES $ 963.00
GAS PIPING.: 38 ft HOOD • 1 0-3 HP • 0 BATH TUBS - 1 DRINKING FOUNT.: 0
FURN<1OOK..: 1 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 2 SUMPS • 0
GAS 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
BBQ - 0 MISC • 0 5+ HP • 0 DISH WASHERS . 1 LAWN SPRINKLERS: 0
GAS DRYER..: 1 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...: 1 > 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AF ' NCE IF ,: i• S STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
* I CERTIFY THAT THE INFO • ION FURNI'AD BY E AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
Walt
OWNER OR AGENT 1'�ari _ ► ----
--i _ DATE :07),..„--A,
-.—..._.______ FILE COPY /3835 $ $901
()(6ti i '> RECEIVED
u..� • City of Federal Way •
- "=`-`�-,� NOV 0 31994
Fill.'" APPLICATION FOR UILUING PERMIT
po n ,^ 34 3 CITY OF FEDERAL WAY
BUILDING DEPT.
PLEASE PRINT APPLICATION #: OLD q ()pi 7-
SITE LOCATION : Addro99 (/3 $ 3/3' pi.n 4i 6`
Tenant (if known) Lot # ^� 3 Assessor's Tex X
�J /:3z/17#v — 0330
Building Owner Name Addross
Campus Glen Limited Partnership 4030 Lake Washington Blvd NE, #201
City Kirkland State WA Zip 98033 Phone 822-7700
Nature of Work Construct Single Family House 415// lie T4/ -C'v Z.-,--- (,may/
Name(F,M,L)
Campus Glen Limited Partnership
Address
4030 Lake Washington Blvd. NE, Suite 201
City Kirkland stato WA Zip 98033
Contact Person Day Phone Other Phone Fax
Lori Perkins 822-7700 N/A 827-4098
I3 0.1.0.G CONTRAC 0 .
Company Name
Polygon Northwest Company
Addross
4030 Lake Washington Blvd. NE, Suite 201
city Kirkland State WA Zip
9nll
Contact Person Phone Fax
Lori Perkins or Greg Arms 822-7700 R77-4n9R
Contractor's #(card must be presented) Exp iration te
DaVerified 0 Yes 0 No
POLYGNC088DP 03/09/95
Name
Jay Middleton Design Group
Address
4030 Lake Washington Blvd NE, Suite 210
city Kirkland state WA zip 98033
Contact Person Phone Fox
Jay Middleton 827-4991 827-6405
LEGAL DESCRIPTION
Campus Glen Lot# 2
Please Complete Reverse Side
CD0492(Rev 4/93)
`_—_1 1 L'1 1 I _: 1 — — — -- —
STRUCTURELaing Usa 41001/0S011 Use
Vacant S.F. Dwelling
Permit includes: _ Building All Plumbing ,j< Mechanical Ll Other
e
•hypo of Work: 'K Itonidootinl )(I Now I I Itnnrorlel I I Nun,bor of Unita Il Deck
U Commercial I-1 Addition 1-1 Garage LI Shod U Other
Enter 1st Floor city sq ft 2nd Floor 72-10 sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement /sq ft Docks sq ft Geroge-70:5 eq ft Proposed Total Area sq ft
Water Availability W Sewer Availability t On-Site Septic System Availability 0 Project Valuation. S
Zoning -5,--A FN.- 7 I lot Size i L.` q l S ,( Existing Bldg Valuation: $
LENULIt
Nome Address
Seattle Mortgage 229 Queen Anne Ave. N.
City Seattle State WA zip 98109
IVIECIIANIC,AL:CON RAC'I'UIi _ •(d(�k n G
Contractor Name J Address
City State Zip
Contact Phone . Fax
License N Expiration Date Verified 0 Yes 0 No
1 . . . E . B( o c i n
5
Contractor Name Address
City State Zip
Contact Phone Fax
License ® Expirnlion Date Verified 0 Yon 0 No
PLUAMINO FIXTUR'COUNT
Water Closets Sinks 1 Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers '2. Electric Water Heaters Sumps
LavatoriesWashing I Drains totsl'Fizttlrb Coilh[
Machine
1 LCIIANICAL UNIT CUUN : :•
.............. ........... .............:......................
Fuel Type (electric/other) 6aS Gas Dryor Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping 3g 1 Range I Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs I Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans y Miscellaneous Fuel Tanks
Gas Hwt I Hood ( Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ'a • Wood Stoves 3-15 Toni Total Urjjt,:Coypt:
DISCLAIMER: I certify under penalty of poijury 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. . a nse of such claim),which may be made by any person,Including the undersigned,and filed against the City of Federal Way,
but only where stich,clens out of flu, .minae of the City,Including Its of lice..mrd mnployee.,upon the accuracy of the Information supplied to the City as a pert of this
application. O4A
Owner/Agent: ( i
Date: / i21q11
VTR PLAN APPROVAL
•
'omit Number. .%a -v oe
Appmyed By: /,
ate: i //!rr .
Com. c:a: '5 - / ../,
3LD q14 --- Ogi---i7
- RECEIVED
•
NOV 031994
CITY OF FEDERAL WAY
BUILDING DEPT.
SITE PLAN
SCALE: 1' = 20'
LOT 33, PLAT OF CAMPUS GLEN
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S. 331st PLACEin
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POLYGON - NORTHWEST PROJ.
4040 LAKE WASHINGTON BOULEVARD N.E., SUITE 2.01 LOT NO. 33 PLAN NO.
KIRKLAND, WASHINGTON 98009 (206) 822-7700 BASIC NO.
CONT. REG. NO. POLYGNC088DF ADDRESS
. F/ce ____ _