93-103202 9;- lo3avCITY a
335300F FEDERAL WAY Firstt Way South BUILDING P E�I T PERMITISSUED: 01/25/9461
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 EXPIRES: 01/25/95
ADDRESS:917 S 295TH PL
NO. : 515180-0050
PROJECT DESCRIPTION:RESIDENTIAL ADDITION - ADDITION TO EXISTING RESIDENCE.
= OWNER — CONTRACTOR — LENDER
DIRK VAN WOERDEN DISCOVERY HOMES CONST INC
917 S. 295TH PL 433 S 289TH
IIIIFEDERAL NAY NA 98003 FEDERAL NAY WA 98003
839-9112 941-9474
DISCOHCO9ILF
BLD?:X NEC?:X PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN 0 FEES:
TYPE OF MORK:ADD USE:RES 1ST.: 2912: 306:sf STORIES • 0 REQUIRED PARKING..: 0 SPRINKLERS? 0 PLAN CHECK DEPOSIT.* $ 134.55
CENSUS CATEGORY •434 2ND,: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS 0 FINAL PLAN CHECK...* $ 0.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS------- FIRE FLOW • 0 gm BUILDING PERMIT....# $ 207.00
:R3 : OTHR: 0: 0:sf EXIST..$: 0 FRONT . 0.00 ft SBCC SURCHARGE * $ 4.50
TYPE OF CONSTRUCTION BSNT: 0: 0:sf PROP...$: 19927 SIDE • 0.00 ft MATER SERVICE..:FED NEC APPLIANCE FEES.* $ 6.50
:5N : : DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:SEP PLUMBING FIXT....93* $ 28.00
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:12/20/93 PUB WKS PLCK(SF)..93 $ 40.00
0: 0: 0: 0: TOIL: 2912: 306:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
WK'EL TYPES.:GAS FANS • 1 BOILERS/COMPRESSORS WATER CLOSETS • 1 URINALS • 0 TOTAL FEES $ 420.55
S PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<IOOK..: 0 DUCT WORK . 0 3-15 HP - 0 SHOWERS - 1 SUMPS • 0
GAS HMT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 2 VAC BREAKERS...: 0
CONV 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 MTR 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 STA ED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE I TION FURNI BY ME IS TRUE N COR CT TO THE BEST OF NY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAI NAY REQUIREMENTS WILL BE MET.
P
OWNEE OP AGENT ___ s _ DATE 1_ 2... . 9/
FILE COPY
I .
ITY OF FEDERAL WAY PERMIT NO: BL— "1
3530 First Way South BIJILDIN'G PEIRIh4IT ISSUED: 01/25/94
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY: FC
661-4000 III *' EXPIRE`.;: 01/25/95
ADDRESS:917 S 295TH PL
NO. : 515180-0050
PROJECT DESCRIPTION:RESIDENTIAL ADDITION - ADDITION TO EXISTING RESIDENCE.
MINER
_.,...r . ._. . _.._._... ...... __- ------ CONTRACTOR �� r,..». .�---.�-- - ._.._=-_ _ = LENDER —..z..- Lfir
_.........=.....,..-_. ___._„_rte
DIRK VAN ROERDEN DISCOVERY HONES f.ONST INC ��
17 S. 295tH Pt 433 S 289TH
EDERAI MAY MA 98003 FEDERAL MAY MA 98003
839-9112 ae @ .a:w
.,a � � ` ' ._..,..,,_. .__,.—....,_,__.. . ,.r-,zu __ . .__,........—.. ._-----. .._---- _....k.....•.
lot
11102:X NEC?:X PLM?:X FLR- E IOP g0 I P PLAN 7 FEES:
TYPE OF MORK:ADD USE:RES IST '' 00 s ; RLL, : v.P T >§ PLAN CHECK DEPOSIT.* $ 134.55
CENSUS CATEGORY •134 ..,� .. LGN � ''� 'SS �:7 FINAL PLAN CHECK...* $ 0.00
OCCUPANCY GROUP---------- --
0; ,„ sf Mit at F ' :, ' _ ° IRE F ' - 0 A' w'; PERMT....1 $ 207.00
:R3 : 1 0 k 1ST -' r'' • 0.00 ft 3BCC SURCHARGE * 9 4.50
€YPE OF CONSTRUCTION-_--- .. ' �O. `0 ' . • 0.00 ft WATER SERVICE..:FED NEC APPLIANCE FEES * 1 6.50
:5N : i • a a .. ,. '.; �
REAR • O.00:ft SEVER SERVICE..:SEP PLUMBING flXi...,93= 28.00
OCCUPANT LOAD.- GA • Cm '.s RE�' "ED.:17 ' • "93 % PUB MKS PLCK(SF)..93 1 40.00
: 0: 0• 0: 0: TOIL: < IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:”
_.-, .-..__._.
r L TYPES.:GAS FANS • I BOILERS/CONPRESSORS WATER CLOSETS • I URINALS . 0 TOTAL FEES $ 420.55
GAS PIPING.: 0 ft HOOD • 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<IOOK..: 0 DUCT MORK • 0 3-45 HP.. ..: 0 SHOWERS • 1 SUMPS • 0
GAS HMT • 0 WOOD STOVES...: 0 15-30 HP • 0 LAVATORIES • 7 VAC BREAKERS...: 0
CONI' BURNER: 0 FURN>1001 • 0 30-50 HP • 0 SINKS - 0 DRAINS • 0
RBQ • 0 NISC • 0 5+ HP.. ....• 0 DISH WASHERS • 0 INV SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC MIR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 (-10,000 CFN: 0 ABOVE GROUND: 0 IAN MSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFN: 0 UNDERGROUND.: 0
;ERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS SI ED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE FAR AFTER DATE Of ISSUANCE.
CERTIFY THAT THE (NLORIIAIION FURNISED\BY NE IS TRUE C CT TO THE BEST Of NY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL WAY REQUIREMENTS MILL BE NET.
TIER OR AGENT __ __ -, —� � = --_ GATE 2_2L "
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EIVED City of Federal Way
�`� - APPLICATION FOR BUILDING PERMIT
DEC 2 0 199-
CITY OF FEDERAL 1
PLEASE PR/NT BUILDING DEPT.WAY APPLICATION #: L-V /J /l
_ 63 l
SITE LOCATION Address
Tenant (if known)V ���^ ��� I r Lot# Assessor's Tax#
,L oi K 1'i ' 04 gLKILi Z 5i51eo • bosb •o8
Building Owner Name
`f 011-7 e;.. 261511 PLACE
City FeD ea-AL, l.✓A`( State L ' PC Zip Ci 0Cb 3 Phone e_e3q • ct t tZ
Nature of Work $L—D Gi &O D t T I b k3
APPLICANT
Name (F,M,L) �I ct)Ve ,1 6,-Yl e C s-k I 0.3 c
Address .433 so • -2-S4-÷k
City -E-C%. --b l.. Go i •/ �"� State it)Pr-- Zip q -5 oo3
Contact Person Day Phone Other Phone Fax
__BIL 1gti --it Bed. 2o ,. c,o-4t • ct y1(' q4H - 43Gc1
............. .. ... .............. .... . . ............ ..... .. ......
... .................... ................... ......................................
BUmret..G CONTRACTOR
Company Name ^� 1--\01 • I
V►SCbva•1 14 . �oro-3 k___ 10 G
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified Yes ❑ No
-MI5 C_o t-}Goat L.'F cv• 3 • q 4
ARCHITECT
Name
t I g�
Address
Zi-3 S Se, - 25°\
CityCe�G''n R-__C Lo !, / State ✓'q--- Zip 9 cC3
Contact Person Phone Fax
QOIaio '---11RD.c. - qW- GI5/7y may,- -1389
LEGAL DESCRIPTION [104,-.0)L D j Z. 1 k1 14 , wt aiftvp.�Q Z Ja Lo wt.c 66- o F PL' ' g
f -ti.‘) at Coo N341 .
Please Complete Reverse Side
CD0492(Rev 4/931
'STRUCTURE ng Use h ►toG��e �rv►t'tti osed Use (L 1ti ----
Pe:mit includes: Jed Building Y Plumbing Mechanical ❑ Other
Type of Work: ,rq Residential ❑ New ❑ Remodel ❑ Number of Units_ IIIDeck
❑ Commercial , Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor ?,r' sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area 2Q I Z sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area 2 ?, 1 8 sq ft
J
Water Availability Sewer Availability ❑ On-Site Septic System Availability JfProject Valuation 8 (;,yx 3C
Zoning gs '= I , (,0 Lot Size Z Z 2 l 3 4i Existing Bl•dg Va(uat on 5 �
LENDER
Name 01� Address
City State Zip
................................................................. ....... .............. .
...........................................................................................
......................................................................... .................
...........................................................................................
MECIYANICAL CONTRACTOR
...................................................................... ....................
..................................................................... .... ..............
Contractor Name Address
e)L019e2 _
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR ;
Contractor Name Address
D ti L."h i)co wt,\p \ q
City SC.,Alt Lle-(L State Lt1 k+. Zip
Contact Phone Fax
D It L,t.14 s 1-1'ic1,e� / g b n., Fn-+t e
License # Expiration Date Verified LI Yes ❑ No
..................................... . ..................................................
........................................ ...................................................
iPLUMBING:FIXTURE COUNT ....
Water Closets ( Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers , Electric Water Heaters Sumps
Lavatories 2 Washing Machine Drains
Total';Fzcure Cant> : :.'>.:: <z > <<
MECHANICAL UNIT COUNT... ..;
Fuel Type (electric/other) Ci 4" 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 1Boilers Above Ground
Cony Burner Duct Work Ac��V p ZD J 0-3 Tons Underground
BBO's Wood Stoves 1 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 t ,. ity, '. luding its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application. " 2
Owner/Agent: W.�, l I Date: IiQC_ 2 0 -1q93