05-101543 RECEIVED
C - _/_ L _f_ 5 _c_(3
my OF 406li III
redera►Way) - 5 PERMIT ASF F CO ME EL PL DE EN FP '
2005 ='
COMMUNITY DEVELOPMENT SERVICES - r/ /
33325E D AVENUE SOUTH 9•PDBOX9718 W APPLICATION To
FEDERAL WAY,WA 98063-9718ERAL :`\ �
253-8352607•FAX 25I-E352609'(-1 DEpT A i ,�
www.cilVo(/ederalwaV.com V
The oIlowi • is re• ired in ormation—an Inco •lete a••Iication will not be acce.ted. Please •(int Ie.ib1 in or J.
II PROPERTY INFORMATION
p�7 ,I41" :
I c�C( SUITE/UNIT#
SITE ADDRESS (-) V / C/ �— 'tel
'73O-0—..i) &
3/0— LOT SIZE(s
ASSESSOR'S TAX/PARCEL# , (,,() C./�✓
�- {- ( yes > —
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) '
(Attach separate page for lengthy legal desc.pt'o^I
S PROJECT INFORMATION
TYPE OF PERMIT [?"BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this l permit only) �L , ,I
1 ti :Ft `lam �a . - !�
•
,jr ("72,c_ ( :/-77/v1/
PROJECT NAME(Name of Business or Owner Last Name)
(_��EL /7 6 5777--mss
5 PEOPLE INFORMATION
q// PRIMARY PHONE {� �/�
PROPERTY NAME
J� f J T / I�)/�/n/ �' L/VLA �53) Jam/c� U��`C J
OWNER ll`-'�'v� >\-/"�I�` '-" '��1 CT(�YJ,STATE,ZIPJ - � /� /%��j'
MAILING o.ADDRESS I / u p L Z p ! v / O 371
0. �vdx 7.371� 1 `� 1
APPLICANT NAME OFFICE PHONE
CONTRACTOR COMPANY NAME `
Q-911/4 /9-g()
/(E CITY,STATE,ZIP CELL PHONE
MAILING ADDRESS (
CITY OF FEDERAL.WAY BUSINESS LICENSE NUMBER EXPIRATION DATE ,✓ FX NUMBER
;CO –D41 –L O4/ 'C/—// –B L / r1 EXPIRATION DATE
CONTRACTORS REGISTRATION NUMBER[copy of card required with each application) / /
COMPANY /J�
APPLICANT NAME OFFICE PHONE
APPLICANT I ( ) _
CITY,STATE,ZIP CELL PHONE
( )
MAILING ADDRESS
`/t FAX NUMBER
RELATIONSHIP TO PROJECT &I
'/GL/61,
L y I /�
0 Architect ❑ Tenant ❑Agent the((Describe) JJcC./� ,r
CONTACT NAME PRIMARY PH(bO1NEI E-MAIL,ADDRESS
IAG!ri DIE- a✓3) zJs _ -� I/716 xuivDA
PTs.cc
LENDER
Per RCW 19.27.095: Lender information is NAME /i N _� / ^ 'v
/Ve
required if project value exceeds$5,000 !y/L ,,n I
CITY,STATE,ZIP
MAILING ADDRESS
S DETAILED BUILDING INFORMATION
PROPOSED USE
E70S'I`IIQG USE �
(e)
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES
E 7p FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDERI AKFAAVEN 0 CI HIGHI.INE 0 PRIVATE(SEPTIC)
PRIVATE
WA (WELL)
SEWER SERVICE PROVIDER 1111 FEHHA
y4Y69ci/13
PROJECT FLOOR AREAS Y
• tL ........._..._ __._..
_.. ....r. ,o, TOTAL
.Y--._.. ._... E ISTING PROPOSED
AREA DESCRIPTION , s..FT. S e-FT_
�- - s..FT.
6 '
SECOND c2---
THIRD
''. 11111111111111111MMI1111 2 1 s)
FOURTH IIIIIIIIII
ADDITIONAL FLOORS(DESCRIBE) -_
DECK(COVE'•`D?)
GARAGE ,ii CARPORT❑ � 111 eaoro� _ rarn�.SF
rout�rmro sr
r�osrmo
NUMBER OF FLOORS 4,1
� 1
ESTIMATED SELLING PRICE $ !_—_—
*'NEWHOMFS ONLY"' NUMBER OF BEDROOMS ----------—
re to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Indicatenumber of each p e o f fixtu
MECHANICAL
Value of Mechanical Work $_ . 0Y4_10--0 _
gE (,,SYSTEMS
GAS LOGS W FRIG. ST
AIR HANDLING UNITS EVAPORATIVE COOLERS HOODS tco ra<I
ES
BOIL FANS RANGES MISC(Describe)
BOILERS i FIREPLACE INSERTS GAS WATER HEATERS
COMPRESSORS FURNACES —�--
DUCTS GAS PIPE OUTLETS
---
PLUMBING ,,
LUMBINGI SHOWERS
WATER CLOSETS Iroaoq MISC(Describe)
BATHTUBS(or ILbiShowerComho( -7—'1, SINKS DRINKING FOUNTAINS
-----1— DISHWASHERS SUMPS RAINWATER SYST
j GAS PIPE OUTLETS URINALS _ - HOSE BIBBS
WASHING MACHINES VACUUM BREAKERS ELECTRIC WATER HEATERS
— LAVS :athroom Sinka
. DISCLAIMER/SIGNATURE BLOCK....- _::....
-- ......^ , penalty .: that the information furnished by me is true and correct to the best of my knowledge,and further,that
furthern is made. I agree to hold
I certify d under owner perjury aa and defense hold am authorized by the Way the above premises to perform the work for which the permit
incurred in the investigation g
ofclaim(including costs, expenses, and attorney feesbut onlywhere such claim
harmless the City of Federal as toany (i the undersigned,and filed against the City of Federal Way, as a la m
beof
made by any person,including ofthe information supplied to the city pa
such claim),which mayern and employees,upon the accuracy f _
including its officers of
arises out of the reliance of the city, -
this application y�,�__
/ DATE
NAME/TITLE LL �u`1
�;�a:.t 1
RELATIONSHIP TO PROJECT 0 Owne gent 0 Contractor ❑ Architect 0 Other
FOR OFFICE USE ONLY REPAIR ❑TENANT IMPROVEMENT
❑NEW o ADDITION ❑ALTERATION egg 0 NO
❑YES o NO BASIC PLAN?
BUILDING SHELL ONLY?
ZONING DESIGNATION CHANGE OF USE? °YES ❑NO UP/6EPAJSU? ❑YES ❑NO
NEW ADDRESS REQUIRED? 0 YES 0 NO ❑YES ❑NO
PLATTED LOT?
o YES o NO DEMO PERMIT REQUIRED?
k\l-Iandouts\Permit Application
August 19,2004 Page 2 of 4
Bulletin#100 Augu ,
LOT 26 COLELLA
NOTE:
STORM WA7ER RUNOFF
TO BE 77GHT-LINED TO
EXIS77NG DRAIN
00)
(56 P lj 'UC
m
aw;
Gi■
0
51 LK
EL. =2 27
UTILITI
101 PRIVATE r
EASEMENT
0RIVEWAY
ALL TEMPORARY 20 6
-V7
MIRAFI SILT FENCE 2,5 2.5
51
2v
I I C'q
I NEW BUILDING
lit F.F. ELEV.=212.5
ADDRESS TO
I BE DETERMINED
C4 206813 V,
GARAGE RT.
I
40
21
'005:
lco I I
LIMITS OF CLEARING t ► I ,.'�'� '�
AND GRADING
208-
210-7- SURFACE WA TER FLO W
212---- BUILDING SET13ACK
EL.=212.9 LINE (TYPICAL)
212-- REVISION DATE
0AY 0 6, 2005
05.101543
LOT LOT COVERAGE 29%
8.349 SF
AMPERVIOWS -AREA.-
ROOF AREA: 1,781 SF
SCALE: 1
DRIVEWAY, WALK *"=20"
SOLINDBUILT & PA770 AREA; 673 SF
HOMES, INC.
2,454 SF 0 10 20 40