04-102272 � � � �
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� fCit�r ofFederal Way Buil�. 1g - Single Family Perm�#• 04-1022��-i�1 -S'�
CorrmuniN Development Services ZZ .
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835.2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: OLSON
Project Address: 29106 REDONDO WAY S Parcel Number: 052104 9026
Project Description: NEW- Construction of a new 6163sqft,3-story,single-family residence (including finished
basement)with an 840sqft,attached garage,and 1028sqft deck,includes plumbing&
mechanical. Project includes 5 engineered rockeries located near the driveway accecs.
***5 bedrooms; proposed selling price $710500X**
Owner Applicant Contractor Lender
LEONARD A OLSON LEONARD A OLSON 29102 REDONDO WAY S GLOBAL DEVELOPMENT
29102 REDONDO WAY S 29102 REDONDO WAY S FEDERAL WAY WA 510 RAINIER AVE S
FEDERAL WAY WA FEDERAL WAY WA 98003-3719 SEATTLE98103 WA
98003-3719 98003-3719
Census Category: 101 - New Single Family House
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction T e: Type V-N
Occu anc Load:
Floor Area(s . ft. U 0 0 0
„' '
Additional Perrnit Information -
New/Additional Sq. Feet- 1 st Floor....................2351 Ne�v/Additional Sq.Feet-2nd Floor...................1462
New/Additional Sq. Feet-Basement...................2350 Basic Plan?........................................................... No
New/Additional Sq.Feet-Deck..........................1028 F�re Dept.Access/Hydrant Loc.Needed?..............Y�s
New i Additional Sq.Feet-Garage.......................840 Height of Structure.:..............................................29.5
Mechanical to be Included?...................................Yes Occupancy#1 -C1ass............................................R-3
New/Additional Sq.Feet-Other.........................0 Plumbing to be Included?......................................Yes
New/Additional Sq.Feet-Tota1..........................0 Zoning Designation...............................................RS 7.2
Mechanical Fixtures
Ducts.............................................. 22 Fans................................................ 6 Fireplace Inserts....................,........ 1
Furnaces......................................... 2 Gas Lobs........................................ 1 Ranges............................................ 1
Plumbing Fixtures
Bathtubs......................................... 2 Dishwashers................................... 1 Laundry Washer Outlets................ 1
Lavatories....................................... 4 Other Plumbing Fixtures................ 2 Showers.......................................... 2
Sinks.............................................. 7 Water Closets................................. 4 Water Heaters................................ 2
CONDITIONS:
1.A fire department approved automatic fire sprinkler system will be required.
2.A pi�e anchor is required for the 145 foot length of 8" CPEP because the slope ex�eeds 20% for
this pipe that extends from the residence down to the bend in the driveway as shown on sheet C3.
3. This decision shall not waive compliance with future City of Federal Way codes, policies,or standards
relating to the subject proposal.
� � �
, � : � PE�T EXPIRES Monday, February ;" �009. � r
' mit Issued on Friday, Feb�ruary 23, ; '
I hereby certify that the above inforrrlatron is corre��aiad th��h con ruction the above described property and
the occupancy and the use � - e in accorSlance with;t�e law rul s and re I ions of the State of Washington
and the.C3ify of F� ral
�._ �. _- ".� ; � � � ✓
Owner o :_.__ __ ._.�.:_.. . _.._ Date:
cr-�
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed bv Citv staff.
Tenant Name: OLSON Permit#: 04-102272-01-SF
Address: 29106 REDONDO WAY S
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction T e: Type V-N
Occu anc Load:
Floor Area(sq. ft.) 0 0 0 0
Owner Name: LEONARD A OLSON
LEONARD A OLSON
Owner Name:
Owner Address: 29102 REDONDO WAY S
FEDERAL WAY WA
003-/�
3 - / Z- �7�
ilding Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affecf the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
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j{;,-�>�H���,�,-:,;���a. Bu:�din� �- �iY��+[;�e Tart��ly� ��a-mit #: �34 - 1a? %2 oU . . .
I C�^uni:::i�'. L�r�clo,;:��:_n:�c"�iccs `j -.— -..-.. -�-=�i�.
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IPh��;;'G:;I�400�1 h�x:..__.i,h;.�,.., rszsnerti�:�� r.E�(,��leSt �Il', . G.:i�.03.�...:��i�
..���.�. I ���.��..�..._.�.�-'.�............,..,...._-'..�. ���
Yroject��atne: OLSO�ti
Project A.�dress: 29106 REDONDO�'VAY S Parcel i^vumher:0_52104 3u��
F•ojecl Descrip�ion: NEW-Construction of a :e-,;ir�b:r-iamily residence wit>> attached garage,inr.�u�ling plum'�;in� ac►a1
r►�echanical. Project inclucle�5 engineei•ed r�.kt:►•ies loe'��ted near tlie ariveway access. x':"3
�edroorns; proposed seii':r;;�,rice�%��)50(i**Y
p��i:cr r\pplicent Contr�ctv, Lender
Leo;ilyd A Ols�-m Leonard A Olson [.conard A Olson GLOBAL DEVELOPMLtiT
2�i102 kZFDO�lDC)WAY S 29102 REDONDO 4VAY S Sl0 RAINIER AVE.5
P�Dl:KAL\YAY w'A FEDERAI.WAY V�A 29102 RF.DONUO WAY:� SEiA7�"fLE98103 ��:\
�8003-�719 98003-3719 FEDER�AL�V;AY V'✓.4
! _._._...._.� _......_
.'t:cludes:
#1 I- ___#2 - � - - - - _ - �
' I ' #3 �� #�
�'en�us c,itr�:ory: 101 -New s� � �� ,, __ ;
�onsh'aict i�n Type -� _ _. -- u�� :=_YP 3__ �� YP 3 _ I ._ _� m,- i . ... a � ,. ;
r� T eV N T eV-N , _ _ _
- ----- � . .
Jc.upxncy Load. ' __ " _ !
i
, .) -- . _- -- _ � ,. ,--. .- --- ,;
� Fluur rea(S�.�t. ��
�� � � _-- _ _ _ __
�._....._...-
Ist Fln�.i P:oposed Sq.Feet.................................23�1 2nd Floor ProposeJ Sq.reet.................. ............i-162
Bascm.�:t Pr��p;.sed Sq. Fe��t................................23�0 Basic Plan........._.. .........................
....... �
Cznsus C' n................................................ 10, •New single famity hous< Constniction"I'ype#2.............................. y�� �
�.�.�-� ' T � -�l
.,,. ,
i��:�,'�:I'_��. ..�
d Sy.Feet......................................i028 �i;;Sprinklers Required................................... Ycs
:
Garag�Prn7osed�y.Peet....................................840 Height of Structure............................................29.�
�vlechanical.............................................. Yes Oc.upnncy Group#L.........................................R-3
Occupancy(nu�ip#2....... ...................................R-3 PI�miUing.............................................. Ye>
"I.ouina Dcsignau�o�i............................................RS 9.6
Plumbing Fixtures
__-- - — __. . -- - �
` Descripti��n ��Quantity,�� _ Description J�Quantity Descnption �Qu��ntity
- --- --- -- -- - -- __
- ---- - =_. -- -- --
Qathtubs i! 2 �� Dishwashers I Laundry�Vasher Outlet� � 1
�� �
_ _. __.. ----�� .--- �_ _ ___ _-. -- � ___ - ___' ,,_-- - ��- ` :.
__ _ - _ --- — �- — _ -- -- -- _ -__ -- ;
l.�vatur�es 4 Other Plumbmg Fixhires 2 S��ower.. �
�-" d !
,
-- - - -- _,
— - -- -- -
Sinks 7 , Weter Closets 4 N-'ater Heaters � '
-- -- --- ___---- -- _ _ __ � ,
_ -- I�� - _
Mechanical Fixtures �
-- _. __ _ -- -
Description ��Quantity''_ Description Quantity� Description C�uantifii;
_ --- _- - - __ -- - - -
- ----
- - _ _ . _ _ __ _ — -- _
iluct.< . 22 Fans 6 Firepl�ce[nserts �; 1
-- -_ __ _.-- ,_,_ =., - --- _ :_ ,:: :._, ,,_.
- -- - - --
Furnaces 2 �����Gzs Logs 1 Ranges �' � �
I� , '
, .
CONDITIONS:
1. A tire department approved automatic ::re spririkler system will be required.
2.A pipe anchor is requ:red for the 145 foot length of 8" CPEP because the slope exceeds 20% for
this pipe that extQnds from the residence down to the bend in the dri��eway as shown on sheet C3.
3.This deci�inn shall not waive comp;iar►ce with future City of Federal Way codes,policies,or standards relating to the
subject;.roposal.
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PERMIT EXPIRES March 13,2005.
Pe:mit issued on September 14,2004
I hereby certify that the above informatioii is cor�ct anc��t}t�� he con ction on the above described nroperty an:�
the occupancy and the use 11-be in accord,u�c��wit,�;1�e-' ws, rules d!:;�ulr.i:�,,;o�tne State of Washington and
the City of Federal W . ,:•';�,':,,�'`��
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Owner Date:/ =��C% C
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. , � . . ` �. ' "�'�IIS CAF{�: I� 'i't7 ` I'�I�;i[�1 �Pd-S�T� . � .
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�;rY o� .�����x� �o�n��Y���� �i����lo ��,nt ���; �ctlon Re�o��
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����r�� ��� IVR �ZT�P�CTIOI�t �2EQU�;ST PI-��N� # (253) 835-3050
PER]vIIT #: 04-102272-00-SF -
Owner: LEONARD A OLS�C:+;V
Address: 2910C ��f�ONDb �'11�►Y S
FED�RAL V1IAY, WA 98A03
'I'his card is part or your required inspection documents. >cheduled inspeciions may be failed if this card is not on-site UU NOT LOSE THIS CARD.
lnspections are listed as cl��se to sequential order as possibie(read left to ri�;'i±,top to bottom). Please schedule inspections as appro�;riate. Work must not
be covered until it is appruved. Check�vith your inspccto�if you are unsure about any of the inspections or the inspecdon sec�uence. On-gaing inspections
are logged on the back of this curd.
/Q Temp. Erosion Control (4365) c� Footings/Setback(4110) ❑ Founclation Wall (41 l5)
"I o be done�>rior fo breaking ground Approved to place concrete Approved to place concrete
By _�...I7atc I3y ' - Date ,� �i��;�� By �''�� D�te � 3 G -
� `
❑ Drai►�anP/17ownspout(40�t0)� ❑ Plumbing Groundwork(4190) ❑ �lab/Concrete Floor (4255)
f.pproved to backt�ll Approved to cover Appreved to place concre[e
�
By G.�� Date � �' Q; By Date ' B}� Date
��� 'J.iderflool•f�'rarning(�18�) ❑ Floor Sheathing (4105) ❑ 5hear 4'Valls (•1245)
� Approved to sheath lloor Approved to install flooring App�oeed to install siding
Bv � Date By Date By ����-�,� Date/� ;� C';�
[] 1to�f Srieathiug (�122Q) [� Rough Plumbing(4230) ❑ Niechanical Rougl►�nn (4165)�
r\pprov�d to install rooling Approved Approved
By �� �1 Date �� � �,� BY � � Date 0 ♦ •p By � Cr� Date �• � (o- O
,��.,r..-�.---�-�
['�j �as Fiping (4125) ❑ Fire/Draft Stops (4095) NOTE: Prior to scheduli�g a rra���n�;�atzo>
Approved to release test Approved inspecciei�;Flectrical,Plmnbing dr M�chanical
Rough-in and l�ire/Dr�ft Stop insp�clions must Ee
i Ii)' L,�,� _ L�ate � �_� �..L+ � B�—�V y Date� " �� signed-off and approved. IBC t09 3 d/UBC 103.5�s�
� Framing (4120) ❑ �nsulation (4150) (]Gypsum Wallboar�l Nailing (413l1 j
Approved to insulate Approved ro install wallUoard Approved to install mud&c tape
E,y� Date •3 •� BY G � Date 3-�0'!J BY �i (N lla4e 3 -29" Q�
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Final-5V4'M (437_5) � Final-Mechanical(4t�65) Final-Plumbin; (4075)
Anproved Approved Approved
�y�� Date 3 •(_, - n By Date By llate 3,G ,� �y
,F.�_.
� Final-Building (4050) ❑Temp. Erosion Maintenance(�1370)
App�oved Approved
By �� Date 3 �/2. p7 By Date
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'��a� PE RM IT SF MF CO ME EL PL DE EN FP
COMMUM7Y DEVELOPMENT SERVlCES
33530FIRSTWAYSOUlN.����.,��� AppLI CATI O N °
k FEDERAL WAY,W ?'�� 7 � �
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The olIowin is re uired in ormation-an inco lete a lication wili not be acce ted. lease rint ibl (in inkJ or
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` SITE ADDRESS �C��'� �+.'. �S��-�� '' . SUITE/UNIT#
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ASSESSOR'S TAX/PARCEL # � � �- � _ � �:�`� LOT SIZE(s� � �������
LEGAL DESCRIPTION (e.g.Acme Estates,Lof 1 J
I (Anach separate page%r iengthy Iegd desoipoonJ
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'I'I'PE OF PERMIT �BUII,DING �LUMBING V�IECHANICAL
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❑ DEMOLITION�ELECTRICAL ❑ F.NGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(f'rovide detai1ed description of work included on this pernut onlul
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PROJECT NAME(Name of Business or Owner Lasf Nam� Cg J��
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� PROPERTY NAME PRIMARY PHONE
OWNER (��Li s �'�! �C,S.S��l�� -C�/?�
MAIW G ADDRESS � CITY,STAT�E, IP
� �� ���E ��.Ci+i�.�� �',�Y � ��/1.�".�" �: l,�' �
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I CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
`{ � - r �T' " �i��l.��/'��iCJ�C� �G�1�, � ��7 S��,S'
MAILING ADDRESS � CITY,STATE,ZIP CELL PHONE
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C[TY OF FEDERAL WAY BUSINESS UCENSE NUM6ER EXPIRATION DATE FAX NUMBER
� — — — — — — — — B L / � � �
` CONTRACTOR'S REGISTRATION NUMBER(copy o[card reqnued with each application� �EXPIRATION DATE
i � f' � G. � � � L �/�� � � .� � � � �
APPLICANT COMPANY NAME APPUCANT NAME OFFICE PHONE �
I -r.�C�.r' c. � `J�S' � ( )
�
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
� f�4 <� �•%�,� � � "f' ,�� ��,,K'� (����)��� - � !��
RELATIONSHIP TO PROJECT Y FAX NUMRFR . ��
i ❑ Architect ❑ Tenant ❑Agent ❑ Other (Describe)��C.�/�,rb'��� ( �
------ ---.A_ __ �
CONTACT NAME PRIMARY PHONE � E-MAILADDRES
---�- � �
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LENDER Per RCW 19.27.095: Lender in orma att'is--. NAME
required if profect vaiue exceeds$5,000 �, _ �- ,�
MAILING ADDRESS CITY,STAT�Ey,ZIP , •/ • �v
��/� .�i�`'//�'�`� �r x 3 �t,.�'.�l�Z? �-t.-.�' ��/=-/ �
J
� • 1 � : 1 1 � 1 C 1 • ' 11 ' •
EXISTING USE (.c� �, /��` �_ PROPOSED USE � /E�"`-'���� �-'j�,/'�-�1� ����
EXISTING ASSESSED/APPRAISED VALUE $ �1 /
��jZ•�J�� VALUE OF PROPOSED WORK $����-��
SPRINKLERED BUII.DING? O YES ❑ NO FIRE SUPPFtE.SSION SYSTEM PROPOSED/RF,QUIRED? p YES O NO
WATER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(R/ELL)
SEWER SERVICE PROVIDER �LAKEHAVEN ❑ HIGHI.INE ❑ PRIVATE(SEPTIC) I
—�
- . . . -
AF2EA D CRIPTIO EXISTING S . FT. PROPOSED S . FT. TOTAL
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FOURT}�
ADDITIONAL FLOORS(DESCRI�3E)
C�/�',,�'� C���
DEC ' COVERED? � �-- �' ��
_ � , c��l" � �� p�.
i,ARAGE/CARPORT�
r`1 -
HOW MANY F'�IAORS? roTnczxisrmc ALPROPOSED TOTALEXISTpPGMpPROPOSED '
�'"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $_� �� �
---- /._-�_- � -��'-- �
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Indicate number of each type of fixture to be instaUed or relocated as part of th�,s pro�ect. Do not i�tclude ez�isting fi.rh�res to remain. !
MECIIAMC,AL � !►`, �
Value oJMec/ianica(Work $���V
__�AIR HANDUNG UNITS �' EVAYOI�.A'I'NF.COOLERS _� GAS I.OGS � REFRIG. SYSTEMS �
'�' E3E3QS ___� FANS __�_ FIOODS�comme�dy� WOODS'I'OVES �
-R- BOILERS I FIREPLACE INSERTS _� RANGES MISC(Descnbe�
'�J'" COMPRESSORS � FURNACES ? GAS WATER HEATERS ;
��� DUCTS � GAS PIPE OUTLETS �� �
�PL ING �
BATHTUBS�„�T���sno�r�cart,no� �� SHOWERS � WATER CLOSE;CS R,,,ie�� MISC(Describe)
DISHWASHERS �� SINKS DRINKING FOUNTAINS �
GAS PIPE OUTLETS SUb1PS RAINWATER SYST
� WASH[NG b7ACHINES � URINAI.S '� HOSE BIE38S �
� _ LAVS�[sae,�000s„�s) VACW11 IIREAIiLRS _ ELECTRIC WATER HEATERS_ �
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I certify under penaity oj perjury that..tke�info - ��afion Jurnished 6y me is true and correct to the best of my knowledge, and further, tha[I �
am authorized by the owner oJ the �ove pre ' es fo perJorm the �pr which the permit appiication is made. I further agree to hoid �i
harmless the City oj Federai�as to any aim(irtcluding costs expense�and atto eys'fees incurred in the inves[igation and dejense of ; i
such c(aimf, which may 6e e by any pe ort, including tF�junde.signed, ancJ file ainst the City ojFederal Way,but only where such claim '
arises out oJ the relia 9f'the city, i udtng its o�ficeYs�a d emp yees e accuracy oj the injormation supplied[o the city as a part oj j j
this applicatiort. I
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NA11� � � DATE�����rj�
....._ (.."�, .._�... ' (Titic� I
RELATIONSHIP TO PROJECT �O�vner ❑ Agent ❑ Contractor ❑ Architect ❑ Othcr _ �,
� �
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FOR UFFICE USE ONLY
❑ NEW ❑ADDITION � AT'T'ERATION ❑ REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑Y�'..S ❑NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CFiANGE OF USE? ❑YES ❑ NO
NEW ADDFZESS REQUIRED? ❑YES ❑ NO UP/SEPA/SU? ❑YES u NO
PLATTED LOT? ❑YES ❑ HO DEMO PERMIT REQUIRED? n YES �_� NO
I3ullctin#100—March 30,2004 Pagc 2 of 4 k\I Iandouts—Reviscd\Pcrmit A�plication
• •
.
RESIDENTIAL COMMERCIAL
NEW RFSIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Fect Seruice or Heeder F,ach Add'n
(P�rst 1300 ft2-$87.00; Each add'n S00 ftz-$2b 00) ❑ 0 to 100 amp $ 94.50 S 58.00
❑ I_)c[ached outbuilding or g<irage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201 -400 amp 220.50 87.00
❑ Detachcd outbuilding or garagc ❑ 401 -600 amp 256.50 103.00
(Inspected separately) S 58.00 ❑ 601 -800 amp 332.00 140.50
NEW MULTI-FAMILY(thrcc units or more) ❑ 801 - 1000 amp 405.50 169.50
Seruice Feeder ❑ Oecr 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
�201 -400 amp 117.50 58.00 ❑ Over 600 volts surchargc S 74.00
❑ 401 - 600 amp 161.00 80.00 ❑ Mast or meter rcpvr S 80.00
❑ 601 - 800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTFtIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MLTLTI FAMILY ❑ 0 to 200 �unp S 94.50
❑ 201 - 600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 �np $ 72.50 ❑ over 1000 amp 369.50
❑ 201 - 600 amp 1 17.50
❑ over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,�6.00/ea)
❑ # of circuits to be added/altered
(1-4 circuits-$58.00;Add'n c3rcuits$6.00/ca) COMMERCIAL/INDUSTRIAL PLAN REVIEW
$74.00 plus 35%of Permit Fee
❑ Mast or meter repair S 43.50 ❑ Service over 200 amps
❑ Medical�Educational�lnstitu�onal Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 lus 35%of Ycnnit I�ec
MOBILE HOMES
❑ Service or fceder only �w 58.00 TEMPOR.ARY SERVICE
❑ Secvice and feeder $94.50
Conunercial Residential
MOBILE HOME/RV PARK ❑ 0- 100 �w 58.00 S 51.00
❑ ___ #� of service or fceders ❑ 101 - 200 74.00 51.00
(First service/feeder-$58.00;c.�ch add'n-w37.50� ❑ 201 -400 87.00 n/a
❑ 401 -600 117.50 n/.�
❑ o�•cr 600 127.00 �,�,,
MISCELLANEOUS SERVICE/EQUIPMENT
� ---- -- -- - - --
❑ � k of Thermostats ❑ _# of Signs
(First-543.50; add'n-S13.50/ea) (First sign $43.50; add'n sign �w20.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub..._........... $87.00
Syuaie Feet to bC SCrvCd l�)' Sy'StCRl(S�_______ _ (Includes additional circuit, if required)
❑ Fire Alann Svstem ❑ Y3rd Pole metci loops....... ............. 558.00
❑ Security nlarm System ❑ Additional Plan Review $87.00/hour
❑ voice Cabting (for rnodiCicd submittals)
❑ Da[a Cabling
❑
(Per System(s� I��2500 C['--�5]_00;
Each add'n 2500 ft�-13.50) 'Pcr wnc 296-�G-9lo/5)(b//1 a,���
I3ullctin#100-March 30,2004 f'age 3 of 4 k\I landouts-Revised\Pennit Application
, ` }�'••� • • � � �� � � � . , , ..
urror'� ' � _
Federa�v��ay � P E R M I T - - -
COMMUM7YDEVEfAPMENfSERVlCES -� , SF MF CO ME EL PL DE EN FP
33530 FIRST WAY SOUTH•PO BOX 9718��;p. A p p L I C A'I'I O N
FEDERAL WAY,WA 98063-9718 � D / /
253-6674/1S�fAX 2536614129
www.dhrol(edcrdwa¢mm
Tice foZlowing is required informatiort-an incomplete application wiIl rtot be accepted. Please print Ze_q(bTy(in inkJ or type.
' • • �` • -��S/ �
SITE ADDI2ESS SUITE/UNIT#
I ASSESSOR'S TAX/PARCEL # _ _ _ - _ _ _ LOT SIZE(sJJ
�
LEGAL DESCRIPTION(e.g.Acme Estates, Lot 1 J
I (Attach separv(e page%r lerigtliy Ieyd desrnt�oonf
�� - • 5 I • - u � �
i TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION O ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Prouide detailed description of work include on this permit onlu)
/� ✓
{ �^' "� `�-� � �'-� C� � �i�
� � , �' Q .e�
� �`�" � ` l�!�� � �
� PROJECT NAME(Name of Business or Owner Last Nam�
I
• • 1 • - u � �
'�� PROPERTY NAME PRIMARY VIiONE
� OWNER
I MAILING ADDRBSS CITY,STATE,7.IP � �
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
� � -
. MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
i � -
C[TY OF FEDERAL WAY 6USINESS LICENSE NUME3ER EXPIRATION DATE FAX NUMBER
- - - - - - - - - - B L � � � � -
CONTRACTORS RFGISTRATION NUME3ER�copy of card required with each applicatiou� EXPIRATION DATF.
� �
' APPLICANT COMPAM'NAME APPLICANT NAME OFFfCE PHONE
i � ) _
�, MAILING ADDRESS CITY,STATE,"I.IP CELL PHONE
I � `
I I2ELATIONSHIPTO PROJECT FA.�i NUM6ER
� ❑ Architect ❑ Tenant O Agent ❑ Other(DescribeJ � � _
� CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
I � �
LENDER Per RCW 19.27.095: Lender informaction ts NAME
required if profect value exceeds$5,000
�'� MAILING ADDRESS CITY,STATE,ZIP
I
r
� � 1 � : 1 � 1 I • ' �� • •
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUII,DING? ❑ yES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/RF.QUIRED? o YF.S ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PFZIVATE(SEPTIC)
Feder Wa+���-��������€�� � i Q � - � � o{ � 7 �
E �' PERMIT -
COMMUNIlYDEVFIAPMENTSERVI �{ (� �� -.�-. ; SF MF CO ME EL PL DE EN FP
1 33530 FIRST WAY SOUTff•Po FiOX�d�! V '' t=i'��.��t
` FEDERAL WAY,WA 980G?-97I8 �
f 259-6G7-0I/S•FAX 25366/4729 P L I C A I O N i �
nru�w_d[i edcrali�ra . .. ' ��j")���;!��L �� `
The ollowin is re`'uired iri ormation-an incom lete a licatiore urili not be acce ted_ P ase rint le ibl (in inlc�or
� - • • � • - ii • �
SITE ADDF2ESS _ � , .� �� � ��
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL � � � � � � � - �C✓ s� � LOT SIZE(s� � /����C
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1 J
�Attach separmle page for lerv�thy lega!desmpoonf
- � > i • - �i � • `
TYPE OF PERMIT �BUILDING �LUMBING .�IECFIANICAL
i
❑ DEMOLITION�ELECTRICAL ❑ ENGINEERING❑ FIRE PF2EVENTION SYSTEri
r PROJECT DESCRIPTION(Prouide detai(ed description of work included on this pennit onlu)
� ,�U�"�/7 i.t d C� .ri�f3 F",� > ����F �.r:lr- ,�1����� f'��if�i'i'
� , .
/'-,-�/�/
PROJECT NAME(Name of Business or Owner Last Nam� ° C.�.���
• • � � - �i •
PROPERT'Y NA�E PRIMARY PI{ONE
O WNER � �'>
c`'-,t3�� . ` �!"� (�_SS)�?S' -�%?�
MNLI G ADDRESS / GTY,STATE�, IP
�� �/�� .�'��.C<3�;�;� �',�.�- '� -;.�._/�:�' /�; l�' ;� 5
� CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
i
_ � .�- c�,�w.�i����;'�� � clr�` 1 g�� - s'���
MAILING ADDRESS � CITY,STATE,ZIP CELL PHONEF
`r �� ,��S�"c�J J< �� �'��/�.'O %l,.f � ' �G���h�� -?�j��
` CITY OF FEDF,RAL WAY 6USINESS LICENSE NUM6ER EXPIRATION DATE FAX NUM6ER
f — — — — — — — — — — B L / / � �
CONTRACTORS REGISTRATION NUMQER�copy of cazd requued with each application� EXPIRATION DATE
� f � �; � !.' .� L �� ;� � � � :� � � � �
APPLICANT COMPANY NAME APPLICANT NAME
� OFFICE PHONE
� /�,
i ��� <'. � � ��J'.J�,.� � � -
� MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
f `� �G- `�� ��' f3 l/.�'� . .�C) � C-� ���.�,�r���/� I`,
� RELATIONSHIPTO PROJECT � � ��� � � J . � ��
FAJi NUM6ER
, � ❑ Architcct O Tenant ❑Agent ❑ Otlier (DescribeJ��C..�/1.,6',��� � � _
CONTACT NAME PF2IMARY PHONF, E-MAIL ADDRESS
( ) -
LENDER Per RCW 19.27.095: Lertder information ts N^AME
required{J profect value exceeds$5,000 (��_ ��/ ��,�l
lJ
MAILING ADDRFSS CITY,STAT.�E,.�Z�IF' ,
���� .F'�'//l.`� ,�r � ) �ti�'i%_/�� �-t—r}��_— !—���� r
J
. � I . : � � � I c �` • - �i : . ,
� EXISTING USE Cy✓ /�:y^ �. PROPOSED USE j//�.���� �j�'�������,
-�
EXISTING ASSESSED/APPRAISED VALUE $ /'��,cJ�.�f.� VALUE OF PROPOSED WORK $_��_�iCJ��, _
/
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRFSSION SYSTE:K PROPOSED/RF.QUIRED? ❑ YFS ❑ NO
WATER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWEF2 SERVICE PROVID�R �I,AKEHAVEN ❑ HIGHI,INE ❑ PF2IVATE(SEPTIC)
- . . . - -
{
AREA DESCRIPTI N EXISTING S . FT. PROPOSED S�FT. TOTAL ,
B E N� ,. .+�
:, � � � � -_ r�E�/F�'r. --- G S j�� �
y//�1/�/yY�^`� �;
•�J _�: V V/ r� �� �/ ��
E�DND � - ' � / — _
�1� _ �.z�2c:.?''�''' � iG' ' � C; ���� t
- ��1�s�/�f,,�'/�'�:�1
- -- - J t�—__
F�OUKTIi - - - - ---- --- -
ADDITIONAL FI,OORS(DLSCRI}3E) �,��/ �i,� � ��
— _ ���r�dyYi �3��?.�
DFC ' COVERI?D? � , ,, �- -
<- - ��l l G�`L
GARAGE/CARPORT �
��,c��''/��A_ �__
HOW MANY f�I,00RS� r \jJ/ T�T"��5T14G
�{-� AL PROPOSCD TOTAL EXIST[TG MD PROPOSE�
_--"-'. /- -_ -_-___ _ . -.--__- ._
"NEW HOMES ONL}"" NUMI3I=�IZ OF E3L•'DROOMS _ _ I:STIMATEll SELL[NG PIZICE $--����/�=� �
` �
►: t - �
/ndicate ru�m6er ojench type of fixture to be iris[nlled or relocated as parf of titis project. Do riot i�idude exisling futt�res to remain.
— --- ------
MECHAIVI('.AL •� !�• — - ---- ---
Vafue of bfecliariica( Work .�_���U
_�AiR HANDI.ING UM'I�S '��' E�;VAYORATIVF,COOLERS _� GAS I,OGS � RE�RIG. SYSTEMS
-�' t3[3QS �_ FANS � }{OODS�com�,�as:,;i 1�'OODSTOVES
-R- E30[LERS I {�IREPLACE INSERTS _� RANGES MISC(Descnbe)
"'J' COh1PRESSORS � FURNACES '? GAS WATER HEATERS
'`_� DUCT'S _�_ GAS PIPE OUTLETS
PLIII�ING ,� - �
��r� E3ATHTUE3S �„�r„��snow«c�,:,,ebi �� S110\VGRS WATE:R CLOSF.I'S
Ro;i„q ._ _ _ A11SC (Dcscribe)
DISIiWASHGRS ___�_ SINKS DKINKING FOUNTAINS
GAS PIPF,OUTLGTS SUDiPS E2AINWATER SYS"I' �
WA>HING MACHINES `�_ URINAIS '�_ HOSP.C31E3F3S
LAVS i3a«,rooms�.,�s VACUUht E3REAF;F_RS ELECTRIC WATER HEATEf2S
� � lui t ` 1 - •
I certify under penalty oj perjury that She�injo�, afion Jurnished 6y me is tn�e and correct fo the best oJ rr�y knowledge, and further, Lhat I �� �
am authorized 6y the owner oj the.ahove prer�i�es.fo perJorm the r wliich the permif application is made. I ftirther agree to iiold
harntless the City of Federal W�as to any aim�(including costs ezpense��artd atto eys'Jees incurred in the in�es[igation and dejense of
such claim), which may 6e nqele by any pe on, including Fh�unde signed, and f le ainst the City oj Federal Way, but only where such c/aim ��.
arises out oj the relia /�f[he ci[y, in uding its officefs�a d emp yees, ie accuracy oj the injonnation supplied to the city as a yart oj j
tiiis applica[ion. �
NA11�E _ . _' '_'�,_�—' — /` v — -- DATE��� �_�i �
-`--�-�.l�L;u�;err� (Titic� � — �- �
RELATIONSHIP TO PROJECT �O�ti�T�cr ❑ Agcnt ❑ ContracLor ❑ Architcct ❑ 0t1�cr
I
FOR OFFICE USE ONLY
o NEW n ADDITION ��ALTEI2ATION ❑ REPAIR �;TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑yES ❑ NO BASIC PLAN? ❑YES ❑ NO
ZONING DESIGNATION CIIANGE OF USE? ❑YES ❑NO
NEW ADDFtESS REQUIRED? __i�y� ❑ NO UP/SEPA/SU? ❑yES ❑ NO
PLATTED LOT? ��YES ❑ NO DEh10 PERRSIT fZEQUIRED? r�yES c NO
l3ullctin N 100-March 30,2004 — - Pagc 2 of A k\I landouts-Rcviscd\Pcnnit l���licalion
i � , • �
C • •
�
RESIDENTIAL COMMERCIAL
NEW F2.FSIDENTIAL SERVICE NEW COMhiERCIAL/INDUSTRIAL SERVICE
❑ Single Fam11y Square Fcet___ Seruice or Feedr�r Eadt Add'ri
(I�irst 1300 f[=- �87.00; Each add'n 500 R=-S2S 00) U 0 to 100 an1]) $ <)4_50 S 58.00
� � I>ctachcd outbuildi��g or gar�igc U 101 -200 a�np 1]7.50 74.00
�� (lilspccted u-it}i servicc) S 36.50 ❑ 201 -400 amp 2?.0.50 g7 �� �
U Dctaclicd outbuilding or garagc ❑ 401 -600 amp 2�6.50 103.00 �
(Inspccted scparatcly) S 58.00 �
f ❑ 601 -800 anip 332.00 140.50
NEW bfULTI-FA141ILY(three units or morc) � 801 - 1000 amp 40j.50 169.50 �
Seruice Feeder ❑ O�-cr 1000.tm1� �i42.00 236.00
� ❑ Up to 200 anip S 94.50 S 28.00
�201 -400 amp 117.50 58.00 ❑ O��cr 600 volts surchargc S 74.00
❑ 401 -600 amp 161.00 80.00 � �Sasc or mcter rcpair S 80.00
❑ 601 - 800 ar�lp 206.00 I 10.00 ALTERED COb'IbiERCIAL INDUSTRIAL
❑ Ovcr 800 amp 294.50 220.50 -- -
Seruice or Feeders
ALTERED SINGLE�hiIJLTI FAMILY ❑ 0 to 200 amp S 99.50
- ----- -
' ❑ 201 - 600 amp 220.50
� Seruice or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 arnp S 72.50 ❑ o��cr 1000 amp 3G9.50
U 201 - 600 ainp I 17.50 i
❑ over 600 amp 177.00 ❑ _ # of circuits to be added/al[ered
(I-5 circui[s-�74 00;Add'n circuits,56.00/ca)
❑ b of circuits to be added/altered
(1-4 cfrcuits-$58 00;Add'o circuits S6-00/ca) COhSMERCI�INDUSTRIAL PLAN REVIEW
�74.00 plus 35%�of Yerinit Pcc
U 1�1ast or meter rep��ir S 43.50 ❑ Se�vice over 200 amp� �
❑ n4cdical�Educational/Insututional Facility
SINGLE/MULTI FAI�IILY PLAN REVIEW
❑ Scrvicc Over 400 amps
�74.00 plus 35%,of Per�nit Fee
MOBILE HOMES -
❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Scrvicc and fccdcr S 94.50
Conini��rcial R�°siciential
MOBILE HOME/RV PARK ❑ 0- 100 �SH.00 $51.00
�� ❑ _ _# oC seivicc or fccdcrs ❑ 101 - 200 74_00 51.00 �
� (f'irst sernce/Ceeder-S58 00;cach add'n -�37_S0) � ���� ��� �., ��
n/a �
� ❑ :}O1 -600 1 1 I.SO n/❑ �
❑ o�er 600 127.00 „�,,
� MISCELLANEOUS SERVICE/EQUIPMENT i
-- _ _-__
� - --- -- ___
- - -
---_ --
� �
❑ � Jl oC Thcrmostats ❑ _____� of Signs I
(I�irst-543.50; add'�i-S13.50/ca) ([�irst sigri-$43.50; add'n sign 520.50/ca)
❑ Low Voltagc ❑ Swimming pool/hot tub ... ...._..... 587.00
Scjuare Feet to be Sen'�'�I }��� SVStCnt(S)_ (Includes addiUonal circuit, if�equired)
❑ Fir��:�lann S}�s�cm U Yard Polc mc[cr luops__ .-------..__. 5�8.00
❑ Sccuricy Alarm Sysccn� ❑ Additional Plan Review S37.00�hour
❑ vo�ce CabGng (for modificd subinittals)
❑ Data Cablin�;
❑
(f'cr Systcm(s) l��2500(C'-SS1.00;
Each add'n 2500 ft�-13.50) •v«wnc 29�-��-�ro�s�p,�(w���
13ullctin fl 100-March 30,2001 1'a!�c 3 of 4 �,
k\I landouts-Rcviscd\I�rmit I�pplication