94-102173 W
S`y-/oo2t73
CITY
335300FirstF DEWay South RAL WAY BU I L DING PERMIT PERISSUED: 03/14 /9583
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: KLC
661-4000 EXPIRES: 09/10/95
ADDRESS:30614 28TH AVE S
NO. : 092104-9096
PROJECT DESCRIPTION:GRADE AND FILL PERMIT ONLY. IMPORT 250 (220 plus 30 yds. topsoil) FOR NON-STRUCTURAL PURPOSES.
= OWNER — CONTRACTOR — LENDER
ALLAN WOIDA $$$ OWNER IS CONTRACTOR ="Y
30614 28TH AVE S
• FEDERAL WAY WA 98003
941-9126
55$ NONE *fl
BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN •SR? FEES:
TYPE OF WORK:? USE:? 1ST.: 0: 0:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS? •? FINAL PLAN CHECK...; 8 22.50
CENSUS CATEGORY .? 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS •? BUILDING PERMIT....' $ 33.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gpm SBCC SURCHARGE $ $ 4.50
:? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BUT: 0: 0:sf PROP...#: 0 SIDE • 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:11/10/94
. 0: 0: 0: 0: TOTL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
dli FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 60.00
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 • 0 SUMPS • 0
GAS NMT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONY 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
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 FURNISED BY WE,IS�TRUti AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS WILL BE MET.
/
OWNER OR AGENT _ c lLt 1/(,e'- c DATE 3// __/Jl
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RECEIVED
EIP City of Federal Way IP
N,w APPLICATION FOR BUILDING PERMIT NOV 1 5 1994
CITY OF FEDERAL WAY
PU%IC;WORKS DEPARTMENT
PLEASE PRINT
APPLICATION #: FLD 9' k O3
SITE ooATION Address r ri A4
Tenant (if known) Lot # As s Tax#
A oye\/ :),K.) —qCPUO
Building Owner Name Address ,a)c.,t,..4
A-0-1 A t:-) ST
LtJJ
City State ::j f),‘ -Zip clew-5 JPhone C1 -JJ %-)-(c3
Nature of Work
--
POKI- yta-r..o, ScIL. -s)
• — r_csPlWCA-P-Os ,-
APPPC.AMignigiMMINEffigingi:!
..............
Narqe(F,M,L)
Alf-LL.A ) & iCA
Address
rt
City
State 95, Zip
C2ntact Person Day Phone
Other Phon Fax
2 k3 A
•
< 6g,_ (00 (o2. OcA-
BUILDING,CONT14045*:,:iui:moUi
Cornlar 4ame
•
Address
City
State Zip
Contact Person
Phone Fax
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
.A:
Name
Jirit) A
k
Address
City
State Zip
Contact Person
Phone Fax
LEGAL DESCRIPTION
ADD Li C k\P-P
I CA
0 A 0
Please Complete Reverse Side
CD0492(Rev 4/93(
a
�
Fryp.CeTof
URE filtmg Use Illipposed Use
it includes: uilding ❑ Plumbing Mechanical ❑ Other
Work: ❑ Residential ❑ New ❑ Remodel LI Number of Units ❑ Deck
El Commercial ❑ Addition ❑ Garage ❑ Shed LI 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
Water Availability O Sewer Availability ❑ On-Site Septic System Availability ❑ ;Project Valuation $ i
Zoning 4--C -7, L Lot Size 2_
l 2(0 }C.,0. Existing Bldg Vafuatlon >x
Wr .-- 1-'2-1-1
/ -715c-
LENDRE '
.
Name Address
City State Zip
1ViECHANICAL CONITRACTOR ,
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING-CONTRACTORAMMIN
.....
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
-
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total:FixtureCount
.....
1CRACALUNI'I COUNT
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 Tanks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBO'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.
Owner/Agent: Date: