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97-102609 � g�. �aa�a� C�I�("`A Q�" �� F PE:F',s�!_ ✓�ir�Y PERMIT NU: BLD97-0430 3 3 5 3 0 F i rs t w a y 5 o u t h .�"'J�b„�p.1N;: �I!„„,..�M;:;X.,�,. IIrM�n��::l� ���i��i�;IN����.�!�: ��I���� I S�u C L�: U 8/21/�7 FeG�ra1 Way, WA ��80f]� .�uilc�:iny Inspection Requests 25�--661--�t1�+0 BY: �C 253--661--4000 EXPTRES: Q2/17/98 RDDRESS: 33Q�3 47TH AVE �W NQ. : 1898q0-C12 7Cl PROJECT DESCRIF"CIQN:NSF - Basic Plan A97-1001-V44 :j NSF - WITH PLUMBING AND MECHANICAL BASIC # 91-1007-V94 �= OWNEft ==_____��_��__________________________________����T= CONTRACTOR =___====_=__==___=_______=__-_=______==-==T= LENDER =-_____=_=_____=_=___=====_==___=_���_�__��T=_� ' LEBARON HOMES INC. � LEBARON NOhIES INC � CONTINENTAL MORTGAGE C0. � 25710 212TH AUE SE � 25710 212TH AVE SE � 11555 SE 8TH ST., #110 j � MAPLE VALLEY WA 98038 � MAPLE VALLEY WA 98038 � BELLEVUE WA 48004 � � 425-432-9124 � 432-9124 � � � � LEBARHI099L1 � � � 1..._,..__._ __—__...._�____�_._______..��.,__.___•�_._______._._.�_..._ ._....._____�__....__......__.__.........,..._.___„__..._.._...__._.___.__..._..___"_"".._�._¢s::.cxc:zx:a�r.cac ..___e�...........________:a_�.amec_�_.�.-ccc::=aa� �.�_��..�..��.��.�.._.��.._.........�__.__'_�.��..._.__...._"�"_______________.�_.____"_"__.___..._..._.__•___.__."____......._...._._._�.� � ..�___..._�___....�.. .. .��.. ��� �i� CONTRACTORS, PLEASE USE LOCATION CODE 1732 MHEN REPORTIN6 SALES TAX FOR PROJECTS YITHIM TkE CITY OF FEDERAL UAIf. TAX RATE = 8.2� x=* --_--_.-----------=----------.--__==_==___=_��:���___=__��:�=__===_===_____===___-----------------�--____-_-=--_--____�___-__=_=_______---____--.,_-------::::���:�Y�-��===_=_____=__= r--------- ----- -- ------ q____.._-----____- ----- -__ _.. ______ _- - -- T-------____ .._ � � BLD?:X MEC?:X PLM?:X FLR--EXIST--PROP--- DWEILING UNIiS: 1 � COMP PLAN,,.......:URBA � FEES: � � TYPE OF WORK:NEW USE:RES 1ST.: 0: 1422:sf STORIES.....,..: 2 � REQUIRED PARKING..: 2 SPRINKLERS?......:N � PLAN CHECK fEE $ 100.00 ) � CENSUS CATEGORY.....:101 2ND.: 0: 1009:sf HEIGNT.....: 21.00 ft HAZARD CLASS...:? � PUB WKS PLCK(Sf)..93 $ 80.00 � ! OCCUPAMCY GROUP---------- 3RD.: 0: O:sf VALUATION---------- REQUIRED SEIBACKS------- FIRE FLON....: 0 gp� � BUILDING PERMIT....# � 916.00 � � :R3 :U1 :? :? : OTHR: 0: O:sf EXIST..$: 0 FRONT......,..: 20.00 ft � Mechanical Permit� $ 54.00 � � TYPE Of CONSTRUCTION----- BSMT: 0: O:sf PROP.,.$: 118342 SIDE,.........: 5.00 ft WATER SERUICE..:FED � SBCC SURCHARGE.....� $ 4.50 i � :5N :SN :? :? : DECK: 0: O:sf ! REAR..........: S.00:ft SEWER SERVICE..;FED SCH IMDACT (SfR)NEW $ 2372.00 � � � OCCUPANT LOAD------------ GAK.: 0: 681:sf RECEIVED.:07/17/47 PLUM9ING FIXT....93� S 98.00 � 8: 0: 0: 0: TOTL: 0: 3112:sf � IMPERV SURFACE: 2411 sf SENSIIIUE AREAS?.:Y � -__-_=___ _-�����-��=�=�_____________________________��_��==_��_���__=__=__ ______________._��__------�______________=_��-=�_��:�� - --- � FUEL TYPES.:GAS GAS FANS..........: 4 BOILERS/COMPRESSORS ; WATER CLOSETS......: 3 URINflLS........: 0 % TOTAL FEES $ 3624.50 � � GAS PIPING.: 0 ft HOOD.....,....: 1 0-3 TON.....: 0 � BATH TU9S..........: 2 DRINKING FOUNT.: 0 � FURN<100K... 1 DUCT WORK...... 1 3-15 TON..... 0 SH04tERS............. 1 SUMPS........... 0 � � ( GAS NWT....: 1 WOOD STOVES.,.: 0 15-30 TON...: 0 � LAVATORIES.........: 4 VAC BREAKERS...: 0 � CONV BURNER: 0 fURN>100K.....: 0 30-50 TON...: 0 � SINKS..............: 1 DRAINS.........: Q � � � BBO........: 0 MISC.,.,......: 0 50+ TON.....: 0 DISH WASHERS.......: 1 IAWN SPRINKLERS: 0 � � � � GAS DRYER..: D AIR NANDLING UNITS FUEL TANKS--------- ELEC WTR HEATERS...: 1 OTHER FIXTURES.: 0 � RANGE......: 1 t=10,OD0 CFM: 0 ABOVE GROUND: 0 LAUN WSNR OUTLTS...: 1 � GAS LOGS...: 1 > 10,000 CFM: 0 UNDERGROUND.: D > � � �=-___=__,_,_���_�,_���_��------==---===--=====�����=___====_=___-=_==_-�---�--==-=__--==_______=-=_==_=-=_��=-=====-_=___==_____=�_____�__������_-�:�-�__��_-=:W.-���__.=__===,�� PERMITS EXPIRE ISO DAYS AFTfR ISSUANCE IF MO MQRK IS STARTED. 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Date -� t�— �j� BY � . �.-r,,..1 � 2 FOUNDATION WALLS '' Date ' :, _ 7,,� � - % �"` c.��c� Y 3 PLUMBtNG GROUNDWORK Date By _ __ __ _ 4 SLAB INSULATION Date By 5 FOOTING/DOWNSPOUT DRAINS ; �� d Date — ��.e L` By �., 6 UNDERFLOOR FRAMING Date By 7 SHEAR WALLS Date � — � 5—`�� BY[ ,� � 8 PI:UMBING ROUGH-1TI '' Date _ Z^ By � 9 (3A5 PIPINQ Date (, - z�- r/By C r 10 MECHANICAL ROUCiH-1N ,: , _,:: Date G ' Z3- �BY _ 11 FRAMING' Date _ � 3_ �'1 By L(.�.� 12 IN�U LA'f ION Date 7— /3` �� By � : 13 GWB � 1ST LAYE�1 Date ._ � _ By 14 61N8 -2NQ LAYEi3 Date7 Z?— __ By _ . _ __ _ ._ ____ _. _.. _. _ _ _ _ _..__ . _ . ..._ _._ . _ _ _ _ _.... __.. _ .... _ 15 SUSPENDED CEILII�G i Date By 16 PLANNIN(3 FINAL Date By 17 PUBUC WORKS FiNAL Date By 18 Flq� �INAt C� c,� dv �,L�ovu�-c T � Date By • 19 BiJILDING FINAL Date _� Z— By _ _._ __ _ 20 GITHER »' Date By C00193(Rev 4/8� � • - ,''�;,',. BUILDINGDIVLSION � G ���-LL�` 33530 First Way South uV FiY E1ZAi_ , ��';`, Federal Way,WA 98003 '� � (20�661-4000 ,�v,- Fax(206)661-4129c '� ��5,�� ��g��-ic��- Y�z�� APPLICATION FOR BUILDING PERMITc�Pn�� a�,v PLEASEPR/NT APPUCATION # ��-�� } �'�� <:;:�::z>::>::»<::::>::::::::>::':::>�>::>:<::::::<:::::>::>:::<:::<:»;:>:::«::;::::>:::::::«::::::::::<::<:::>:«<::<:>::>::>::::: :>?::<�>':'. Address ��€'�<�t3��ti� :::>::>::>:::::<;<:�:::::::�::::>�::>:::::>::>::>::>:���>�-���:�<>�:: - . ��...........................::.....::.:::.:::.�::::._: 330 3- � �. S. cc7, � r�x. 8'c�L�� Tenant(if known) Lot# Ass ssor's Tax# � -'. Q• L1 Building Owner's Name � Address � �o- a�a'� � S:� Ci L� State� z �' Phone ,a�,s 3 2— ,� � Nature of Work � � .�::. x:;:i.r,,,c...::....:..... ... -t.;:3o: t :,4;;=;,ci::�',�..k;;rS;;::;:,::',:i:::;-='.::.,,::•:..::-;"-:';:.;<�>�;;=:::r::.::.: s.<,•; L '::,t.:i{r.:�G�:^:-i::�Si�<;v'::SL:�:�:,+.�fti•i'F-i::vy.}}i::ti::. }-. } l'vv::':j:�Si:'•Y.\�.;?i:;yi;r,�[�r.}M1::?i;-,•}t;i:i?}:•:y;C:::ivtii:f.{r?r{r _ �•.•:?.�.�C��.:.::....<. . . :: .:i:.:: � ""{:..ti4i:i: Name (F,M,L) �- ) Address C� State � Contact �son 1 ' Day,Phone � `��` � the Phone �� F x � � C✓C� ��S .�- rS:.v�;}i•�:•�;p;t;;;;��:r;;:':v:;:::x.::x::<:5:�:::;k::;::t:•,;;;,;r>�F:::r:';:;`-;:i�;:�:;?`�:;; , r . .. ;.; �•..•..:..�:;����`#��'�`.'.#�`....r�:�.�<.��..�`{f::>:«<:r::��:�:;.;;?<:.; Company Name Address Ci State � Contact Person � �� Phone Fax � � ) _3,�- � - �_ Contractor's #(card m st be presented) � ` z Expirati n D e Verified � Yes O No [.. ;:".• ,-:;;�f,::..•:•: :•;::•: •,>,:.�:�::��-,::.x<::••: C '' ry,a��.i'!::;'Sv??t3::�:.;.j::..;;u;>:>:;.:,;y_ 3. J } hni }:'_i\:irr•.{.:%:��{: :�l. '" .� .#u:�`.'���::z::as�:?:�,�«<:::;:.:r:h{;::•s::::::.:.;•.;; Name 5(f.�? Address C� S tate � Contact Person Phone Fax LEGAL DESCRIPTION �_ � � �� (S f�n� I ����� - 1.c f .2? ����" � � s �i � �t� P/nacv !`mm�/nfn On.mr�.� C:.d„ . :::::<:�<>�:Y::;;�-::>:::;;«�::<:;;::::<>�::;::::::::::::<=::;::;:<;::::::::�::>:;<.«<:;::>:::=><.<.=::r:7:<::=:::::::> .w.£........ I _ ���::c;<:::::�:<:;:':;<>:::�:�z;z:>:::<:::>::::;:�:;�:;:.,>..::>:::>:<:: Existin Use :i'$����::��<:;.�:;:<�.,,.::,.•,:.:::::::..,,,.�:::::::::.,,::.�s:..... 6 �-6' � Proposed Use , ) � 1�' , Permit includes: Buildin Plumbin Mechanical ❑ Other Type of Work: � Residential �4 New ❑ Remodel '� Number of Units,� . Deck ❑ Commercial ❑ Addition Gara e O Shed ❑ Other Enter 1 st Fioor�,�,2 sq ft 2nd Floor �� sq ft 3�d Floor sq ft Existinp Floor Area sq ft Area Basement s ft Decks s ft Gara e s ft Pro osed Total Area ^�r— s ft Water Availabilit ❑ Sewe�Availabilit � On-Site Se tic S tem Availabili O Pro'ect Valuation S Zonin Lot Size ,( �`,. Existin Bld Valuation S �:iti;k}:_: ��':•:'A`��'.;:ti�:4}'•}.4.:L4:C'�i:�iiti\4riyr:•i;.:ii:: (� ii�h^i}�i._:.t.i;i:?v._i::::>:::.i,?:5:.},{:fi?::?_: '.::x•<:•::�::::::?:::•ti•::.?:•::::•:::::•>:::.::.:•::::::::: :��•..'�12}}?ti:;%�.:"+a:2�::''v::... . ......:.....;;...."' 1......... .....................::...:..::..:..�:::::>::a.>:•>:+:•::-:::..;•`.:':;::;:;:;:;:i:`:;::2.:�:'t.'•::i:�i:�:: Name i A�ess �� � ���� e � � y c� _ sceto � ,L't .�y�{.X.*�{/t j:}:{i::}�:,Kv�jjY�'ti*�$:>.i+y<::!i�i}::^�i:i::::::=:,yi�!:ti•'.��iy:i:;V tii:ii::;:v?v}:i.1ii;:: .iYtR:'4+i:f717�1:1�.'4'�'�'�E�»?:'{�11i!}�:i::F:l"!'�1c�:S=.�.F7.c':;:A-;:"i•':?w`r;;?; .. ............. ...... . .. . . ............. .. ...... Contractor Name Address C� State Zi � Contact Phone , Fax License# Ex iration Date Verified ❑ Yes ❑ No ti :�<:>;��(^�:;;:z<:�=�':�=���==::<i=>:=:::: y�}� �(y�/��Y�}x��y� �►y.^.+{{F}:{:::}ti�.j,i>yi::::::: �#.<7:iki�i.l7RCx:�:V.V'.t!F.;�.:C:THC��..':i�::4:'�.'2::':i:•::'i':�::`.�i:�:::: . .. .�7t......,r........:...:........ Contractor Name Address C� State Z Contact Phone Fex License# iration Date Verified ❑ Yes ❑ No ��:�>::;>::-'::.:::<:::>::>:::;::;>:<>::<:<:::>::>:<:::>::>.<:.:;:>:::>:>>::::;:»:::::::::�;:::<:>':<:>:�:=`:»:z:s>:: 2�1�,EN��i�;t't.�E3�.CC�U�1T;:.;:.::;,,,.::.;:.;;:.;:.:.:;.. Water Closets � Sinks j Urinals Lawn S rinklers Bathtubs Z Dish Washers � Drinkin Fountains Other Showers Electric Water Heaters Sum s Lavatories Washin Ma chine Drains >:�:o�>::>�: �.tal.;E`tiii#iire:;�ouiiE`':::<;>>:<:»::::iz:::>:>��z:?>: yx}xi:si:iriJ�Fj?::j3:i?;i}:,{�,@;j>.y�}?'.{i:4SYf.0'�ti�„ii;i{i_:;r;:i:j.4}{{i;i::::i�:�:{%,::S�ti.::: ���J��1C#��:�N�'�:.CC���!':<:�?�v<:::;«:,�;�:.:;<:: MECHANICAL EVALUATION ONLY S Fuel T e(electric/other) T " � Gas D er Air Handlin < = 10,000 CFM 15-30 Tons Len th of Ges Pi in Ran e Air Handlin > = 10,000 CFM 30-50 Tons Furn <t00K BTUs Gas Lo Unit Heater 50+ Tons Furn >100 BTUs Fans Miscella�eous Fuel Tenks Ges Hwt Hood Boilers Above Ground Conv Burner Duct Work 0-3 Tons Under round BBa�$ Wood Stoves 3-15 Tons 1`atal;ljnt��`nvrlt D IS CLAIM ER:I ceRify undec penahy of perjury t}wt the infortnation fumished by me is ttue and oorrect to the best of my knowledge,and furtha,that I am authoriud by the owna of the above prcmises to perfam the work for which pertnit application is mada I further ag[re to save harmless the City of Federal Way u W any claim(including costs,expetues,and attorneys'fas incvrt�ed in investigation and defense ofsuch claim),which may be made by any pusoc4 including the undersigned,and filed agawt the City of Fcderal Way,but only where such claim arius out of e reliance of the city,including its officcYs and employees,upon the aocuracy of the infortnation supplied to the city as a part of this applicatioa Owner/Agent: �� �^ " Date• �— f �—� � BtRD�IO.AR 11EveEo tt/11/06 , O Res _ �ntial Sewer Use Certific..«on K,.�,:o�.rY (T o b e c o m p l e t e d f o r a l l n e w s e w e r c o n n e c t i o n s, r e c o n n e c t i o n s, o r c h a n g e o f u se o f exis ting connec tions. This form does not apply to repairs or replacements of existing sewer connections.) Pursuant to King County Ordinance No. 11034, all sewer customers who establish a new service which uses metropolitan sewage facilities after February 1, 1990 shall be subject to a capacity charge.The amount of the charge is established annually by the King County Council but is limited by state law to$10.50 per month per residential customer or residential customer equivalent for a period of fifteen years.The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers.The charge is collected semi-annually.All future billings can be prepaid at a discounted amount. Questions regarding the capacity charge on this form should be referred to King County Wastewater Treatment Division at 684-1740. (Please print or type) Owner's Name �,�e. ��e-rQ 1'� .rn.�r'S .�t For King County'use. (Last.First,Middle nitial) � ACCOUI1t#, __;, __�, _.T, Property Tax I.D. Number_ _ �_� ��C� '�2��' - Property Legal Address: Mc�nthiy Rat�.._ _. ..._.�_ ___.__ __ _ ___. . _ , Subdivision Name�'�"an,e.�J��� Subdiv. # �;x Manth Que -- — _ __ Lot# �7 Block# Building Name (if applicable) � < Property � ' � ��f ���q � � -� � Street Address�.3 C�.3� "y7 �(/� S� KJ' . � � $ - � � ' � City, State, Zip �,�c� �Q.Q.���' 9"8��1 Q� Owner's Mailing �/� Address ��,/D - 2/�.�� y}L��. S, , (If different from above) �( / �� /���/i�� ����D /�—►�si�6�� !rl i Owner's Phone Number(�) �.�2— ���y Property Contact Phone Number ( ) � .; Party � to be Billed (if different from owner) ` - ' '' � Party's Mailing F � Address (if different from above) City or Sewer District�,�� ,�j,c�.(J�n„_ Date of Connection: Side Sewer Permit# Residential Customer Please check appropriate box: Equivalent(RCE) � Single-family 1.0 ❑ Duplex (0.8 RCE per unit) 1.6 ❑ 3-Plex (0.8 RCE per unit) 2.4 ❑ 4-Plex (0.8 RCE per unit) 3.2 ❑ 5 or more (0.64 RCE per unit) No. of Units x 0.64= ❑ Mobile home space (1.0 RCE per space) No. of Spaces x 1.0 = For condominiums, please fill out Supplemental Form A in addition to this form. I certify that the information given is correct. I understand that the capacity charge levied will be based on this information and any deviation will require resubmiss' n of correcte a for determination of a revised capacity charge. Signature of Owner/Representative � �-� �— r--�-v Date � "� •—�i , Print Name of Owner/Representative��4�1t���f�-S/� ios��Ae�.iuss> White—King County Yellow—Local Sewer Agency Pink—Sewer Customer LAKEHAVEN UTILITY DISTRICT OFFICIAL USE P.O.Box 4249 •31627-1 st Avenue South•Federal Way,Washington 98063 APPL# Seattie:941-1516•Tacoma:927-2922•Engineering:941-2288 PERMIT# DATE BK# APPLICATION FOR A SIDE SEWER PERMIT A�C# SITE PLAN IS REQUIRED FOR ALL APPLICATIONS S�N # TYPE OR PRINT LEGIBLY OWNER �2 T��t Y1�YL _�YYl P S �1''l L PHONE (��) ��;.�- q�%�7 PROPERTY ADDRESS ���13� " � � � �� � v ,J ` � � CITY / IP� BILLING ADDRESS T�� e �f r IN S ATE ZIP LEGAL DESCRIPTION: NAME ��'" � a �-� ����� LOT � BLK I � (IF APPLICABLE) OTHER LEGAL DESCRIPTION ��l.�� o� �t� �n ��'�✓L�� AUTHORIZED SIDE SEWER CONTRACTOR PHONE BLDG. IDENTIFICATION ` �°- NO. OF UNITS PER BLDG. WAS BLDG. PREVIOUSLY CONNECTED? YES ❑ NO � IF YES, ACCOUNT # IS BLDG. CONNECTED TO WATER? YES ❑ NO � IF YES, ACCOUNT# RESIDENTIAL _�APT/CONDO/MOBILE HOME NON-RESIDENTIAL WITHIN ULID TYPE OF BUSINESS ( BE SPECIFIC) SQUARE FOOTAGE OF NON-RESIDENTIAL BLDG. SQ. FT. PROPERTY AREA SQ. FT. (MULTIPLEX AND NON-RESIDENTIAL ONLY) REGULATIONS AND REQUIREMENTS ARE SET FORTH ON REVERSE SIDE OF THIS APPLICATION FOR DISTRICT USE ONLY IN LIEU OF ASSESSMENT CONNECTION FEES BILLING TYPE RESIDENTIAL ❑ FRONT FOOTAGE $ NO.OF ERU NON-RESIDENTIAL ❑ OTHER FACILITIES $ CFC/CIC $ SIC GROUP DEVELOPER PAYBACK $ AREA CHARGE $ APT/CONDOJMH ❑ SUB TOTAL $ BASIC PERMIT $ PUB AUTH ❑ RIGHTOF WAY $ DISTRICT IN ❑ OUT❑ WATER DISTRICT PRETREATMENT $ LIFT STATION SUB TOTAL $ ULID TREATMENT TOTAL $ PLANT vaSEC BOOK D.P. 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