93-100913 I;ITY OF FEDERAL WAl' B U I L D I N P E g�j � �D b g�3
C� R M I T P E R M I T N O.: B L D 9 3 0 3 9 8
;?3530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 04/16/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 28220 28'd'H AVE S
PARCEL NO.: 111700-0190
PROJECT DESCRIPTION: REROOF — REPATR ONLSt FROM DAMAGE AS A RESUY,T OF STORMo
OWNER CONTRACTOR LENDER
DOROTHY LENIS EASTSIDE INSP CNSLTS HM IMPRMT
28220 - 20TH AVE S 2330 CHEROKEE BLVD
fEDERAL LJAY WA 98003 PUYALLUP WA 98374
848-8539
EASTSIC088L5
BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DUELLING UNiTS: 1 COMP PLAN.........:? FEES:
TYPE OF 410RK:REP USE:RES 1ST.: 0: O:sf STORIES........: 7 REQUIRED PARKING..: 0 SPRINKLERS?......:? PLAN CHECK DEPOSIT.* f 128.70
CENSUS CATEGORY.....:555 2ND.: 0: O:sf HEIGHT.....: 0.00 fit HAZARD CLASS...:? FINAL PLAN CHECK...* S 0.00
OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION---------- REOUIRED SETBACKS------- FIRE FL01,1....: 0 gpm BUILDING PERMIT....* S 189.00
:R3 :? :? :? : OTHR: 0: O:sf EXIST..E: 0 FRONT.........: 0.00 ft SBCC SURCHARGE..,..� S 4.50
TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP...S: 18000 SIDE..........: 0.00 ft NATER SERVICE..:?
:5N :? :? :? . DECK: 0: O:sf REAR........... O.00:ft SE41ER SERVICE..:?
OCCUPANT LOAD------------ GAR.: 0: O:sf RECEIVED.:04/13/93
. 0: 0: 0: 0: TOTL: 0: O:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.: FANS..........: 0 BOILERS/COMPRESSORS LJATER CLOSETS......: 0 URINALS........: 0 TOTAL FEES E 322.20
GAS PIPING.: 0 ft NOOD..........: 0 0-3 HP......: 0 BATH TUBS..........: 0 DR[NKING FOUNT.: 0
FURN<100K..: 0 DUCT 410RK.....: 0 3-15 HP.....: 0 SHOWERS............: 0 SUMPS..........: 0
GAS HWT....: 0 4100D STOVES...: 0 15-30 HP....: 0 LAVATORIES.........: 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K.....: 0 30-50 HP....: 0 SINKS..............: 0 DRAINS.........: 0
BB�........: 0 MISC..........: 0 5+ HP.......: 0 DISH LJASHERS.......: 0 LA41N SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNdTS FUEL TANKS--------- ELEC 41TR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
f OGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AWD GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT /�-� /,7 � DATE rL( ��� " ���
bld_prmt 10/23/92 �
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SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK
OATE . —....—BY DATE _—..—__BY DATE .. --__- ._BY __._ _ _
PLUMBING ROUGH IN WATER LINE O.K. _......— _ _—_ MEGHANICAL INSPECTION
DATE__ __ .—__BY GAS PIPING O.K. _ DATE ____ _-__ _BY _._ __ __
O.K. TO ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE 7_"�7' �3._ BY �� __—_ DATE _ BY --_.._ DATE _ BY _
FINAL O.K. TO OGCUPY
DCD PSD FD
DATE y`�7.�3--.BY 1i�� ___-
�9AhrQCc ��r=7L 2S an� c�i�F-/�� 5 rvc D �� 1/'✓1Z �9cso �0�2 2L-"c-- �u
p,,,� G City of Federal Way
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�� �' ���;���t���PPLICATION FOR BUILDING PERMIT ��`�"�'� -� a`�� �%;�7
AP� i 3 1993 �� - �' ��'�
PLEASE PRINT ;'`,�}`��?'"� ` •,.��.,' APPLICAT/ON#: i"7;� j`?:.:� �, .. :< ; �'
SITE LOCATION � < addrass ?�%` ; v . ? �, " � ��-�- �
Tenant (if known) Lot A' Assessor's Tax #
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Building Owner Name Address
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CitY L� State � ZP ��3 C 3 Phone ���� _ l/� �
Nature of Work ��\� � �� �iC17j� /L_G" /�'T/L-
APPLICANT '
Name (F,M,L)
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Address
✓L�.s '4 > l,� L � �..._:
City State Zip
Contact Person Day Phone Other Phone Fax
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BUII.DTNG CONTRACTOR: �
Company Name
� , 1 ,� , /�c�v�-� z_ I r1� ro L-`c�;..„ � S
Address •
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Contact Person Phone Fax
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Contractor's # (card must be presented) Expiration Data Verified ❑ Yes O No
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ARCHTTECT :;; �'�i"
Name
Address
�
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
; �� j1,
P/ease Comp/ete Reverse Side
� CD0492 IRev 4/931
Si UCTURE Ewsting Use �`', , �roposed Use �_"
Permit includes: �Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential O New ❑ Remodel ❑ Number of Units ❑ Deck
� Commercial ❑ Addition ❑ Garage ❑ Shed '� Other
Enter 1 st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existinp Floor Area sq ft
Area 8asement sq ft Decks sq ft Garaga sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability � On-Site Septic System Availability O <: Projact Valuation S '�' G��'��
Zoning _ Lot Size — Exisling Bldg Valuation $ ' .�'�"""""""`"
LENDER� /\,% � �
Name Address
City State Zip
T7ECHANICAI;'CONTRACTOR J� ��
Contractor Name Address
City State Zip
Contact Phone Fax �
!
License �f Expiration Date Verified O Yes ❑ No
PLiTA'�ING CONTRACTORi: /v /a
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified � Yes ❑ No
PLU1��I1VG.FIXTURE COUNI` ,�/ /�
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other !
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total',':Fixiura Count :'
r�CHAN�CAI: U�VIT C�UNT �� +
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handiing > = 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 3-15 Tons Total Unit Count
DISCLAIMER: I certify under penalty of perjury that the intormation furnished by me is true end correct to the beet of my knowledpe and further that I em euthorized by the owner
of the ebove premises to periorm the work for which permit applicetion is made.I further apree to seve harmless the C'rty of Federel Way as to any claim�including costs,expenses,
and ettorneya'tees incurred in investigation and defenae ot such claim�,which may be made by any percon,including the undersigned,and filad egainst the City of Federel Way.
but only where cuch claim arices out of the reliance o(the City, includinp itc officers and employees,upon the accuracy of the information cupplied to the City as e pert of th�
application. �
" OwnerlAgent: Date: