93-101810 CITY OF FEDERAL WAY B U I L DING PER MIT PERMIT NO.: BLD93-0796
:3530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 08/02/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 35817 10TH AVE SW {�
PARCEL NO.: 440560®0114 1 I�'3� /
PROJECT DESCRIPTION: RESIDENTIAL ADDITION/ALTERATION Ji//lA7LL >
- OWNER CONTRACTOR - LENDER
DAVID MOORE
35817 - 10TH AVE SW
FEDERAL WAY WA 98023
11926
BLD?:X MEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN •SR FEES:
TYPE OF WORK:ADD USE:RES 1ST.: 913: 225:sf STORIES • 1 REQUIRED PARKING..: 2 SPRINKLERS?......:? PLAN CHECK DEPOSIT.* $ 105.30
CENSUS CATEGORY '434 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS...:? FINAL PLAN CHECK...* $ 0.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW....: 0 gpm BUILDING PERMIT,...* $ 162.00
I :R3 OTHR: 0: 0:sf EXIST..$: 70300 FRONT • 20.00 ft SBCC SURCHARGE * $ 4.50
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP.,•$: 14652 SIDE........,,: 5.00 ft WATER SERVICE..:FED MEC APPLIANCE FEES.* $ 17.50
:5N : : : : DECK: 0: 0:sf REAR..,..,..,.: 5.00:ft SEWER SERVICE..:SEP PLUMBING FIXT....93* $ 21.00
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:07/16/93
0: 0: 0: 0: TOTL: 913: 225:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:ELE FANS.........•: 1 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS....,,..: 0 TOTAL FEES $ 310,30
GAS PIPING.: 0 ft HOOD..,....,..: 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 1 3-15 HP•...,: 0 SHOWERS • 0 SUMPS....,,..,.: 0
GAS HWT..... 0 WOOD STOVES...: 0 15-30 HP....: 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K,.•..: 0 30-50 HP...,: 0 SINKS • 2 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP.•....,: 0 DISH WASHERS • 1 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 1 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GeOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
ALL 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 IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET,
OWNER OR AGENT /a1-1/ .. DATE /2—/ J3
btd_prmt 10/23/92
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RECEIVED BY •
-COMMUNITY DEVELOPMENT DEPARTMEI
City of Federal Way
eG-ri r Iii I '7
�u �v APPLICATION FOR BUILDING PERMIT '143u.)
o —2 I — 04
PLEASE PRINT )APPLICAT/ON #: f- "-/) / l-/�/t'
7c. SITE LOCATION Address
Tenant (if known) Lot # //e/ Assessor's x#
Building Owner Name Address
Ja.()/ 0 r-- 12,'4-bbv(_ KY)oU 7 f 3s62/7-/D 7 i ,,Y ,-c- 5, c•<_5 .
City /c' Je yeti coC !State Gv/:i Zip l f'0,,; 3 Phone g7 y-/9:77,
Nature of Work !7 DL7 dl
APPLICANT
Name (F,M,L) _
.1Rvlt, `l . foo re_ De 6kp. , a ogre
Address
358/7-74 -f� 4 I.� 5. Lo .7 �; -
City ,,, lie iid it (C�, State /itjf� Zip 71� 3
Contact Person Day Phone Other Phone Fax
,d6bb,r-- Mr re__.- 2 7 c-19,- , 9,-,2 7-oa-7 3
BUILDING CONTRACTOR'
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
k'ARCHTTECT • 1
Name
/ %/r iter L t)f/v .C7
Address sq/i��, ✓ V�, /) j� �f�
City �``rf�G(.4.,/, �L�iW State E"0r� Zip .9 C% 2 ?
Contact Person Phone Fax
Chi- Afed n A 6 s- -saU
\� LEGAL DESCRIPTION v+0T //, ,
Please Complete Reverse Side
C00492(Rev 4/93)
•
•�� ,%'.-1 JTRUCTURE Existing Use //2, Proposed Use ,,,,{`
e
Permit includes: ,Building ❑ Plumbing Cl Mechanical ❑ Other
Type of Work: )71... Residential ❑ New ❑ Remodel Cl Number of Units ❑ Deck
❑ Commercial '*. Bdition ❑ Garage Cl Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Areasq ft
Area Basement sq ft Decks sq ft �
Garage sq ft Proposed Total Area�.,2S- sq ft
Water Availability Sewer Availability ❑ Site Septic System Availabilit > -4: Project Valuation $
Zoning �„ '1,k; Lot Size +f-Existing Bldg Valuation S 7 tr-' , c,,ti
77L1.. 240 P/oz e5c ul -i,k . eNv«
LENDER
Name Address
City 1 State Zip
MECHANICAL CONT• • . OR .
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name Address
CityNNN. State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
A PLUMBING FIXTURE`;COUNT
Water Closets Sinks J Urinals Lawn Sprinklers
Bathtubs Dish Washers ( Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count -
44 MECHANICAL UNIT COUNT
Fuel Type (electric/other) ,L 7 Y( Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range `'-`14,_er r� E;fjL> d J 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 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),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.
,�. sOwner/Agent: ,d./1._,..6 ��L Ga /J 4,rz}--� 1 Date: 7 67/93
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