94-102189 9y., I0aot- 9
CITY OF FEDERAL WAY BUILDING P PERISSUED: 1MIT NO: 61/28/9489
33530 First Way South
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 05/27/95
ADDRESS:626 S 331ST PL
NO., : 132140-0430
PROJECT DESCRIPTION:NSF - N/PLUMBING & MECHANICAL. APPROVED BASIC 194-1029-V91.
CAMPUS GLEN, LOT 143. PLAN 34A2.
OWNERillr
CAMPUS GLEN LTD PARTNERSHIP
CONTRACTOR LENDER
POLYGON NW COMPANY SEATTLE MORTGAGE
4030 LK WASHINGTON BLVD NE 201 4030 LK NASH BLVD NE 229 QUEEN ANNE AVE N
KIRKLAND NA 98033 KIRKLAND NA 98033 SEATTLE NA 98109
822-7700 822-7700
POIYGNC088DP
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?......:? PLAN CHECK DEPOSIT.* $ 100.00
CENSUS CATEGORY •101 2ND.: 0: 740:sf HEIGHT • 0.00 ft HAZARD CLASS •9 PUB WKS PLCK(SF)..93 $ 40.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW 0 gps BUILDING PERMIT...,* $ 709.50
:R3 :M1 OTHR: 0: 0:sf EXIST..$: 0 FRONT 20.00 ft SBCC SURCHARGE * $ 4.50
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 119296 SIDE • 5.00 ft WATER SERVICE..:FED NEC APPLIANCE FEES.* $ 68.00
:5N :5N : DECK: 0: 0:sf REAR - 20.00:ft SEWER SERVICE..:FED PLUMBING FIXT....93* $ 91.00
OCCUPANT LOAD GAR.: 0: 497:sf RECEIVED.:11/15/94 RADON KIT 93 $ 20.00
0: 0: 0: 0: TOIL: 0: 2204:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:GAS ELEet FANS 5 BOILERS/COMPRESSORS WATER CLOSETS . 3 URINALS • 0 TOTAL FEES $ 1033.00
GAS PIPING.: 38 ft HOOD 1 0-3 HP - 0 BATH TUBS • 1 DRINKING FOUNT.: 0
( FURN<100K..: 1 DUCT WORK • 0 3-15 HP - 0 SHOWERS • 2 SUMPS . 0
GAS NWT • 1 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 4 VAC BREAKERS...: 0
CONY BURNER: 0 FURN)100K • 0 30-50 HP • 0 SINKS - 1 DRAINS - 0 I i
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 AFTER ISSUANCE NO IRK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE I -:' ATION RNISED B •E • TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
OWN,444R AGENT -6.1=114TINMOgit .
DATE _u/ iA-1.
FILE COPY
RECEIVED
111, City of Federal Way •
-}!' >L NOV 0 31994
r-IlY APPLICATION- I - / FOR BUILDING PERMIT
?/ A►N/ 2L I A2 CITY OF FEDERAL WAY
�+ ,• ! BUILDING� DEPT.
PLEASE PRINT APPLICATION #: ` "I `7—08<r
SX E LOCATION Address baU 5,
Tenant (if known) Lot # , f3 Assessor's Tax #
`-� / 2/vi ' C;.CIJI
Building Owner Dame Address
Campus Glen Limited Partnership 4030 bake Washington Blvd NE, #201
City Kirkland state WA zip 98033 mono 822-7700
Nature of Work Construct Single Family House
Name (F,M,L)
Campus Glen Limited Partnership
Address
4030 Lake Washington Blvd. NE, Suite 201
city Kirkland State WA zip 98033
Contact Person Day Phone Other Phone Fax
,Lori Perkins 822-7700 N/A 827-4098
BWLUhNG CONTXtACTO t
Company Name
Polygon Northwest Company
Address
4030 Lake Washington Blvd. NE, Suite 201
City Kirkland State Ka_ Zip 9f303�
Contact Person Phone Fax
Lori p rkins or Greg Armes 822-7700 R27-409R
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
03/0
POLYGNC088DP 9/95
[ CIJITECT
Name
Jay Middleton Design Group
Address
4030 Lake Washington Blvd NE, Suite 210
City Kirkland stato WA Zip 98033
Contact Person
Fox
Jay Middleton Phone 827-4991 827-6405
LEGAL DESCRIPTION
Campus Glen Lot# L43
Please Complete Reverse Side
CD0402(fey 4/93)
1__Ls.cii I 1
IS".9t.perUitEo;tal, Uso oposnd Uso
.. . Vacant S.F. nwel1 i ng
Pormit includes: _ Building I<Plumbing Mochnnicnl U Other
`ypn of Work: '{Q Rani,Inntinl l(I Now I I ftonurdol I N bar of Unita _ I I Dock
• U Comntorciol L1 Addition U Gnrngo Ll Shod U Other
Enter let Floor 9(p7 sq ft 2nd Floor 79n sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Docks sq ft Garage y C/7 eq ft Proposed Total Area eq ft
Water Availability e Sewer Availability V On-Situ Septic System Availability 0 Project Valuation $
Zoning �19-1.I, Lot Size ---2,__ -3 Existing Bldg Valuatiori $ - i
LLNI)LR
Nome Address
Seattle Mortgage 229 Queen Anne Ave. N.
City Seattle state WA Zip 98109
i4001.4.0wA.L.coNtitAcrolt • Lt t ou,n3
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUMBING CON'.I'RACTOIL B( (Acts,n
Contractor Name Address
City State Zip
Contact Phone Fax
License I Expiration Unto Verified 0 Yoe 0 No
J'LUMBING FIXTURE COUN r
Water ClosetsSinks , Urinals Lawn Sprinklers
'
Bathtubs Dish Washers IDrinking Fountains Other
Showers '2- Electric Water Heaters Sumps
Lavatories 4 Washing Machine I Drains TOtal:Ftxttlra Coilht
11 a.LCIIANICAL UNIT COUNT;
. ...............................
Fuel Typo (electric/other) 6GkS Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping 38 r 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 flood ' Boilers Above Ground
Cony Burner Duct Work 0-3 Tons
Underground
BBQ's Wood Stovos 3-15 Tons Tat el Ur)li Cablit:,
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,end filed against the City of Federal Way,
but only wham su h cin arises out of the tnlinnce of the City, including Its officer■and employees,upon the accuracy of the information supplied to the City as a pert of this
application. �/J � } r
Owner/Agent( C�l ez......,„„
e��� Date: / 1 /z,/9