96-103785 CITY OP FEDERAL WAY PERMIT NO: BLD96-0428
33530 First Way South DV.I. L DI Hie P EA Pt I Tr ISSUED: 10/09/96
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 04/07/97
•
ADDRESS:29323 11TH PL SW/6376b
NO. : 515230-0040
PROJECT DESCRIPTION:RE-ROOF PERMIT - TEAR OFF PLYWOOD & RE-ROOF WITH LIGHT WEIGHT TILE.
f= OWNER =________________________________=====a=s=======max = CONTRACTOR =_______________________________________====y= LENDER =______________________________________________i
I MR & MRS FONG JENSEN ROOFING COMPANY INC 1
( 29323 11TH PL S 23641 7TH AVE S *18 1
( FEDERAL WAY WA 98003 DES MOINEES WA 98198 1
Iiil324-1876 824-6210 1
JENSERC053L8 1 ff
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*vs CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN TIE CITY OF FEDERAL WAY. TAX RATE = 8.2% xss
====________=====a===aa=========a==a==a=a======aa=a=aattl�aw __ =a=====__=====a=====______=====a===a=====ea==st=====a= =a=a===a=====___________________=====a===='
i BLD?:X NEC?: PLM?: FIR--EXIST--PROP--- DWELLING UNITS: 0 a COMP PLAN •9 1 FEES:
TYPE OF WORK:REP USE:RES 1ST.: 0: 0:sf STORIES 0 REQUIRED PARKING..: 0 SPRINKLERS' •' i BUILDING PERMIT....* $ 126.00
CENSUS CATEGORY •555 2ND.: 0: O:sf HEIGHT. 0.0O ft HAZARD CLASS •9 SBCC SURCHARGE * $ 4.50
OCCUPANCY GROUP 3RD.: 0: ' O:sfVALUATION REQUIRED SETBACKS FIRE FLOW 0 gpu
:? :? :? :? OTHR: 0: O:sf EXIST..$: ' 0 FR ....., : 01.00 ft '
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP..* 10200 SIDE: ... 0.00 ft' WATER .uICE..:?ti. ,
:? :? :? :? DECK: 0: O:sf . ;.,... F: ;0.00ft SEWER SERO L,:?
OCCUPANT LOAD GAR.: 0: O:sf RECEIVED 40i00196, 1
: 0: 0: 0: 0: TOIL: 0: O:Sf IHP€RV SURFACE: 0 sf SENSITIVE AREAS?.:? 1
___________________________=====WW=sera== ==a ==nta=mak===a==fit==== s==========a====aa==a==a========s=as=s=a====sae=====
FUEL TYPES.:? ? FANS.., ..,...i, 0 BOILERS/COMPRESSORSWATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 130.50
GAS PIPING.: 0 ft HOOD...,: ' • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
illiRN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 SHOWERS • 0 SUMPS • 0
HMT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
ONV BURNER: 0 FURN>100K • 0 30-50 HP • 0 1 SINKS • 0 DRAINS • 0 y
BBQ • 0 MISC • 0 5+ HP • 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0 I
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC NTR HEATERS...: 0 OTHER FIXTURES.: 0 1
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0 {1{
=====as=====_________=====a==ss==s==s====a==sss====s=s=sa=a===sma=sa====a=assles=a==s=====a=as=sa=====_____=====stra=====a===s======3=======a====z=ss===s=======s=sa=a=s=====s=i
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WOR[ IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY NE IS TRUE AND CORRECT TO THE BEST OF NY CNOMLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE NET.
OWNER OR AGENT __.4044/ — 15", DATE 29
FILE COPY 9Y56>>19a
• ^ BUILDING DIVISION
WY OF G R EC FE I\.. D 33530 First Way south
-A- 11-1 .. Federal Way, WA 98003
VV �y (206) 661-404)0
OCT ��� " Fax (206) 661-4129
l ii vAY
BUiLLJING DEPT.
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT • APPLICATION#: g LD¶ -
SITELOMITONMENEEEMEER Address
,;(73J3
VJ
Tenant (if known) ' Lot# Assessor's Tax#
Building Owner's Name a/1/)/ Addres 91.A- L/
City Fj(10,P1 ////„V State WA r Zip �` cr 3 Phone 3 c Z! - �7.8
Nature of Work rO�j 1(- K
Name (F,M,L)
('s75eri bvf i/?,' �p_ ITV ,
Address -77411
AY
City r (i"' ' (A i/ State (Av A Zip 93' I'(
Contact Person Day Phone Other Phone Fax
j9-601 O /— bcI(D —1<)3 ,5►-
statamstavoNTRAcToRmimmo
Company Name
Address
City State .Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
::»»>:<;;::>:::
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
I Use
•Posed Use
9
;:::.::.::.:>:.>::»
Permit includes: 0 Building 0 Plumbing 0 Mechanical Other
Type of Work: �j Residential 0 New 0 Remodel 0 Number of Units
—
0 Deck
0 Commercial 0 Addition 0 Garage 0 Shed 0 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 Availabili 0 On-Site Septic System Availability 0 Project Valuation $ /Oh 1( _
Zoning I Lot Size Existing Bldg Valuation $
/� - / cucyjc�� / �C,•�.
�1
i e—
Name Address
City State Zip
MenittilettigIONTRAGTORMEM
Contractor Name Address
City State Zip —
Contact Phone Fax
License # Expiration Date ,Verified 0 Yes 0 No
i
VLUMBINOVOIVERACTORMEMMOR
Contractor Name Address
City _State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
.................................................................
Lavatories Washing Machine Drains TotalFixtureCount
MiUMMEgMaiMiMiMii.VigniNiNiN� 'iY:?iiE
ONLY
EVALUATION
MECHANICAL
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 Total Untt 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), 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.� " '9?
' -
Owner/Agent: j),,,,1-4--- k„,,,,.,.., 1�-1 (1—
Date: -/p 9 / /
BUILDING.A PV
HEv6E0 8121!98