96-1034669G-b3 y&A
CITY OF FEDERAL. WAY PERMIT NO: BLD96-0406
33530 First Way South ►1J T L V I N,ICI P C n P4.,.T.. ISSUED: 09/24/96
Federal Way, WA 98009 Building Inspection Requests 661--4140 BY: FC2
661--4000 EXPIRES: 03/23/97
ADDRESS:1030 SW DASH POINT RD
NO.: 515320-0441
PROJECT DESCRIPTION: PLUMBING ONLY - WATER CLOSET, LAVATORY, ELE WTR HTR, WASH MACHINE
g= OWNER == -----====-= CONTRACTOR =====
CHARLES BUTLER MT. RAINIER PLUMB
1030 SW DASH POINT RD P.O. BOX 171
( FEDERAL WAY WA 98023 33419 HWY 507
MCKENNA WA 98558
'31-9840 458-2250
MTRRAIP*196D7
*;* CONTRACTORS, PLEASE USE LOCATION CODE 1732 NNEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL NAY. TAX RATE = 8.2%
-T--=��—�� FEE
BLD?: MEC?: ^PLM?:X ^- FLR--EXIST--PROP--- DWELLING UNITS: 0 I COMP PLAN ......... :SFMD FEES: Y ^ I
TYPE OF WORK:flLT USE:RES 15T. 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 HAZARD CLASS...:? i PLUMBING FIXT.... 93* $ 28.00
1 OCCUPANCY GROUP---------- 3RD. 0: O:sf VALUATION---------- REQUIRED SETBACKS------- FIRE FLOW....: 0 9pm I
:? :? :?
:?
OTHR: 0:
0:sf
EXIST..$: 0
TYPE OF CONSTRUCTION-----
BSMT: 0
O:sf
PROP...S: 0
•? •?
•?
DECK. 0;
O:sf
OCCUPANT LOAD------------
GAR.: 0:
O:sf
RECEIVED.:09/24/96
0: 0:
0: 0:
TOTL. 0:
O:sf
_
I FUEL TYPES.:?
?~
FANS...........
0
BOILERS/COMPRESSORS
' "S PIPING.:
0 ft
HOOD......,...:
0
0-3 HP......: 0
-10RN<100K..:
0
DUCT WORK.....:
0
3-15 HP.....: 0
1 GAS HWT....:
0
WOOD STOVES...:
0
15-30 HP....: 0
CONV BURNER:
0
FURN>100K.....:
0
30-50 HP....: 0
BBQ:
0
MISC..........:
0
5+ HP.......: 0
........
GAS DRYER..:
0
AIR HANDLING UNITS
FUEL TANKS ---------
RANGE ......
0
<=10,000 CFM:
0
ABOVE GROUND: 0
GAS LOGS
0
> 10 000 CFM•
0
UNDERGROUND.: 0
FRONT.........: 0.00 ft
SIDE..........: 0.00 ft WATER SERVIC€..:?
REAR..........: O.00:ft SEWER SERVICE..:?
i
IMPERV SURFACE: 0 sf SENSITIVE AREAS?...
WATER CLOSETS......: 1 URINALS........: 0 TOTAL FEES
BATH TUBS..........: 0 DRINKING FOUNT.: 0
SHOWERS ............. 0 SUMPS........... 0
LAVATORIES.........: 1 VAC BREAKERS...: 0
SINKS ............... 0 DRAINS.......... 0
DISH WASHERS.......: 0 LAWN SPRINKLERS: 0
ELEC WTR HEATERS...: 1 OTHER FIXTURES.: 0 I
LAUN WSHR OUTLTS...: 1 1
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO NORK IS STARTED. RES E IAL AND GRADING PERMITS EXPIRE ORE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE IHF TION HISHED BY ME IS TR ND CORREC - THE BEST OF NY KNONLEDGE AND THE APPLICABL CITY OF FEDERAL WAY REQUIREMENTS HILL BE NET.
OWNER OR AGENT_ __ r _ DATE
$ 48.00
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PLEASE PRINT
BUILDING DIVISIGN
+L� 33530 First Way South
Federal Way, WA 98003
(206) 661-4000
Fax (206) 661-4129
'rE)iv..'t7ING
APPLICATION FOR BUILDING PERMIT
APPLICATION #. Vb 1 � ♦ C� *
>:'>; `
Address
Tenant (if known)
Lot #
Assessor's Tax #
Building Owner's Name
Address
City
State
Zip
Phone
Nature of Work
Name (F,M,L)
Address
City
State
Zip
Contact Person
Day Phone
Other Phone
Fax
Company Name
Address
J
city- G
State Lia
Zip
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
LEGAL DESCRIPTION
Pleaseamnleie �q@vArsa_ S►de
Ling Use
posed Use
Permit includes:
❑ Building
❑ -Plumbing
❑ Mechanical
❑
Other
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 ❑
Pro'ect Valuation
$
Zoning
Lot Size
Existing Blda Valuation
$
Contractor Name
Address
t-Ily I State Zip
Contact I Phone Fax
License # I Expiration Date I Verified ❑ Yes ❑ No
Contractor Name
Address
g
City f�<
State
zip
Contact
PhOno _
Fax
License L
Expiration Date
Verified ❑ Yes ❑ No
Water Closets
Sinks
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
-Drinking Fountains
Other
Showers
Electric Water Heaters
Sumps
Lavatories
Washinn Machine
Drains
Total F(*ture Cgt3rit
Fuel Type (electric/other)
MECHANICAL EVALUATION ONLY $
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
Conv Burner
Duct Work
0-3 Tons
Underground
BBQ,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 Wa t only where such claim arises out of the reliance of the City,
including its officers and employees, upon the accuracy of the information s plied to the City as a part of this application.
Owner/Agent: /' f _X1, ( Date:
nuuort Avv
nEv n121/06