92-100653 CITY OF FEDERAL WAY S , - /U a33530 lo b3
FederalON
Way,I ` W 98003 BUILDING PERMIT BUILDING INS 661 41
140
PERMIT NO. 92-0681 OT OWNER'S NAME HAROLD WILSON SITE ADDRESS 1020 S 372ND WAY
CONTRACTOR SQUARE & LEVEL ADDRESS 10615 10TH ST CT E PUYALLUP CONT.PHONE 927-6809
CONT.REG.NO. SQVARL08158 EXP. OWNER'S PHONE 838-2987 OWNER'S ADDRESS 1020 S 372ND WAY 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 _DETACHED STORAGE_GARAGE
TAX ACCOUNT NO. 322104-9133 LEGAL DESCRIPTION THE SOUTH 170' OF__T_HE—V2_ OF_THF E _V_2— OF THE NW 1/4
OF THE NE 1/4 OF SEC 32-21-04 LESS CO. ROAD
ISSUED BY JOANNE JOHNSON DATE OF ISSUE • . =� Q° DATE OF APPLICATION 5-1-92
BUILDING INFORMATION
illiONE RS 35.0 SET BACKS:FRONT 20' SIDE_ —_ REAR_ --__ 5 HEIGHT LIMIT 30'
Woo CCUPANCY Ml TYPE OF CONSTRUCTION VN CENSUS NO. TYPE OF HEAT BLDG.SQ.FT._ 640 STORIES__—
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC.HOT WATER HEATER GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS - GAS HOT WATER HTR. _ _ AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS _ _ _ CONVERSION BURNER MISC.
RETURNED
SINKS MISC. BBQ BASIC FEE
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL AMOUNT
PLANNING DEPT APPROVAL: NO VEHICULAR ACCESS PERMITTED OTHER THAN FARM
VALUATION 10,306.56 MACHINERY. DB 5-29-92
PERMIT FEE 176_OOPUBLIC WORKS DEPT APPROVAL: CONSTRUCT 33 LF DISPERSION TRENCH PER ATTACHED
PLAN CHECK FEE 81 -90 APPROVED DETAIL. BLDG INSPECTOR SHALL INSPECT
PLUMBING FEE AND APPROVE PRIOR TO BACKFILLING TRENCHING.
MECHANICAL FEE JS 7-27-92
ilk RT P/C FEE — BULDNG DEPT APPROVAL: KC 5-18-92
OEPA REVIEW
PUBLIC WORKS 35.00
S.B.C.C.FEE 4.50 y
FIRE FEE - - DATE: 7 —e)-C1
l G-
OTHER FEES AMOUNT: 0$247.40
AMOUNT DUE ___ 247.40 RECEIPT: c). 115';3
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. /
7
OWNER OR AGENT .A .i - - DATE / - > (-= ^
2 a
CITY OF FEDERAL WAY
33530
Federal Way, WA 98003 BUILDING PERMIT BUILDING INSPECTION661-4140
PERMIT NO. OWNER'S NAME SITE ADDRESS ---
CONTRACTOR ADDRESS --_ CONT.PHONE
CONT.REG.NO. EXP. 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
flONE SET BACKS:FRONT _ SIDE REAR HEIGHT LIMIT
CCUPANCY TYPE OF CONSTRUCTION _CENSUS NO. TYPE OF HEAT BLDG.SQ.FT. STORIES
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC.HOT WATER HEATER GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC.
RETURNED
SINKS MISC. BBQ BASIC FEE
DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
zRT P/C FEE
PA REVIEW
PUBLIC WORKS
S.B.C.C.FEE
FIRE FEE DATE:
OTHER FEES AMOUNT:
AMOUNT DUE RECEIPT:
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 REQUIREM 1-' l ILL
BE MET.
--- ` !
OWNER OR AGENT DATE _ __-
SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE 2 BY 4/_,4/ .._ DATE l cl Z _BY 1/v.. DATE _ __BY
PLUMBING ROUGH IN WATER LINE O.K. MECHANICAL INSPECTION
DATE — __BY .. GAS PIPING O.K. __—__—_.___ DATE —_ BY
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
_ — .
DATE `�/��--- BY� BY
_ DATE _ BY DATE __ _
FINAL O.K. TO OCCUPY
DCD PSD FD
DATE L2-1.' BY m'1__
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.� - SEATTLE-KING COUNTY DEPARTMENT OF PUBLIC HEALTH
• ENV I RONENTAL HEALTH SERVICES
Total Fee: $75.00 APPLICATION FOR HEALTH DEPARTMENT
APPROVAL OF BUILDING PERMIT
Submit application, route map, building permit plot plans, and other required documents in triplicate.
The following must be completed and the fee must accompany this application:
Note: If the property 1s located in unincorporated King County, make direct application to the King
. County Building and Land Development Division (B.A.L.D.).• Properties in:i ncorporated cities apply
to local building departments. •
PROPERTY INFORMATION
House/structure Is served by an on-site sewage (septic) system
- Distance to the nearest public sewerNF„4kCs'T-5 ,,,,t/- ?Q? FT-So,oF'3 59/3C7Or'-E of ip cmc kkv
Address of property l A 2 0 ‹a 3 7 Z L✓/4- - -
C
Parcel Number (Tax Lot Account I) 3a )(21(--( -' 11„3.3 •
Appl i cant's name K.p „ /1/1 ,i rrseji/ •
• . Day Phone 927,40`0?
Applicant's mailing address /04 S /f? ST c7 PU a (f up i24--
Owner's name }Q r p/cr w r f 5'r, 1) Day Phone .2.38r- 2 .5?7'
Age of house aO Number of existing bedrooms .q Existing square footage of, house 3560
1 . -Ara'additional bedrooms being constructed or created? 11WO
. Description of proposed changes/remodeling (attach plot plans, showing existing_structure, remodeling
and septic system):
C r9 C7P c7-imr ,F �. �. •- '. - • .) • (AJ • I.O. P
, • • ! -. • ..e
'a'�-��� �
. .. --
New squarefootage after construction:.- - rt - � w' +;�f
- SEWAGE SYSTEM INFORMATION
Approximate dates septic tank was pumped (attached receipts) tin K np w ,
Additions or major landscape changes since house was constructed (examples: add familyroom, bed-
rooms, garage, patio, deck, pool, etc.; major fills or excavations done in landscaping):
�eJ isrt.nrFee--r -e c ,U-eri In lC 8'4
Additions or repairs to sewage system (give date and describe briefly) f/.4224) .--
Other information which would be helpful in evaluating the sewage system (le. drainfield easements,
covenants, etc.):.
WATER SUPPLY INFORMATION •
AZ' Public system (2 or more connections) Q Private (well, spring, etc.)
Attach copies of well log, well
Name of Public Supply Fec1,4 ped o, cite?: covenants, chemical/bacteriological
sample reports
FOR H TH DEPARTENT USE ONLY
Date Received
_.,APPROVED 6 - (J' --c,zeY:
Date `
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 1f done so within 60 days of the above decision.
/hd/sewage/forms/form37/6-3-91
-3 • irmit C `,--) ,
CITY OF FEDERAL WAY
BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME:
OWNER H ktLD 6 IA ITE LOCATION
OWNER'S ADDRESS /0 0 SD 7� w 141 CITY Fe(€r'c L k ,ay' PHONE S35'29c 7
DESCRIBE JOB fn') Cohl,5"r-kUCrICA) Df' 0-er2 -tc t tri $rorcg-e 6/4,2/3--( 7-
THE
3-(-THE PROPERTY IS OWNED BY: SINGLE/MARRIED V PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME SO l4-kE 91\1b 4.EV EL CONTRACTOR'S REG. #21'.14R L 0-.'�1 5 8
Card MUST be presented
CONTRACTOR'S ADDRESS 1O 6 I S to r'`srC rt'' CITY PuYcc //VP PHONE c 7
EXPIRATION DATE
— OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIA ' CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. r 74 ,'i-'
BOX 3 CONTACT PERSON `Ke/v1 e.."-H1 MU/4'4y PHONE 9 6807
BOX 4 SEWER DISTRICT Fed. c' 'd kv,4 V WATER DISTRICT 1c-eL--e.--cj LNA y
BOX 5 ESTIMATED PROJECT COST 16, 000.00 EXISTING BUILDING VALUATION Cr ?600
BOX 6 PROPERTY TAX ACCOUNT NUMBER 32 a I D 4 --9 13_3
LEGAL DESCRIPTION THE. Isp•wt.* 17o' 0 f'rh-e., 441 L/7 o_L=. 'rh& E -r-A .� 1?/GcJ
0 ' -r-k,4z to,F- Yti Qf .rye G+ 3 Z" Z.J—6 4 L e SS - 14 0
(If necessary, please submit a seQarate page with the legal description.) �/ -
K.C. Plat Recording# N/
BOX 7. BUILDING SQUARE FOOTAGE: (Existing/Proposed)-- 'f FLOOR / 2ND FLOOR /
3RD FLOOR J BASEMENT_____/ DECK / GARAGE 0 / 6 /O
BOX 8 ( ) SINGLE FAMILY (X) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS =,,, ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY S6, aon SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES— BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER j $
SINKS -----~--"'"'""'"'130fLtR, SIZE BTI $
DISHWASHERS ' { -------A1R HANDLING UNITS �' $
ELECTRIC HOT WATER HEATER HEAT PUMPS,'SIZE - 7 _ '
LAUNDRY WASHER OUTLET UGIT HEATERS $ "
URINALS AIft COOLING UNITS, SIZE- —'‘-__ $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUMcIVED_—__—OTHER 1 $
DRAINS , $T_
OTHER MAY 01 1992 $
TOTAL FIXTURES
a1Y oF FEDERAL WAY TOTAL MECHANICAL FEE $
BUILDING 06123:
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 EMPL YEE (UPOf,THE ACCUR Y OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
OWNER/AGENT: i & 7 DATE: 1/— —?
ANP-000 3/90
M
(Y\ N
q m
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ADDRESS OF PROPERTY. /1:-.) C` • a ` GSEATTLE-KING COUNTY DEPARTMENT OF PUBLIC HEALTH
DIVISION OF SANITATION
904 Public Safety Building
• AS-BUILT SEWAGE DISPOSAL PLAN
(Submit in Triplicate)
LEGAL DESCRIPTION: PERMIT NO. a ?5 4
Owner LTA rasa, /-.7aA) _ ... Address a.01
,.. .. . _ _ _ Phone. 0.1l¢�r.-- L 3 e2
Builder r c' .} .. . Address n ` • Phone
Phone
<Designer. _( no6no Address �i:�..)
Installer �, Nl2hT..tOrk!_ . Address.(: ? . : J • .1ta` T - Phone CN-c-_1272-- •
• I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed address. I further certify all recommen-
dations and restrictions (concerning plumbing stub elevations, maintenance of grades, fills, surface drains, etc.) listed by me on my approved site plan (or
latest approved revision thereof) dated 5- o 2 - ..__ have been complied with. I further certify that this system meets all requirements of
the Rules and Regulations established under King County Resolution No. 22873 or City of Seattle Ordinance No. 90181 whichever is applicable.
C�
c[Nnnc•r[NO. •16NATUPt or otuoHu o•rt
TO BE FILLED IN BY HEALTH DEPARTMENT ONLY
Date Accepted /Q� 7. Date Not Accepted .
Signature of Sanitarian J
Remarks
7J1 ;
•
INSTRUCTIONS: You may use the reverse side of this form for the drawing or attach separate sheet. Use a scale which will permit the greatest derail and
still contain the entire site on one page.
ATTENTION HOME OWNER: o
•
Your septic tank has limitations! It was designed and installed to care for an average-size family. Overloading the septic tank or disturbance of the drainfield
may seriously impair satisfactory operation. Points to remember:
I. Have your tank checked periodically to see if pumping is necessary (21/2-3 years).
2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield.
3. Do not excavate, fill, place a structure, driveway or patio in, on, or over the drainfield.
4. Limit toilet fixture disposal to sanitary wastes and toilet tissue.
5. )etergents and bleaches used in normal household quantities will not harm the action of the septic tank and disposal field.
C•■1[.1[.1•
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330 ' 0 ► ' _ — i►
NORTH PROPERTY LINE N
- \
100' o A
Pif�����ONOfareerd7A1iOX" - 7 , C�J
109 ' 6" 0:_:::::::::::::::::::: : : : : : 0 i ! 00
O: .ro.osed structure I 100 gallon septic tank o
: ::� 197' drainfield O
0
%�/���/��/a��/�//� 1 c ., 19,0„
- I
- garage I
- 1 I w 41O4OZ
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- „9 ,9 2 - -` I - I - I - I - I O
- I - 1 - 1 - 1 - house
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4-
MR
MR & MRS HAROLD WILSON ;
_driveway
E SOUTH 170' OF THE W 1 /2 OF '"
E 1 /2 OF THE NW 1 /4 OF THE IT. 0N '-x
\IE 1 /4 OF SEC . 32 - 21 - 04 LESS 0 1 � `�
E
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CO . ROAD c,
1 020 SO. 372 WAY \hcy
FEDERALWAY WA 98003 t �\ nn (`
s -A
1110
SOUTH _PROPERTY LINE I T
t. vel
gate gate gate
372 ST