92-102275 %),JD..).?-7 S
CITY OF FEDERAL WAY BUILDING PERMIT PERMIT NO.: BLD92-2577
38530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 01/04/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 34623 4TH PL S
PARCEL NO.: 276230-0120
PROJECT DESCRIPTION: ALTERATION — FINISH 3/4 BATH, BASEMENT, DEN, & RECREATION ROOM
-- OWNER CONTRACTOR - r LENDER
ALBERT DOWSING III J L WHITE CONSTRUCTION CO
34623 4TH PL SO 30639 MILITARY RD S
FEDERAL WAY WA 98003 AUBURN WA 98001
RZ' 1583 941-8702
JLWHICC108C7
BLD?:X MEC?: PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 1 COMP PLAN •IP FEES:
TYPE OF WORK:ALT USE:RES 1ST.: 810: 0:sf STORIES • 2 REQUIRED PARKING..: 2 SPRINKLERS? .7 FINAL PLAN CHECK...* $ 58.50
CENSUS CATEGORY •434 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS •? BUILDING PERMIT....* $ 90.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm SBCC SURCHARGE * $ 4.50
:R3 :? :? :? OTHR: 0: 0:sf EXIST..$: 68000 FRONT • 20.00 ft PLUMBING PERMIT/SPK* $ 15.00
TYPE OF CONSTRUCTION BSMT: 840: 0:sf PROP. $: 6895 SIDE • 5.00 ft WATER SERVICE..:FED
:5N :? :? :? DECK: 0: 0:sf REAR • 5.00:ft SEWER SERVICE..:FED
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:12/21/92
. 3: 0: 0: 0: TOTL: 1650: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 1 URINALS • 0 TOTAL FEES $ 168.00
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 • 1 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 • 1 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
LOGS...: 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 <_'�C/ C,( 1��j�... DATE .,,..,--L_ y,�
17 l�
bld_prmt 10/23/92 / V
r
SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE BY _ DATE _....___.-_..... BY . DATE BY .._
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE,-2?^��.....BY3GAS PIPING O.K. ___ DATE 2 _2 2-93__BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE _:2-'22-93 BY _Clii - DATE 22-93_.......BY .._ DATE `2 �-9 3 -BY -,
FINAL O.K. TO OCCUPY
DCD PSD FD
DATE_..3 I').._5 BY it
• 4111 .
i Perm# Gi--D -- Z % 7
RECEIVED i r:: ;
DEC 21 1992 CITY OF FEDERAL WAY
cnvoFFEDERAL wAY BUILDING PERMIT APPLICATION
BUILDING DEPT - Please Print—
BOX 1 TENANT NAME: Soy\e,)
- OWNER 1\�.'aeR A-- E..T( �A---Z- SITE LOCATION I im2.,,
OWNER'S ADDRESS 31�1,02, -- )A-4`4\ CITY « _ % PHONE 1.. .4"
DESCRIBE JOB vr,>J«h 3/!_4‘. �c, 1\ -Q c i e.,),A., 10f-4., -4 A ti ;r' c, f Om y C-1(,t..—,s
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME CV,L,, I_Ahk\-Q CA1J5*fvC A•AC)0 CONTRACTOR'S REG. #St,1A-I\CC,1Qc�C tl
Card MUST be presented
CONTRACTOR'S ADDRESS Y0' S (A1t1-,A-+ sy d,So CITY 4l)/Ol `.IJ PHONE Q �a�R\-� ,
EXPIRATION DATE ,�//6/9.3 1
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON J-47r lA//7, /- -- PHONE 94//- .1-7;70.A
BOX 4 SEWER DISTRICT FedC i CLL, l X (-1 Uk`'e C a .',C WATER DISTRICT (tale))
BOX 5 ESTIMATED PROJECT COST folC-6 Ge' EXISTING BUILDING VALUATION (ogcG
BOX 6 PROPERTY TAX ACCOUNT NUMBER Z,rKornO 0 k2.0.
LEGAL DESCRIPTION 1-tl. L. P G C Q(' 'V
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Propo ed) 1ST FLOOR ..,1
BOX 1 2ND FLOOR /
3RD FLOOR / BASEMENT 1�C) / DECK / GARAGE /
BOX 8 (.>‹) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (K) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY I I , "-ICC) SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. I WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $
l SHOWERS GAS HOT WATER HEATER
LAVATORIES CONVERSION BURNER k S
1 SINKS BOILER, SIZE BTU c bb \fpS
DISHWASHERS AIR HANDLING UNITS el
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS 5
OTHER 5
3 TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
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.
OWNER/AGENT: '.:%- _ .,�_ -
DATE: / / , 0 .,.�
- - AM1P-008 3,50
R
SEATT410KI40 COCNTY DEPAR TWNT OF Pte L I C HEAEN -
•
llROftENTAL FE_ALTN SERV ICfS tar
'-'Wyk ,
Total Fe*:
575.00
APPLICAT ",` ,,— i, at ,u - ' NT
APPRO - ;' 'c.
PERHIT '
Submit application, route nap, building permit plot plans, and other required documents in triplicate.-=--"-
The following must be completed and the fee must accompany this application:
Hate: If the property is located 1n uninco 1- ia ` r
unincorporated King County, make direct application to the Kingr
County Building and Land Development Division (B.A.L.D.).• Properties in incorporated cities apply
to local building departments.
PROPERTY INFOP,ltlTIOHI ;t -,>
I j House/structure 1s served by an on-site sewage (septic) system•
t
Distance to the nearestpublic`-`sewer ..k.Z
Address of property cSka,, 1 °'ts"-N �\.. V AE',(6X,. , U\ 1 .JQ ()
Parcel Number (Tax Lot Account t) .
Applicant's name e c\A., V. . uwall:Kg: Day Phoria __ -
Applicant's mailing address " I,Ct\�
Owner's name S(�'(`(\e , DayPhone
m
Aga of house Number of existing bedrooms ," Existing square footage- of house
•
Are additional bedrooms being constructed or created? Cj
Description of proposed changes/remodeling (attach pPot plans, showing existing structure, remodeling
and septic system): .
New square footage after construction O C{1e_.,
SEWAGE SYSTE4 INFO3 TICA
Approximate dates septic tank was purred (attached receipts)
Additions or major landscape changes since house was constructed (exaples: add family room,: bed-
-
rooms, garage, patio, deck, pool, etc.; major fills or excavations done in landscaping):
•
Additions or repairs to sewage system (give date and describe briefly)
Other information which would be helpful in evalu ting the sewage system (ie. drainfield easements, .- ;:.,
covenants, etc.):. ` `
i� 3 �uJ€A U, `\-'l\\S *\\e,
WATER SUPPLY I r TIO#1
Public system (2 or more connections)
F-1 Private (well, spring, etc.)
Name of Public Supply Attach copies of well log, well
covenants, chemical/bacteriological :
sample reports
FOR HEALTH DEPARTH€NT USE ONLY — __ --
j APPROVED BY. Date Received
Date
I ! DISAPPROVED BY:
Date
Comments/Conditions:
Any person aggrieved by any decision or final order of the Health Officer may make written application for,.-
appeal to the King County Board of Sewage Review if done so within 60 days of the above decision. -
/hd/ser ge/fors/forr.,37/6 3 91