90-100008 9D - JtYoot8'
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
qo- oo)l)
PERMIT NO. OWNER'S NAME TERRY JENSEN JOB ADDRESS 36731 1ST AVENUE S.W.
CONTRACTOR JENSEN CONSTRUCTION ADDRESS 2006 S W 306 LANE FEDERAL WAY CONT. PHONE 838-9860
CONT. REG. NO. JENSEC*132C0 OWNER'S PHONE 838-9860 OWNER'S ADDRESS 2006 SW 306 LANE FEDERAL WAY
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION LOT 20 MOUNTAIN VIEW HEIGHTS
ISSUED BY JOANNE JOHNSON DATE OF ISSUE DATE OF APPLICATION 3-1-90
BUILDING INFORMATION
WINE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
SET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS 3 ELEC. HOT WATER HEATER GAS PIPING 10 GT. 2.00 BOILER
BATHTUBS 2 LAUNDRY DRAINS 1 COMPRESSOR TANK(S) RECEIVED _
SHOWERS 1 URINALS FORCED AIR FURNACE 10.00 AIR HANDLING UNIT NUMBER _
LAVATORIES 5 DRINKING FOUNTAINS GAS HOT WATER HTR. 6.90 MISC.
RETURNED
SINKS 1 MISC. CONVERSION BURNER BASIC FEE
DISHWASHERS 1 TOTAL FIXTURES 5 X 14=70.00 UNIT HEATER TOTAL MECHANICAL 18_50 AMOUNT
VALUATION 221 ,396-70
PERMIT FEE 1067.00
PLAN CHECK FEE 694.00
PLUMBING FEE 70_00
OCHANICAL FEE 18_50
TAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
WATER SERVICE
WATER MAIN CHG.
DATE: S."---5/ 0
S.B.C.C. FEE 4-50c)
,(
OTHER FEES
AMOUNT: /0 5 4,
AMOUNT DUE 3854.00 Z
RECEIPT: 7 S S
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: C�
OWNER OR AGENT / / DATE S v 7 <2
CITY OF BUILDING INSPECTION
FEDERAL WAY BUILDING PERMIT 941-1555
PERMIT NO. OWNER'S NAME JOB ADDRESS
CONTRACTOR ADDRESS CONT. PHONE
CONT. REG. NO. OWNER'S PHONE OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO. LEGAL DESCRIPTION
ISSUED BY DATE OF ISSUE _ DATE OF APPLICATION
BUILDING INFORMATION
ONE OCCUPANCY_ _ _ _ TYPE OF CONSTRUCTION BLDG. SO. FT.
SET BACKS: FRONT SIDEREAR _ _ STORIES. _._ HEIGHT LIMIT _
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER _ _._ GAS PIPING FT. BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS _ COMPRESSOR _ _ TANK(S)
SHOWERS URINALS FORCED AIR FURNACE _ AIR HANDLING UNIT _ NUMBER
LAVATORIES DRINKING FOUNTAINS GAS HOT WATER HTR. MISC
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT
VALUATION
PERMIT FEE _
PLAN CHECK FEE
PLUMBING FEE
.CHANICAL FEE
TOTAL BLDG. FEES
i
PART P/C FEE
SEPA REVIEW
WATER SERVICE
i WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
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 DATE
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CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
— Please Print—
BOX 1 OWNER \; SIL 1JOB LOCATION _
OWNER'S ADDRESS/MP/// V! /i y_ CITY- _RVP _ PHONE . . - .
DESCRIBE JOB WY,% ' �~ / J /
THE PROPERTY IS OWNED BY: SIN /MARRIED /,, PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAMEQ1- & e77 CG�7-�(/ G4d/�tJ CONTRACTOR'S REG. # f/7 -d-ie}CO
gift,
Card MUST be presented
CONTRACTOR'S ADDRESS � , j " 2c // CITY �..�dc � HONE���/// Y3r 9��/
EXPIRATION DATE / j '
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 . _SII ' A. / .77 PHONE /////.i
BOX 4 SEWER DISTRICT ^ AV.�1 /4 , WATER DISTRICT GI.P�'6 (-(
BOX 5 ESTIMATED PROJECT COST ) S1 boo EXISTING BUILDING VALUATION .3 `2`0 C C,70
BOX 6 PROPERTY TAX ACCOUNT NUM:,, R . -
LEGAL DESCRIPTION , '����� ffei ff��/�1��/MA VA g"'�/1_ r
(If necessary, please submit a separate page with the legal description.) C/
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR ,/e49'/ 2ND FLOOR ./7Dq:?J
3RD FLOOR / BASEMENT - / DECK --- / GARAGE g .L./
BOX 8 (✓f SINGLE FAMILY ( vi-NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY i/4!' SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. -3 WATERCLOSETS GAS PIPING, FEET /C C $ L e 00
Z BATHTUBS NO. 1 FURNACE, ELEC. GAS X $ 10 e 00
l SHOWERS � GAS HOT WATER HEATER $ ( .r O
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
1 DISHWASHERS AIR HANDLING UNITS $
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 - $
OTHER • $
y TOTAL FIXTURES • $
TOTAL MECHANICAL FEE 0 '$ 1O. TO
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 PER—
FORM THE WORK FOR W. ICH PERMIT APPLICATION IS MADE.
OWNER/AGENT: 400/77/.--/-"Por---- DATE: /
/ .
ANP-000 2/90
yo ' WO
• •
''OFFFFIIC,rrE USE ONLY (PLEASE DO NOT WRITE
�BELOW THIS LINE)
ZONE ETBACKS: FRONT_SIZE 3_ REAR_ , Z-2' HEIGHT LIMIT 0I
PLANNING DEPARTMENT APIDROVAL
REMARKS: 31 ` ie yk - Poe kJ,f copL f ey y-(..v.
yOclo.4(.00C Cor Co Cie- ' c7 / ti A G' k-1(Ay 57ZgS re l
SEPA: EXEMPT ?( NOT EXEMPT..
FIRE DEPARTMENT APPROVAL DATE
REMARKS: V
/7 4-
PUBLIC WORKS DEPARTM NT_ APPROVAL _ ` ' ATE
REMARKS: 5 r 1-(- S ( e,f,4� V t c e—c _ r C c 7po /
LA ter & K
TYPE OF JOB: NEW RESIDENCE )( RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY _ (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY 9.3 TYPE OF CONSTRUCTION v ,t/ STORES
LI v( BUILDING SQ. FT. 3317 @ 69 < a0 = 2-2-64373 ‘ 0oC.A.rityt, BUILDING SQ. FT. 153 Z @ 17 3 o L. - 7f 3 ,60
BUILDING SQ. FT. @ € = 0. es
BUILDING SQ. FT. @ =
BUILDING SQ. FT, @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION 2-24 3`T6- Z-0
EBUILDING PERMIT NO. 9c-6)('C PLAN CHECK FEE REC'D --C---)---- RECEIPT NO.
PERMIT FEE IUL.7. Ob PLAN CHECK FEE --6- -.4-‘-- PLUMBING FEE --G--Q-- MECH. FEE (8- S0
TOTAL FEES SBCC SURCHARGE ENERGY SURCHARGE 'l€SC AMOUNT DUE
BUILDING DEPARTMENT APPROVAL DATE
REMARKS:
�1 5 T
ASSIGNED ADDRESS: ' �?2 7 ( �1- gyp— S ' IA),
RECEIVED
/-,,c u 1 1990
CITY OF FEDERAL WAY
BUILDING DEPT.
RECEIVED ACCEPTED FOR FILING
Seattle-King Count epartment of Public;Health
•
, RECEI\/EiD
Site Application for On- ite Sewage Disposal System
(Submit 5 copies of application with 4 copies of plans) APR 5 1990
ALDER SQUARE
Site Address: Af OrOY.f.+^altelV 36645 1st Wty S.V. 5, 1
---
(Attach a Site Vicinity Map) 90°0 /
Street Address I 20 i; S. J.t306 `,rir
Owner I.7ettaett Con.at • J City-Zip Code Ij'e,f• r3y' 980;1' I Phone I •''R-9869
Street Address I
Builder I 9wtter. I City-Zip Code I I Phone I
Street Address 113422 .` E 9 '
Designer I Ed Illtwoos) I City-Zip Code lAuhurn! `a>. ()02 I Phone I x;33`5262
PROPERTY INFORMATION:
Section: I -` I ': I Township: I " 1 I I Range: IO lit. I Parcel#: 14-4,4 1rh-r -r-0-r •—1----4-1
Subdivision Name: I Uoun to in View Heights ! I Lot: P 12 101 Block: I i tI
Property Size: 19 I I i 1 t ) I I sq.ft.
Distance from property line to nearest sewer: I i,/A i 1 1 ft.
Water Supply Li (IP)1=Individual P=Public(More than One Connection)
Public Water Supply Name: I '' ••t •''f•i)• -41 r it. J ID# I I I 1 1 I I
Sensitive Area: L_) (Y/N)If yes,specify Li (L,W,0) (L=Landslide W=Wetlands O=Other)
SYSTEM INFORMATION:
Repair(existing) LJ New System H I Y
Type of Building i._- I 1LLA
(SF/MF/COMM/INST) SF= Single Family MF=Multi-Family COMM=Commercial INST=Institutional
Type of System Proposed: L- J .79 /PD/SF/HT/CT/E/O) G=Gravity GP=Gravity with pump M=Mound
PD=Pressure Distribution SF=Sand Filter HT=Holding Tank CT=Composting Toilet E=Experimental 0=Other
Date Soils Logged: 12- I ' I 1 I `I °I �'I Soil Logs Attached:(Min.4/lot) I ` I (Y/N)Detailed Plans Attached:(4 sets): V- I (Y/N)
Depth to Watertable or Restrictive Layer: I ) I 0 I inches Average Slope in Drainfield/Reserve Area: H. I ) )
CALCULATIONS:
Number of bedrooms: 141 Total Gallons/Day(450 miniumum): F) 4 13 i° I gal. Soil Texture Type(1-5): LI
Application Rate: I_- J gal/sq ft/day Total Absorption Area: I 91 t-i 1I t•'I sq..ft.
Total Drainfield Length: 100_0:f ft Se`pttic Tank Size I 1 t� I`) I `' I gal.
Pump Chamber Size(if needed) I t f t I "1 'I gal. Trench Depth(min/max): I—_i:_.'__I/'±r H inches
I understand that failure to comply with King County Board of Health Rules and Regulations#3 may result in the disapproval of the sewage
system being proposed in this application.Non-compliance may also lead to revocation of my Designer's Certificate of Competency and/or
appropriate legal action by tfe,Healtl-Department.
74'
r _.. -------- ,
`2 »` 1Designer's Signature: I.D.# Date:Irt ti r403
OR HEA Tji DEPARTMENT USE ONLY
APPROVED4+2-c—cU BY. R`- / -stuu
(date)
Comments/Conditions:
APPROVAL OF THIS DESIGN APPLICATION IS BASED SOLELY ON INFORMATION PROVIDED IN THIS APPLICATION AND DOES NOT CONSTITUTE
PERMISSION TO BEGIN CONSTRUCTION OF THE SYSTEM OR ANY OTHER IMPROVEMENTS ON THE SITE.THIS APPROVAL SHALL NOT BE
CONSIDERED AN ASSURANCE,EITHER EXPRESSED OR IMPLIED,THAT DEVELOPMENT PERMITS FOR THE SITE WILL BE ISSUED.
THIS APPLICATION EXPIRES TWO YEARS FROM DATE OF APPROVAL.
DISAPPROVED _ BY:
(date)
See attached Site Deficiency Sheet.
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.
WHITE—DISTRICT/GREEN—AUDIT/YELLOW—DESIGNER/PINK—OWNER/GOLDENROD—LICENSES&PERMITS CS 13 15.97
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