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91-101805 CITY OF FEDERAL WAY �J ( ' �� $�� Fede aFlWay`,NW 98003 B U I L D I N G P E R M I T BUILDING INS 661 4140 PERMIT NO. 91-17H4 RA OWNER'S NAME MIKE CARLISLE SITEADDRESS 3111 SW 3O2 PL CONTRACTOR OWNER ADDRESS S� CONT.PHONE 83H-941.2 CONT.REG.NO. NA EXP. OWNER'S PHONE SAML' OWNER'S ADDRESS SAMF TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBLIC PUBLICADD. NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER CONSTRUCT DETACHED GARAGE TAX ACCOUNT NO. 416710-OOBS LEGAL DESCRIPTION LOTS 3 4 BLK 9 LAROTA DI 2 ISSUED BY ELI ZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 12/30/91 BUILDING�NFORMATION ZONE RS 7.2 SET BACKS:FRONT ZO� SIDE S� �S� REAR S� HEIGHT LIMIT 3O� MAX OCCUPANCY M-1 TYPE OF CONSTRUCTION S-N CENSUS NO. 43H TYPE OF HEAT NA BLDG.SQ.FT. 72O STORIES�QA PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC.HOT WATER HEATER GAS PIPING FT. GAS LOGS RECEIVED BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. RETURNED SINKS MISC. BBQ BASIC FEE DISHWASHERS TOTAL FIXTURES NONE DRYER TOTAL MECHANICAL ]�QI�E- AMOUNT NONE VALUATION �12,367 PLANNING DEP APPROVAL = DEB BARRER PERMIT FEE �135.OO PLAN CHECK FEE ' "ROOF OVERHANG SHALL NOT EXTEND MORE THAN 18" INTO 5� SIDEYARD -�unnBiNG Fee SETBACR. DRIVEWAY SHALL BE PAVED PER FWZC 105" _CHANICAL FEE PART P/C FEE PUBLIC WRS DEPT APPROVAL = RON GARROW SEPA REVIEW 35.�� PUBLICWORKS "INSTALL 4X4'X6' DEEP DRYWELL IN FRONT YARD. TIE GARAGE DOWNSPOUTS S.B.C.C.FEE 4.50 FIRE FEE DATE: OTHER FEES AMOUNT: �262.5O AMOUNT DUE �262.5O RECEIPT: ALl 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 FURNIS ED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET. I , / � OWNER OR AGENT DATE ✓ � f ` � , CITY OF FEDERAL WAY Fede al IWay\,NWA 98003 B U I L D I N G P E R M I T BUILDING INS 661 4'140 PERMIT NO. OWNER'S NAME SITE ADDRESS CONTRACTOR ADDRESS CONT.PHONE CONT.REG.NO. EXP. OWNER'S PHONE OWNER'S ADDRESS TYPEJOB: NEWRESIDENCE ADDITION NEWINDUSTRIAL NEWCOMMERCIAL COMMERCIALADD. INDUSTRIALADD. NEWPUBLIC PUBLICADD. NEW MULTI-FAMILY (UNITS )MULTI.ADD. SIGN GRADING OTHER TAX ACCOUNT NO. LEGAL DESCRIPTION ISSUED BY DATE OF ISSUE DATE OF APPLICATION BUILDING INFORMATION ZONE SET BACKS:FRONT SIDE REAR HEIGHT LiMIT OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG.SQ.FT. STORIES PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC.HOT WATER HEATER GAS PIPING FT. GAS LOGS RECEIVED BATHTUBS LAUNDRY DRAINS FORCED AIR FURNACE DUCT WORK SHOWERS URINALS GAS HOT WATER HTR. AIR HANDLING UNIT NUMBER LAVATORIES DRINKING FOUNTAINS CONVERSION BURNER MISC. RETURNED SINKS MISC. BBQ BASIC FEE DISHWASHERS TOTAL FIXTURES DRYER TOTAL MECHANICAL AMOUNT VALUATION > ,> , ., _ .., PERMIT FEE PLAN CHECK FEE f�$ �� S�ALIs i1� �''� PLUMBING FEE �.�.�CR. C��X .��`�'4�`3,j MECHANICAL FEE PART P/C FEE SEPA REVIEW PUBLIC WORKS S.B.GC.FEE FIRE FEE DATE: OTHER FEES AMOUNT: AMOUNT DUE RECEIPT: ALL 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 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 DATE SET BACKS AND FOOTINGS O.K TO POUR FOUNDATION WALLS PLUMBING GROUNDWORK , DATE ��lt�BY�,�__.__ DATE .i?��Y�1.—_..BY a�<.m._— DATE --__BY __ __ _ � PLUMBING ROUGH IN WATER LINE O.K. __.— _ . ____ MECNANICAL INSPECTION DATE__ __. .—___BY GAS PIPING O.K. DATE ___BY __ ._ O.K. TO ENC�OSE FRAMING INSULATION WALL BOARD AND FIRE WALL DATE ��^ � �2 BY �� __—._ DATE _......BY _ DATE _____ ___ BY __ FINAL O.K. TO OCCUPY DCD PSD FD DATE `�"' _3—Y2 BY � _ �/'�"/�%'�/�-G %1�� c1�1_ �_Z 7•->'Z � �- �,-� - , , � � �,�� _�� ;,� � � �' /h'�`, - \ ��'�� '� � l � - � Per # 1 . . �� 3 a �991 8(/j��Hq� CITY OF FEDERAL WAY �� °°'E�wA� BUILDING PERMIT AP LI ATION —Please Print— � BOX 1 TENANT NAME: ' OWNER �" - SITE LOCATION C� � OWNER'S ADDRESS. ' � ' CITY '� PHONE ��"�'1�1JZ� DESCRIBE JOB �L!/L!'7 G��P/�G(�= � � THE PROPERTY IS OWNED BY: SINGLE/MARRIED �/ PARTNERSHIP CORPORATION BOX 2 CONTRACTOR'S NAME Q�Cs'hff� CONTRACTOR'S REG. # Card MUST be presented CONTRACTOR'S ADDRESS CITY PHONE EXPIRATION DATE — OR— I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. 'i j� `7'''-�� BOX 3 CONTACT PERSON 0�1,�/'tJ��Z PHONE 838 -9�//Z / BOX 4 SEWER DISTRICT ��'� � WATER DISTRICT TA�omA j�80X 5 ESTIMATED PROJECT COST y.�GU �� EXISTING BUILDING VALUATION BOX 6 PROPERTY TAX ACCOUNT NUMBER 'S�/�'7/Q —UC��3��7'] LEGAL DESCRI PTION �o T5 .3�y� �3l�c,� 9. L�KoTi9 JJ/!J/SiDN �'2, A�c ��v� 'Tv 7'lir PLAT 7`t�E�FaF (le�L ZZ vF p[,�ts , ��GG=iL, i;��G ��. ,�JAsG (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording # BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) iST FLOOR 11 2ND FLOOR �/:50 / j 3RD FLOOR / BASEMENT / DECK / GARAGE a- BOX 8 (�SINGLE FAMILY NEW CONSTRUCTION ( ) MULTIFAMILY (N0. OF UNITS = ) EXISTING STRUCTURE O COMMERCIAL/INDUSTRIAL OTAL AREA OF PROPERTY �y� SQ FT BOX 9 PLUMBING FIXTURES(including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$ N0. WATERCLOSETS GAS PIPING, FEET $ BATHTUBS N0. FURNACE, ELEC. GAS $ SHOWERS GAS HOT WATER HEATER $ LAVATORIES CONVERSION BURNER $ SINKS BOILER, SIZE BTU $ DISHWASHERS AIR HANDLING UNITS $ ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $ LAUNDRY WASHER OUTLET UNIT HEATERS $ URINALS AIR COOLING UNITS, SIZE $ DRINKING FOUNTAINS COMMERCIAL HOOD $ SUMPS, SPRINKLER VACUUM BREAKERS OTHER $ RAINS $ OTHER $ TOTAL FIXTURES $ -5�� TOTAL MECHANICAL FEE $ 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 FI LED AGRINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: �' DATE: ANP-008 3/90 . .a=-m..�-...._._.-;� ..,, ,....>*.'.._� ..:....r. . ............:_._...."_ _,�,..-e� -.. ___..__.�., , �-<:.,... .y�.y.. , . ... . ...�..- , . .. . ' " ... .' _ .n-.- . R. � OFFICE USE ONLY (PLEASE DO NOT WRITE BELOInr THIS LINE) � ZONE��L SETBACKS: FRONT �� SIDE 5� REAR ��HEIGHT LIMIT �� PLANNING DEPARTMENT APPROVAL ��.�.�'� ��,� _ REMARKS:. v��E��hQ �. � � ,� • �t_ /�'�� L, �' S�CLi-r A c v/ .�fL' l � t�t ' ` CG� �D.S. � SEPA: EXEMPT 1� NOT EXEMPT FIRE DEPARTMENT APPROVAL ` DATE REMARKS: ' PUBLIC WORKS DEPARTMENT APPROVAL � � DATE z�a�9 2. REMARKS: 1�,-�� y T`r � �-� �� 02�arC-c� .,., .��,�� yn,�c-� i�c c.�c��c� �e�,.,.�„�.s-rr�3a 7i� 7 2 i'wEu _ TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT�NEW INDUSTRIAL IND. ADD/ALT NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS ) MULTIFAMILY ADD/ALT TENANT IMP. OTHER OCCUPANCY M � TYPE OF CONSTRUCTION !V STORES �C�tC��<- �- BUILDING SQ. FT. � @ (� ' 3 f, _ � `'r�S �` I BUILDING SQ. FT. � ' @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ � d � �(�-L� "= U " � TOTAL SQ. FT. TOTAL VALUATION r ��6 7� e l BUILDING DEPARTMENT REMARKS: PERMIT FEE � � PLAN CHECK FEE PLUMBING FEE MECHANICAL FEE TOTAL BLDG. FEES PART P/C FEE SEPA REVIEW �� 3 S�.c c S.B.C.C. FEE �� S� OTHER FEES AMOUNT DUE ASSIGNED ADDRESS: S��— e--�C ( S ( V��1 PARTIAL PLAN CHECK FEE RECEIVED Amount Date Receipt# BUILDING DEPARTMENT APPROVAL RECEIVED BY � DATE � � Z � `� (� Z ACCEPTED FOR FILING M . � SF11T IHO COl1tITY DEPIIR7�ETIT Of PISLIC FEl1l ' , ENV I RONC1iTAL NEAi.1}i SERY ICES Total FN: =75.00 IIPPLICATION FOR FEALTH OEPARTI/ENT MPROVAL OF BUIl0IN0 PERI/IT �� Submlt applicatlon, route map, bu11d1ng permlt plot plans, and other raquirad documents 1n trtpllcate. The following roust be completed and the fee must accompany this appllcation: Note: Yf the property is located 1n unlncorpo�ated K1ng Cou�t � make direct appllcatlon to the King County euildlng and Land Development 01v1s1on (B.A.�.D.�. Propertles 1n lncorporated clties apply to local butlding departments. PROPERT1f INFOMUITION House/structure 1s se�ved by an on-51te sewage (septic) systetu • Dt stnnce to the nearest pub 11 c sew�r �� /Y//�� Ad�ress of pro�rty_ �3/l/ �SI.J �O�^!� G� F� �,�,�L �y� �.cl.� �'1�02 3 ParcQt Number (Tax Lot Account #) yJ(p ~Jl —Q��y -Q%' Appllcant's name_ ///jC�iq�L, L. �i9,�'�%,s'L ' Day Phone �3f�'9�//,2 Appt tcant's mai 1 tng address �L/l S!� 30�"��,�L. ��/��-L L��; !�!¢ �'j�'p�� Owner's name__ �j�� Oay Phone__ Age ot house/��?SNumber of e�cisttng bedrooms_,`Exlstln� square tootage of house ,,,/�o O� Are additlonal bedrooms being constructed or created? �O Description of proposed changes/rearodelinfl (attach plot ptans, ahowir� extsting structurs, romodelin� and septic system):�dc� �-A/i Ag£ New square foota�s after construction_,�o20 �iuus£ �7�70 �s9�2.q�� SEllAG£ SYSTEN INFOW{ATION � Approxlaaate dates septic tank was pua�ped (attached receipts) ��D1� /-�j�'1/ � Addltlons or �or landscape changes slnce house Nas constructed (examples: add fam11 room, bed- rooms, 9aroge, patio, dack, pool, etc.; ma,jor fills or excavattons done 1n landscapiny�: /�/On(G- --. �_� _. Additlons_orO rep��rs to sewa�e system (glve date and descrlbe brlefly) _ N /Y Other tnformation Mhich would ba helptul in avaluating the sewage system (10. drainfietd easements, � covenants, etc.):�QN� NATER SUPPI.Y INFORNATtON [��ub11c system (2 or more connections) [^] Prlvate (wett. spring, etc.) /� •'/ � Attach copies of Meil log. we11 Name of Public Supply S�1�r O � /Ac'��/� covenants, chemical/bacter1olog1ca1 � sample reports F'OR tEAI.TN DEPI1Rt1ENT USE ONLY ,_ _ ,, � . � - a e ece ve [��APPROVED -�� ,L� BY��yy ( . p ots��ovEo T�� sY: , ae Comments/Conditlons: Any person aggrieved by any decislon or tlnai order of the Haalth Offlcer may make wrltten appitcatton tor appeal to the King County Board of Sewage Revtew 1f done so withln 60 days of tha above declston. /hd/sewac�e/forms/form37/6-3-91 � ` /ilO o° , � � - . ,�-� �e � � � �. ,. ;\ � �� p � r (/� �� _ �� 0 � � • � � _, � , ;� � ,� � � . ` x � �`°� w � � � � � � r - '�,. � i � � W � � K ��.�"' ' � o � � � i s '� .:o O � �`. __ � 1 I � < <-� � �- 0 — � � � - � �� - -0 � � 1 � � � �' � 0 O T o-rt-c�-1 � � `� ,'� O r � � o�o I � , i :^�� Hr ' r � �� - - - � _ -�' � � S'o �' �; o G o � o� o 0 �� rR t � � �r �r '` � '_° Ln ' — cg rn � �:_":. �--� � � a � �s �� ' � � � t� '"! r`'��' �' � � � � � � '`_ � (, :,il � 'a� y�� M � � v� o ..� , r.:�::. � _ l-ry , /' �}� � �-' �: �,�+ti' r � .. � . � ; :,: �� s � � � �; �0, �.i � � (,? �y !"�,,P9 � f� � � ;=y~� :.": �� Pj —� � � _. � i .L'.. � � �• � � � � . �,i � -� ��- � y� cs� < ' fi_ � � --- ` �