93-101806 93 - �D� gb�
CI fY OF FEDERAL WAY �lJ I L D I N G P E R I�/I I T PERIVIIT 6V0.: �I�D93-079�
33530 First Way South Bl11LDIIVG IfVSPECTIOfV - 661-4140 ISSUED: 07/2A/93
�cc�eral Way, WA 98003 BY: �I,F
561-4000
SITE ADDRESS: 28401 22� AVE S
�ARCEL NO.: 422220-0530
PROJECT DESCRIPTION: REm1200F° ONL�
OWNER CONqRACTOR LENDER
DENNIS BONNEVILLE °OWNER IS CONTRACTOR*
28401 - 22ND AVE S
FEDERAL WAY WA 98003
45�-8931 1-951-2633
�04iNER*
BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UPIITS: 0 COMP PLAN..a......:? FEES:
TYPE Of WORK:REP USE:RES 1ST.: 0: O:sf STORIES,,.,....: 0 REDUIRED PARKING..: 0 SPRINKLERS?.o....:? FINAL PLAN CHECKe.," S 46.80
CENSUS CATEGORY.....:570 2ND,: 0: O:sf HEIGHT.....: 0.00 #2 HAZARD CLASS...e? BUYLDING PERMIT....* $ 72.00
OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION-_________ RE�UIRED SETBACKS------- FtRE fL041....: 0 gpm SBCC SURCHARGEa.o.o" f 4.50
:M2 :? :? :? . OTHR: 0: O:sf EXIST..S: 0 FRONT.......... 0.00 f4
TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP...S: 4500 SIDE,,........: 0.00 #t NATER SERVICE..:?
:5N :? :? :? . DECK: 0: O:sf REAR...ao.,.... O.00:ft SENER SERVICE..:?
OCCUPANT LOAD------------ GAR.: 0: O:sf RECEIVED.:07/95/93
. 0: 0: 0: 0: TOTL: 0: O:sf %MPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.: FANS..........: 0 BOILERS/COPIPRESSORS NATER CLOSETS......: 0 URINALS........: 0 TOTAL FEES $ 123030
GAS PIPING.: 0 ft HOOD,,........: 0 0-3 HP,o....: 0 BATN TUBS...o......: 0 DRINK[NG FOUNT.: 0
FURN<100K..: 0 DUCT NORK.....: 0 3-15 HP,....: 0 SHOWERS.ee.........: 0 SUMPS..........: 0
GAS HWT....: 0 WOOD STOVES...: 0 15-30 HP....: 0 LAVATORIES.........: 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K.....: 0 30-50 HP....: 0 SINKS..............0 0 DRAINS...o.....: 0
BBQ........: 0 MISC..........: 0 5+ HP.......: 0 DISH 41ASHERS.......: 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UN1TS FUEI TANKS-----___e ELEC WTR HEATERS...: 0 OTHER FIXTURES.; 0
RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN 4►SHR OUTLTS..vo 0
�'- LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
ALL PERMITS EXPIRE 180 DAYS AFYER ISSUANCE IF iV0 ViIORK IS STARTED. RESIDEFITIAL AND GRA6ING PERM17'S EXPIRE OiVE YEAR AFTER DATE OF ISSUAfVCE.
i CERTIFY THAT THE INFORMATION FURIVISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AfVD THE APPLICABLE CITY OF FEDERAL WAY REQUIREMEIVTS WILL BE MET.
7
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�WNER OR AGENT DATE ��U � S �
btd_prmt 70/23/92
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�„� � City of Federal Way �
-�- :^�rzm
�`, � APPLICATION FOR BUILDING PERMIT �
� _. .. . . 5.:......�:.
PLEASE PR/NT ' - APPL/CAT/ON #: �L��� �U l ��
STTE LOCATION Address J z�i`► 4 , �'
Tenant (if known) Lot # Assessor's Tax #
'.� C_ ...._ L'- G� i��_
B 'Iding Owner Name Address
s�' �y �o,'G`�/' / �' /�Gc/� ����
City �, State �/� Zip Phone —
Nature of Work /y/ �
APPLICANT
Name (F,
�S �
Address
�
City State Zip
Contact Person Day Phone — O he hone � Fax ��
�._J
BUII.DING CONTRACTOR'
Company Name � �� _
Address '
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT ':
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION � D� �N ,'l � � ^ ���/ ��
=� i G
Please Complete Reverse Side
C00492 IRev 4/831
STRUCTURE ' Existing Use Proposed Use
Permit includes: uildi ❑ Plumbing ❑ Mechanical ❑ Other
�
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial 0 Addition ❑ Garage ❑ Shed Other,�"-/0-U��
Enter 1 st 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 .oEe1 sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability O rojact Valuationy
Zoning Lot Size 6cisting g aluation 5
LENDER
Name Address
City State Zip
MECHA1vICAL CONT CTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRA OR.
Contractor Name Address
City State Zip
Contact Phone Fax
`
License # '`� Expiration Date Verified ❑ Yes ❑ No
\
PLUMBING FIXTURE UNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories ashing Machine Drains Tatal'Fxturei�ounf :
MECHAIVICAL'LJNIT UNT
Fuel Type lelectric/other) 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 uct Work 0-3 Tons Underground
BBQ's W od Stoves 3-15 Tons TotaPUnit Count
.�
DISCIAIMER: I certify under penahy of perjury that the information furniahed by me ie true and correct to the beet of my knowledee and further thet I am authorized by the owner
of the above premiaes to perfortn the work to�which permit epplication is made.I further apree to save harmless the City of Federal Way es to eny claim(includinp costs,expenses,
end attorneys'fees incurred in investipation end defense of such claim�,which may be made by eny person,including the undersigned,and filed againat the City of Federal Way,
but only where euch clai anses the i ce oi the City,including k icer employees,upon the accurecy of the information supplied to the City aa a pert of this
applicetion.
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.�Owne►/Agent: Date: _ �—/�
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