93-100944 �
93 . �ao�yy
ClTY OF FEDERAL WAY B U I L D I N C PE R M I T PERMIT NO.: BLD93-0416
3 3:;3 0 F i r s t W a y S o u t h B UILDIIVC; INSPECTION - 661-4140 ISSUED: 04/28/93
Federal Way, WA 9�003 BY: FLF
6ii1-4C�00
Sil�� ADDRESS: 3001 S 28�TIi ST Unit: #170
:'rZFi::�.'.. !V(;.: 04210��9231
PROJECT DESCRIPTION: CAMELOT MOBIIoE YiOME PF�12Ito Io0'�' NUMBEl� 1'70
OWNER CONTRACTOR LENDER
NANCY JEAN MARTINSON NORTHWEST SERVICES INC
3001 S 288TH #170 614 197TH AVE CT E
FEDERAL WAY LJA 98003 SUMNER 41A 98390
'"'•1330 735-1627
NORTHS*190JG
BLD?:X MEC?:? PLM?:? FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN.........:HDR FEES:
TYPE OF 410RK:? USE:? 1ST.: 0: O:sf STORIES........: 0 REQUIRED PARKING..: 2 SPRINKLERS?......:? PLAN CHECK DEPOSIT.° E 55.00
CENSUS CATEGORY.....:112 2ND.: 0: O:sf HEIGHT.....: 0.00 ft HAZARD CLASS...:? FINAL PLAN CHECK...* S -2.35
OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION---------- REDUIRED SETBACKS------- FIRE FLON....: 0 gpm BUILDING PERMIT....* $ 81.00 '
• OTHR: 0: O:sf EXIST..$: 0 FRONT.........: 10.00 ft SBCC SURCHARGE.,,..* E 4.50
; :� .� _� .
TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP...S: 5161 SIOE..........: 5.00 ft NATER SERVICE..:FED
�? =? .? • DECK: 0: O:sf REAR..........: S.00:ft SEWER SERVICE..:FED
OCCUPANT LOAD------?----- GAR.: 0: O:sf RECEIVED.:04/19/93
. 0: 0: 0: 0: TOTL: 0: O:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N
FUEL TYPES.:? ? FANS..........: 0 BOILERS/COMPRESSORS 41ATER CLOSETS......: 0 URINALS........: 0 TOTAL FEES S 138,15
GAS PIPING.: 0 ft NOOD..........: 0 0-3 HP......: 0 BATH TUBS..........: 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK.....: 0 3-15 HP.....: 0 SHOWERS............: 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 NP....: 0 SINKS..............: 0 DRAINS.........: 0
BBQ........: 0 MISC..........: 0 5+ HP.......: 0 DISH NASHERS.......: 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS fUEL TANKS--------- ELEC NTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN 41SHR OUTLTS...: 0
i OGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
ALL PERMITS EXPIRE 180 DAYS AFTER tSSUANCE IF NO WORIC 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 � �/�� j� � ��/� �J '��'?�j`/ DATE �-rO��� `� j
l�e��e+f+ f
bld_prmt 10/23/92
t �������
�
� � �
- I� �' J �''�..
J
Y m z m � m
¢ o '
0
� ' � i � � �
o W
z �j a ' o i
�
O z � Q
�
� I' a I � '�
c� , � a
z I z ' o� �
m Q
� w U � J �
~ w a
aJ. o � o � a
� I i , I
� � � i i o i
J
J �
� � � i I a
z
o m i m
o i �
z i I
�
° � o O I
� z
� z c� o
o � z �,
a � a F=
w n- a
� F r � � � o
Y a Q a �' Q c�
0 0 � c� z o 0
I , � � �i
� ��� ;
� � , �
3 , �' ���� ��� ��,
� ,� 'I I �,
cn�l�� Z
�1�
~� Y Y � >- } Y
• � m Z m Q m a m
V� h = � � ', � �� �
� a �
►
, i � �� � I � i o MI
{� 1 z �i
�V � C7 Y � �
I;� m I p I � 'vl
'3w � W � W Q W
'_ �~' � � Y ~ Z ~
� a o O � u. o
� a„� � City of Federal Way '
�-
�"� APPLICATION FOR BUILDING PERMIT
PLEASE PR/NT APPL/CATION #: ��-�1,��� ��'-/ � �,
_ _ _ _ __
SITE LOCATION ' Address ') 5 ' ,'r�
Tenant (if known) Lot # Assessor's Tax #
� �) �� Jr' � �r) 7
Building Own r Name Address
City State Zip Phone
Nature of Work ���
� ,r� �,i-,,� ^� '� � �j �
__ __ __. _ _ .. ____
__ __ _ _ _ ___ _
___ _ _ _ ___. .. _
__ _ _ _ __ . _. __._ ... ._
APPLICANT
Name (F,M,L) .
-J �. � � %i
Address �
7, � - 1� - � - � � 7
c�ty - a stete z�P
Contact Person Day Phone Other Phone Fax
� � � 73 � , , � �-%7 ��
BUII.DING CONTRACTOR
CompanyName �
l a ' 'I
Address '
_ C�yh � � - �� .
City State Zip �' � C"' �
Contact Pe son Phone Fax
�
Contractor' card must be presented) Expiration Date Verified ❑ Yes ❑ No
! i � -
ARCHITECT ::
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
APR 1 � 1993
Please Complete Reverse Side �/ A
�✓��� ��A����CD0492 IRev 4/931
����
STRUCTURE isting Use Proposed Use
Permit includes: � Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: �I Rasidential ❑ New O Remodel ,�] Number of Units� ❑ Deck �
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other `
Enter 1 st Floor I 17 ; sq tt 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks aq ft Garage sq ft Proposed Totai Area sq ft
Water Availability O Sewer Availability O On-Site Septic System Availability ❑ Projact Valuatio� S
Zoning Lot Size Existing Bldg Valuation $
LENDER
Name Address
City State Zip
__ _ _____ _
_ _ __ _ .. _ _
_ _ _ _ _. _ _
__ . .. _. . ____ _ _
MECHANICAL'CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License � Expiration Date Verified ❑ Yes ❑ No
_ _ __ __ __.. _
_ _ __ __ ..__ __ __
__ __. __ .___ __....... __.
_ _ _ ___ __._.. ........ _...
PLITMBING'CONTRACTOR::
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLU11'IBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total:Fxture Count
MECHANICAL UNIT`COUNT
Fuel Type (electric/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 Boilere 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 parjury that the informetion furnished by me is true and cortect to the best of my knowledge and further that I am authorized by the owner
of the above premises to periorm the work for which permit application is made.1 further agree to save harmless the City of Federal Way as to any claim(includinp coste,expenses,
and attorneys'fees incurred in investigation and defense of such claim�,which may be mede by any person,including the undersigned,end filed against the Cky 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. —-
OwoerlAgent: / Date:___��� / i,/
7—
1
1 ,
C �I� ��l� ..L��l .� �! b' � • ,
�
1� a�,+, +�
``�.., < - _ - - -- - - - - r, - - - � � � � - - �- - - �--- _.
i , g
�
� '� �k ��� �- � e��� '
� i �I
, a� � ;}�:' � �N���t�►d T.��If�l� �
� � Q I f
� o � c° f
�' ' A' � �
--, l� �:
� -e �'� (� � W
� `"' _�� � � _. �
'7' �--s = E0086 VM'�eM Is�apaj V►
Q � 3t N � �° � � � 4i88Z'S LOOE �
�
p i� �� � i, ' a.�enbs �o�auae�
�
7" � �s o �' '�, .� _ = .
� �
� � ' � � � � � � �
'C h rn � rty �o/ _�,� 3�d�S
� C� �} � �
° � '� , � � 0 L � T o i o
� � �; � � T � �'" `� � l..� �-� �� � �/
� ° z �n � � � 0 s. � m � �I-�h X �Z rT 3 S Oci 0�1�
� p. �; j' � R7 �.
v. � � � � � � Q C7 C ��n� �
;, � �� 'h � S �lr 1�M �_..� 3
� y � � i .$ �3""d Cl �
° '� �{ .—
- � � � t� 1� �
� � ur � � � s � T , � �g
t: � � e � ' � L
c � �' �,; `;� � � z� ' �
� P
n` _. C'� r '�'� � �
� � I�' ;r z c �
�:„ •..� � t a
�� � � '" -� �� � v� ��I� 3'�t�� S ����o� 9 IV t.�.s1k�
� �' � � � (� � ^i� �
� �:_ r n
. � �
�
�