97-103314 9�- ����y
�'iTY'��F i: t:L�c::.RE?L �J{�Y QERMIT l�IU. ELD97-C)�25
�3 5 3 0 F i r�s t W a y S o u t t�� .��`;J�.,,�.�,. �.�,.��.,,�. �'��i��:'„�' i�'"�'�.�"�w�"'�'..�. u����. T 5 S U E D: 0 9/0 3;9 7
F�Geral Way, WA 98C10� f3uildir7g Insp�ctian f��qu�sts 253-66]_ _�+�.40 BY: FC2
25�--661-4Qq0 EXPTRES. 0�/Q2f98
ADDRES5:347�.9 6TH RVE S
NO. : 2_02104�-9178
PF20JECT D�SCRIPTION:REPAIA WATER DAMAGE :SHEETROCK, INSULATION , SHEAR WALL, DRYNAII REPAIR.
- ONNER -------------------- ------::__-____---_____----__=_-= CONTRACTOR -=__=_-___=-____�_��_�__��_:�__=_______=====T= IENDER =====__=____=====___=__====_==___===_=_==_=====i
p- --------------------------- --_----____________
� 10HN JARSTAD, DR. MD PACIFIC GENERAL CONTRACTORS � �
( 34509 9TN RUE STE#101 10317 BRIDGEPORT WAY SW � �
� FEDERRL WAY IiA 98003 LAKEWOOD WA 48494 i
� -5646 206-582-4236 �
(
i � PflCISGC044Q0
E__,._____-._----•-------_____.-----��__._-----•---•.--------•-----_...._.i...,._._...,,.__�.____--------------------------------_____..________---1-----------------------------------__._____.____--___._---__._...t
__._.___________.__...._.______-------------__..__ _..___._.
*x# COMTRACTORS, PLEASE USE LOCATION CODE 1732 YNEN REPORTIM6 SALES TAX FOR PROJECTS MITNIII TNE CITY Of FEDERAL MAIf. TAX AATE = $.2� =�x
r��__�__��_��-_�=====�:_-__:..____:_�__.-�..-.-_:_�:_-�-:�w�.�-�r�-::,»���._���=___--==_�___�.:=--_=____�,=-__--==~-___-_.___�.__�-_._,.__..=_-_==��_,�=----=------------------=--------�_____=_====��w,_�_�
; . __ ____________ _ ___ ., - T--_-^^--------- -- ---"-- ---
� BLD?:X M�C?:? PLM?:X FLR--EXIST--PROP--- DWELLING UNITS: 0 � COMP PLAN..,......:I/OP � FEES: I
� TYPE OF W�RK:REP USE:COM 1ST.: 0: O:sf STORIES........: 0 REQUIRED PARKING..: 0 SPRINKLERS?......:? � BUILDING PERMIT....� S 284.50 {
� CENSUS CATEGORY.....:499 2ND.: 0: O:sf HEIGHT.....; 0.00 ft NRIARD CLASS...:? � SBCC SURCHARGE.....� $ 4.50 �
� OCCUPANCY GRQUP---------- 3RD.: 0: O:sf VALUATION---------- REQl1IRED SETBACKS------- FIRE FLOM....: 0 gpm � PLUMBING fIXT....93� $ 49.00 �
• •� •� �� • OTHR: 0: O:sf EXIST..$: Q r fRONT.........: 0.00 ft I
� TYPE OF CONSTRUCIION----- BSMT: 0: O:sf PROP...S: 30Q00 SIDE..........: 0.00 ft 6iATER SER'JICE..:? �
� :? :? :? :? . DECK: 0: O:sf � REAR,.,........ O.00:ft SEWER SfRVICE..:? I
� OCCUPRNT LOAD------------ GAR.: 0: O:sf RECEIVED.:09/03/97 � I
� : 0: 0; 0: 0: TOiI: 0: Q:sf � IMPERV SURfRCE: 0 sf SENSITIVE AREAS?.:? � �
�__�=���=�__����=======__=���„==___��_��__:______________��__�,��:;�_���_�,=_=�_===____=_=__________=_______=_=��_�_���-�=«��_���_,�
� FUEL TYPES.:? ? FANS..........: 0 BOILERSJCOMPRESSORS � WATER tLOSETS......: 0 URINALS........: 0 � TOTAL fEES a 338.00 �
� PIPING.: 0 ft NOOD........... 0 0-3 TON...... 0 BATN TUBS........... D DP,INKING FOUNT.: 0 � �
� <100K.,. 0 DUCT WORK...... 0 3-15 TON..,.. 0 � SHOWERS............. 0 SUMPS........... 0 � �
( GAS H9�T....: 0 WOOD STOVES...: 0 15-30 TON...: 0 � LRVATORTES.........: 3 UAC BREAKERS...: 0 � �
� CONV BURNER: 0 FURN>100K.....: 0 30-50 TON...: 0 SINKS..............: 3 DRAINS.........: 0 I
( BBQ........: 0 MISC..........: 0 50+ TON.....: 0 DISH WRSHERS.......: 0 LANN SPRINKLERS: 0 � I
� GAS DRYER..: 0 AIR HRNDLING UNITS FUEL TANKS--------- � ELEC WTR NEATERS...: 0 OTHER FIXTURES.: 1 � I
� RRNGE......: 0 <=10,000 CfM: 0 ABOVE GROUND: 0 � LAUN WSHR OUTLTS...; 0 � I
E UNDERGROUND.: 0 � � I
� 6AS-LOGS�_��:::_��==_�_�=___����_>_10,.OQONCfM:__-:�W_»=�-:����_�_���=__=====�_,=_w::_==��=��.__�r�_=-==���,�_�::�r_=-_w_���==_=_-__�_��_»��1�=====___������__��_������====_=__===��-_-d
PERMITS EXPINE 180 DAYS AFTfR ISSUAMCE IF MO NORK IS STARTED.-�RES NTIAL-AMD 6aADIk6 PERMITS EXPIRE OME YEAR AFTER iMITE OF ISSUAMCE.
I tEBTIFY TNAT TNE IN�O IOM F NISNED BY AE TR ORR T�E BEST OF MY KNOMLED6E AND TNE APPIICABLE CITY OF FEDERAL MAY REQUIREMENTS YILL BE MET.
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OWNER OR AGENT - � - = - -�� ---------------------------- DATE �� ---�lE�
FILE COPY
Buu.nnvc Dn
� G � 33530 First Way S
Federal Way,WA 9
�� �y (20�661-4 „
Fax(20�661-4129c
APPLICATION FOR BUILDING P�RMIT
PLEASE PR/NT APPLICATION#
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Tenant(if known) Lot# Assessor's Tax#
Building Owner's Name �.� � � �? Address
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C� State Zi Phone
Nature of Work
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Name (F�j -� -
Address
Ci State Zi
Contact Person Day Phone OtherPhone Fax
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Company Name-�a`�'�'
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Address
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Contact Person hone ax
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Contractor's #(card must be presented) Expiration Date Verified ❑ Yes ❑ No
AR�HFTECT
Name '
Address
Cit State Zi
Contact Person Phone Fax
LEGAL DESCRIPTION
L'/ease Comp/ete Reverse Side_
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.::.;::::;:;•:•�:z.>•>;:•: >::s:::;:::�:::::i;::<�:::;<.:::;<>«.:<>::��. oting Use �posed Use
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ermit includes: ❑ Buildin ❑ Plumbin ❑ Mechanical O Other
Type of Work: ❑ Residentisl ❑ New ❑ Remodel ❑ Number of Units_ ❑ Deck
❑ Commercial ❑ Addition ❑ Gara e ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement s ft Decks s ft Gara e s ft Pro osed Total Area s ft
Water Availabili ❑ Sewer Aveilabili ❑ On-Site Se tic S stem Availabili O Pro'ect Valuation $
Zonin Lot Size Existin Bid Valuation $
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Name Address
Ci State Z
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....... .................. . .
Contrector Name Address
Ci State Zi
Contact Phone Fax
License # Ex iration Oate Verified ❑ Yes ❑ No
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.. ....
Contractor Name Address
Ci State r
Contact Phone Fax
License # Ex iration Date Verified ❑ Yes ❑ No
_._............................................._......_._.
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_ ______ _.... ........................................_....._.
Water Closets Sinks Urinals Lawn S rinklers
Bathtubs Dish Washers Drinkin Fountains Other � � �
Showers Electric Water Heaters Sum s
;:..... ;
Lavatories Washin Machine Drains 7otal:.FiacYure:�ount .;;,.. :::
;11��+�k�EA(til`I�A�:'_�N�'F`:�t�i��lT:::::::::::<;:::::>:::::>:<:>:::>:
MECHANICAL EVALUATION ONLY S
Fuel T e (electric/other) Gas D er Air Handlin < = 10,000 CFM 15-30 Tons
Len th of Gas Pi in Ran e Air Handlin > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Lo Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Conv Burner Duct Work 0-3 Tons Under round
3-15 Tons 't""tel:U`:"t`Cotrritr«i:<r<:><::««;<;:;:<i:>::>::
BBQ's Wood Stoves ti ..__Ytt_..._....
DISCLAIM ER:I certify under penalty of perjury that the information fumished by me is true and cotrect 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 pemut application is made.I further agree to save harmless the City of Federal Way as to any claim(including costs,e�enses,and
attomeys'fees incurred in investigation and defense of such claim),which may be made by any on,including�de�signed,and filed against the City of Federal Way,but only
where such claim arises t the reliance ofthe city,including its officers and employees,u th oftl"ie ormation supplied to the city as a pazt ofthis applicatioa
r
Owner/Agent: r� � � J ';r�� Date: � � ��
Butnxa.Arr
REVSEO 1 T/11