93-101688 9 - )0I Gag
CITY OF FEDERAL WAY B U I L D I N G PERMIT PERMIT NO.: BLD93-0737
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 07/14/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 31000 7TH AVE SW
PARCEL NO.: 5557700090
PROJECT DESCRIPTION: RESIDENTIAL REPAIR WORK ONLY — TO INTERIOR OF EXISTING RESIDENCEO
OWNER — CONTRACTOR 6 LENDER --
JOSMITH MEDALLION CONSTRUCTION INC
31000 - 7TH AVE SW 3123 S 268TH PL
FEDERAL WAY WA 98023 KENT WA 98032
941-9835III
854-5927
MEDALCI13102
BLD?:X MEC?: PLM?: FLR EXIST PROP DWELLING UNITS: 0 COMP PLAN FEES:
TYPE OF WORK:REP USE:RES 1ST.: 0: O:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS BUILDING PERMIT....* $ 56.70
CENSUS CATEGORY •434 2ND.: 0: O:sf HEIGHT • 0.00 ft HAZARD CLASS SBCC SURCHARGE * $ 4.50
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm PLAN CHECK DEPOSIT.* $ 105.30
:? :? :? :? OTHR: 0: O:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 15000 SIDE • 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: O:sf REAR • O.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:07/06/93
If : 0: 0: 0: 0: TOIL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.: FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 166.50
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 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 • 0 DRAINS • 0
BBQ • 0 MISC • 0 5+ HP • 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
1
•
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.
1
OWNER OR AGENT y'J,,..1)� 6( DATE
bld_prmt 10/23/92
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d,,,=„..._ • City of Federal Way •
Fri. APPLICATION FOR BUILDING PERMIT
4
ILL
PLEASE PR/NT APPLICATION #: 434-044; e)/73 7
SITE LOCATION Address 3)6)n0 '744--_12-)kc„ Sll)i (4.'e eid II%'F- it It-
Tenant (if known) Lot # Assessot's Tax #
55-5-'770 - Of)1;e-I.
BuildiOwner Name Address
njC 0 4 i -S-111/1 t4tTk
City State Zip Phone
CPI/ c1 X53
Nature of Work 411d7iA��� 1 r - 4ae, t2er/'s 1-4\* -.41Yti)
APPLICANT
Name (F,M,L) ff j
A\P c1? I r I I'h V) nn vl styu1° ifb V\ t)i<a
Address
_1 4 '3 St' --:. IV., �y
City )c ,"L - State )4 Zip �O Z-
Contc Person -{- _ iN1 5`J7 `5 Day Phone ^1 Other Phone Fax
fid\1>ic l 11 �, (12
BUILDING CONTRACTOR
Company Name
AVEi Ch 1 11.01) C' o'YN S t . t ji -
Address
City 7'T C_ N- r State l G iii Zip jev3
Contact Person PhoneFax
�l_\r)Pt k S l �.�s ' r-541- 2')
Contractor's # (card must be presented) Expiration Date Verified Yes ❑ No
A\ I A1 C I- R ; 0 99 -2_2_9)
0(716(
ARCHITECT N/A
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION �` t- 1 �t 2 LLiell) / /i, 4/t /
Please Complete Reverse Side
CD0492(Fe. 4 93,
STRUCTURE ill Existing Use 0-1 Proposed Use
Permit includes: ' 1.0 ; ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: '❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
LI Commercial ❑ 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 1 r
Water Availability V Sewer Availability . On-Site Septic System Availability ❑ Project Valuation $ : JdCwn n�
Zoning Lot Size , Existing Bldg Valuation S
LENDER / R
Name / Address
City State Zip
MECHANICAL CONTRACTOR N/11—
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR )V/42
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT .i it 4.
Water Closets Sinks �7`' Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL UNIT COUNT A-7/4
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 flanks
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 aris s out of the reliance of the 'y, including its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application. / (
Owner/Agent: L. _(12 1/2-Zit --/7")1/2 W Date: /7-- '' •- - ,_