98-103932 gs-�39�a
CITY OF FEDERAL WAY PERMIT NO: BL_D98-0704
t WaySouth t r, ; �°4 O.....0:;';': I+.. :.1M',',,rt:!°: I'"I M'::::,r IF' :.`',;`if" .Ill.I „ " ISSUED: 10/14/98
33530 F�i rs ��
Federal Way, WA 98003 Building Inspection Requests 253-661-4140 BY: FC
253-661-4000 EXPIRES: 04/12/99
ADDRESS: 33028 49TH AVE W
NO. : 802952-0150
PROJECT DESCRIPTION:GRADE AND FILL PERMIT- 458 CUBIC YARDS
F= OWNER . -- -- Y CONTRACTOR -- -- - _- - LENDER
DOUG IVERSON ; OWNER IS CONTRACTOR -
33028 49TH AVE SW
FEDERAL WAY WA 98023
E i
•3-952-6377
N/A
3 rt
*** CONTRACTORS, PLEASE USE LOCATION CODE 1132 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.6% ::t
BLD?:X MEC?:? PLM?:? FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •SFHD FEES:
TYPE OF WORK:? USE:RES 1ST.: 0: O:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS' •' PLAN CHECK FEE $ 49.25
CENSUS CATEGORY •999 2ND.: 0: O:sf HEIGHT • 0.00 ft HAZARD CLASS •' BUILDING PERMIT....* $ 107.50
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION ` REQUIRED SETBACKS FIRE FLOW • 0 gpm SBCC SURCHARGE * $ 4.50
:? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 0 SIDE . 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: O:sf ! REAR • 0.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: O:sf RECEIVED.:10/14/98
0: 0: 0: 0: TOIL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
_ -. 1
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS j WATER CLOSETS • 0 URINALS • 0 1 TOTAL FEES $ 161.25
GAS PIPING.: 0 ft HOOD • 0 0-3 TON • 0 E BATH TUBS • 0 DRINKING FOUNT.: 0
N<100K..: 0 DUCT WORK • 0 3-15 TON • 0 I SHOWERS 0 SUMPS • 0
h NWT • 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES • 0 VAC BREAKERS...: 0
J CONV BURNER: 0 FURN>100K • 0 30-50 TON...: 0 r
SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 50+ TON • 0 ! DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 ; LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 , t
g
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 INFORMATION FURNISHED BY ME TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT _Z): _e _ _ DATE /v,/i ./71,
FILE COPY
, . .
CIT,' OF FEDERAL W,-.,Y PERMIT NO: BLD92-0704
33530 First Way (.2:outh DU T. g DI HO PC rt toil ii 1.:,--,SULTI: 10/14
Federal Way, WA t-mo0A Building In .F r,:-_,.. 11w.7.f,-.7-, 253-661 4140 UY: FC
253-661-4000 EXPIPF ' 12/99
. ,
ADDRESS;:330:"13 491.11 AVI. k1
NO. : 802952 01511
PROJILt I DLSCR I P 1 ION:GRADE AND FIR PERMIT- 58 CUBIC YARDS
DOUG IVERSON OWNER IS CONTRACTOR
` 33028 49TH AVE 'A
FEDERAL WAY NA 98023 ‘K Iltillir
116-952-6377 I
! N/A
ris CONTRACIONS. PLEASE USE 1.0thrION t ' Itif - 1 , igili oh U 01 FEk?A1. MAY. TAX RATE : LA% sts
I
BLD :% ME(^:? PLN?:? 1ut-ortI-4f0P-,- '-DWELLING PRITr! r .:SFHD FEES:
I TYPE or NOM? OSE:RES 1ST.: 0: 0:sf STMTS. : 0 SPRINKLERS"' -, PLAN CHECK TEC $ 49.25
I CENSUS (Al;iGORY.....:999 2ND.: .0:: O. ' -0' .00 fE 1 HAZARD CLASS 0 WILDING PERMIT....1 $ 107.50
OCCUPANCY GROUP-- .----- 3RD.: 4:: 01
's..? 08: 0:. ,.
Of (INSTRUCTION 4
-.-- -'1901! - ' ,- 4/: ' -k, ,,, ,114f11,00,..,: 0 *a 'la SURCHARGE.....* $ 4.50
:? :? :?
, I,,...44,4,.* (1.00 ft
TYPE ,-,-, -
ADE.i.i. i...: 0Gt It, *TER tIft8141..:^
I :? :? :? :" • DE(T: -9 ' REMM.:... ::'0.00tft -SEWER sERVICE..:7
• ,
OCCUPANT LOAD--------- -- L - . i 0 "
: U: 0: 0: 0: A --- '''' 'On* SURFACE: 0 sf SENSITIVE AREAS?.:?
- , ,
FUEL TYPES.:? ? i OMPRESS016 ' WATER CLOSETS • 0 URINALS • 0 1141 FEES I 161.25
. I GAS PIPING.: 0 ft ION • 0 OATH TUBS._......: 0 4INKING FOUNT.: 0
0111 ILIOOK..: 0 ' 4111:: , : i5 TOW • 0 SOONERS • Cl SUMPS • n
1011 0 15-30 ION...: 0 LAVATOKIES • 0 VAC DREAKERS...: 0
CONY BURNER:
..
8110 ,,
50f TON 0 DISH WASHERS
GAS DRYER.,- ' UNITS 30-50 'W..: 0 SINKS
•
FUEL TANKS ' 0 DRAINS • 9
• 0 LAWN SPRINKLERS: 0
ELEC VTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE... 10 (FM: 0 ABOVE GROUND: 0 LAUN WSHII 00ILTS...: 0
CP, LIC. _ ,000 (FM: 0 UNDERGROUND.: 0
Pt ISAMU If NO NONE IS SIARIFO. RESIDENTIAL AND OAKS ?UNITS MIRE ONE YEAR MIEN DAR Of ISSUANCE.
I i '41I FURNISHED 8Y Mf/p TRUE AND CORRECT TO THE ktSf Of NY KNOWN' AND JUL APPIICAIILE CITY 0 RAM RAY KtOOMAINTS VIII Et 10.T.
ONIffP / ,a,
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FIELD COPY -k
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i CiTI! OF FA`VE�OPMENT
MUNE®ERITY UE
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A N 0EPT• pF Cum" LD98-D'04 -
B
I 49TH AVE SW FILL -
3,:028 GRADE AND t, r1
10-14 98 �'
IVERSO►`I b � � �1
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DATE APPROVEDL -- it
DATESUBM ,�.�Is /i
APPROVED BY G ,.• --/
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ysgCL,\Coti C _ `� '�� BUILDING DIVISION
33530 First Way South
Er<F•11._ Federal Way,WA 98003
(253)661-4000
Fax(253)661-4129
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION # S 9`-0 O
n
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h
Address
C._
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3 L
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Tenant(if known)--D„` L� r c n�"t/� IVCsbid Lot # 5 Assessor's Tax #
Building Owner's Name-00""(4 Si4>1p,2-.d 2 l/.r2S a A/ Address
3 30-2.6, 49 Avg S:
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City �CI7ur/Z/�L j State 1/sofA .�Zip v 13 Phone Zg-3 . f-37-7
Nature of Work ,Li— A /0 4/ A/4 kt/4LL•'
AVM.ll Ntsimingigismismigengo
Name (F,M,L) I
-DC)v40/.6 1-vg/2- O//
Address �)2,8
City 1'•&-- 6/2.,4/— W47 State Wed Zip 76 U z 3
Contact Person ( Day Phone / 7v Other Ph ne Fax Z S3
Va v, L 4/ b c ., �? ZS3 hIgz c_•t23
FEDERAL WAY BUSINESS LICENSE
• Company Name • -
LL‹ L.L. 6..
• Address
15 - '0 t\i,,,zr1-4 14A/21
City a(_O M1 A.. State ''�f f,A Zip ("C.
Contact Person _— 6 Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
Afroirtgamonsommmumm
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
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Please Complete Reverse Side
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Existing Proposed Pro osed Use
Permit includes: ❑ Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
0 Commercial 0 Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability 0 Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation $
Zoning I Lot Size I Existing Bldg Valuation $
...................... .................. ........................ ...............
E:<:::>:::::�>: > #'z> '>'> > > > > ' `'''
...........................................................................................
Name Address
City State Zip
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
......................... ....................:.':: .. ........ ....................
..................................... .............................................
Contractor Name Address
City State Zip
,--
Contact
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No '
......................................', ::::...............................................
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Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total FixturelCount
................. .................. ......... . . ..............................
.................. ....... ......... ........... .................................
................. .................. ......... . . ..............................
.................. ....... ......... ........... .................................
tUt itf.AN:I;CA .....t. :; ......::::::::::::: < ::; MECHANICAL EVALUATION ONLY $
......................................:....................................................
Fuel Type (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 TOtar Unit Count
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), ich 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 fficers and employees,upon the accuracy of the information supplied to the city as/774::,5
aapart of this application.
Z
Owner/Agent: c'C7t/ ��"--'
` '
Date: /°
BUilowc.A,
nEv45Eo 8/26/97