95-102731 ' 9 5--10d 73(
-
CITY OF FEDERAL WAY PERMIT NO: BLD95-0834
33530 First Way South . `;; ww.,w .,,�,,. ..,...,�.,;M „�.,. "'' ::F P h. '"�.M .I,. ...�..• ISSUED: 10/24/95
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC2
661-4000 EXPIRES: 04/21/96
ADDRESS: 33020 10TH AVE SW Unit: 12
NO. : 182104-9063
PROJECT DESCRIPTION:PLUMBING - DOUBLE CHECK (FEBCO 805Y, 1.5°)
¢- OWNER -------__. -____. - ---q- CONTRACTOR -• -- •- - LENDER - ---=-- x--•- T
BARCLAY RIDGE/FEDERAL WAY APTS T PUGET SOUND LANDSCAPING INC
( 33020 10TH AVE SW BLDG #12 3147 46TH AVE NE
FEDERAL WAY WA 98003 OLYMPIA WA 98506
360-943-9201
t
PUGETSL1500S
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY Of FEDERAL WAY. TAX RATE : 8.2% ***
T --
BLD?: MEC?: PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 0 1 COMP PLAN •' FEES:
TYPE OF WORK:? USE:RES 1ST.: 0: O:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS? •' PLM PRMT ISSUANCE.. $ 20.00
CENSUS CATEGORY •800 2ND.: 0: O:sf HEIGHT • 0.00 ft 1 HAZARD CLASS •' PLUMBING FIXT....93* $ 7.00
OCCUPANCY GROUP 3RD.: 0: O:sf VALUATION i REQUIRED SETBACKS FIRE FLOW • 0 gpm
•? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 1 FRONT • 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 0 ! SIDE • 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: O:sf 1 REAR 0.O0:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:10/13/95 1
: 0: 0: 0: 0: TOIL: 0: 0:sf I IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
I FUEL TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS 1 WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 27.00 3
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 1 BATH TUBS • 0 DRINKING FOUNT.: 0
SRN<100K..: 0 DUCT WORK • 0 3-15 HP • 0 1 SHOWERS • 0 SUMPS • 0
S HNT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 0 VAC BREAKERS...: 0 1
CONY BURNER: 0 FURN>100K • 0 30-50 HP • 0 1 SINKS • 0 DRAINS • 0 1
BBQ • 0 MISC • 0 5+ HP • 0 I DISH WASHERS 0 LAWN SPRINKLERS: 1 I
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0 I 3
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 ) LAUN WSHR OUTLTS...: 0 3
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 FURNISHEI BY ME IS TRUE AND CORRECT_II;O THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT 7ZC_ /
1-1, -)--- 1, DATE ___21;,4-9/ $..29
FILE COPY
• !
City of Federal Way COMMUNITY DEVELOPMENTRECEIVEDBY DEPARTMENT
•
R'' APPLICATION FOR BUILDING PERMIT OCT
PLEASE PRINT
APPLICATION #: wq5 0 g3
SITE LOCATION I Address 10 Hi V , , )
Tena known) � � � �1� lG/ �l.�� /�
—V14re-7x' �!� ,„"0�� Lot # Assessor's Tax #
y Building Owner NarrSe Address
City I State Zip
(Phone
Nature of Work
IAPPLICANT I
Name (F,M,L)
Address
City
State Zip
Contact Person iDay Phone Other Phone
Fax
'BUILDING CONTRACTOR ;I
Company Name
Address
City
State Zip
Contact Person
Phone Fax
Contractor's # (card must be presented)
Expiration Date Verified ❑ Yes ❑ No
ARCHITECT I
Name
Address
City
State Zip
Contact Person
Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/93)
LTRUCTURE •ting Use *posed Use
r
Permit includes: ❑ Building ❑ Plumbing ❑ Mechanical ❑ Other
a Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ 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 ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation $
Zoning Lot Size Existing Bldg Valuation $
LENDER
Name Address
City
State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City
State Zip
Contact
Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
—1U3i 'dN CONTRACTOR
C ctor Name /7 Address
aro 7' ( )oc e .1---ii-- ..Ar_10 � /c. �/c.
City / -' / !1 7 id V Z� ,, / 12 7 State `'l l4 (---
/V/i tel/ !Y Zip �FS-9y
Contact
16 .
!? [�z ��7J
r�
Ns .A.)
rV6.5 , Pig56 >
Fax 7 7 ✓ /
License # Tu66 SLS/.. 60 s 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 Fixture Count
Y2" &o DOu_-/5 c� V 4 Z
MECHANICAL UNIT COUNT Fos Y
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
BBQ'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 ari •s out of the reliance of the City,including it is rs and employees,upon the accuracy of the information supplied to the City as a part of this
application. JfD��
Owner/Agent: • L/c+-l�i- / /' Date: / ` j f4/)
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