96-100988 q�-�oa g�g'
rTTY OF� r���:�EFZr�I._ W�;Y � I����FZf�fII� NU : kiLD�1�-(��.J.6
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� �,. � TSSU�D. 05 30 96
Federal WaY, WA `��3U0� f3uildir�g In��ectiar� f�equest�s 6E>1--G14U BY: FC2
661.-�000 k=:XI��9t.E� : ♦1-J-/`.'�/96
ADDRES5.3Q860 22ND AVE:. �
NO. : Q53�00-0536
PROJk�CT DESCRI p f I0N:RES ADDITION - CONSTRUCTION OF 312 SQFT GARAGE.
�= OkNER ��_�__���_�,���_���_==�=�w=�=�-ww��a�_���������__��q:: CONTRACTOR _____________�;_.�_ ____� _ _ - .-- _ -___ - LENDER =���=_�==_=__�_��_�_���_=��-�M����r:�--��__���_�
.�-- - �-�z-�-r-__=_-_____-
� TERRY IOCKARD ` OWNER IS CONTRACTOR �
� 30680 22ND AUE S � �
iFEDERAL WAY WA 48003 � �
� -7790 � !
� � 4 ............. �
_ .
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**; COMIRpCIQRS, PLEASE USE LOCA(ION CODE 1731 likEil REPO�TIM6 SALES TAX FOR PROJECTS NITNIN THE CITY OF FEDERAL UAY. TAX RATE = 8.2� *�i
F-'-'c:_z=�='=====iccemc❑===c--s__.r.»cm::.-:=c_cca=a:��axxsc^c:�s=�:�-�_—==--:c::c�r.='-=.•vs_r::cc�_-=cs�--�-ccznxm�-•:a:c::-wx="=='==:::cc.'rav=�=�=�'_=_-e======='`==c:�on-c^a:^��=:cam::s_:ca=i
I BLD?:X MEC?: PLM?: FIR--EXIST--PROP--- DWELIiNG UNITS: 0 � COMP PLAN.........:? � FEES: (
� TYPE OF WORK:ADD USE:RES 1ST.: 0; O:sf STORIES........: 1 � REQUIRED �AF,KING..: 0 SPRINKLERS?......:? PLAN CHECK FEE $ 52.65 �
� CENSUS CATEGORY.....:438 2ND.: 0:' O:sf HEIGNT.....: 0.00 ft � HAIRRD CLASS...:? � BUILDIHG PERMIT....� $ 51.00 �
� OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION---------- , P,EQUIRED SETBACKS------- FIRE FLOW.. .: D gpm � SBCC SURCHARGE.....� $ 4.50 �
:U1 ;? :? :? : OTHR: 0: O:sf EXIS L.$: 0 � FRO1�T�....,.,.: 4.00 ft � FiNAI PLAN CHECK...� $ 0.00 �
I TYPE OF CONSTRUCTION----- BSMT� 0: O;s' PROP...$: 5382 SIDE..........: O.OQ ft WATER SERYICE..:fED �
� :5N :? :? :? . DECK: 0: D:st REAR..., ..,.... O.00:ft SEWER SERVICE..:FED
� OCCUPANT LOAD------------ GAR.: tl: 312:sf RECEIVED.:04/10/% �
� : 0: 0, 0: 0: TOTL• 0: 312:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:? '
�_«r.---__ -_..-_ _�_.-__---. __-_ - _--__ ------ --------- _�-___ --------------__ __--------------------•-----=
�..........__cm_....�__.._..._._......_�_..._..�c..,Sm___�•''o__a_.-�'»--.:•_•'_____._...___'cc»:c_.,........_ ...__.__.____".,....»_aoc�e__.........._.._.______......._..__...._ c:oc�a �
� FUEL TYPES.:? ? FANS.....,..,.: Q BOILERS/COMPRESSORS � WATER CLOSETS......: 0 URINALS........: 0 TOTAL FEES $ 138.15
� FIPING.: 0 ft HOOD..........: 0 0-3 HP......: 0 BATH tUBS...,......: 0 DRINKING fOUNT.: 0 ;
f <100K..: 0 DUCT WORK..,..: 0 3-15 HP.,...: 0 � SHOWERS............: 0 SUMPS..........: 0 j
� 6AS HWT..,.: 0 WOOD STOVES,..: 0 15-30 HP....: 0 � LAVATORIES...,.....: 0 VAC BREAKERS...: 0 �
I CONV BURNER: 0 FURN>100K....,. 0 30-5D HP..... 0 � SINKS............... D DRAIMS.......... 0 �
j BBQ......,.. 0 MISC........... 0 5+ HP....,.,. 0 � DISH WASHERS........ 0 LAWN SPRINKIERS: 0 +
� GAS DRYER..: 0 AIR NANDLING UNITS FUEL iANK5--------- ELEC WTR NEATERS...: 0 OTHER FIXTURES.: 0 !
I RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUMD: 0 LAUN WSNR OUTLTS...: 0
i GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
t_----______..---���:_-=_=__:.�_��:--==__=��.�_�w:�����_-�=__�_�-,_���__���=��_�_�=_-�4_���_�-=-_��-���:-.�=-::m:��w--:.�_Y�-�:-,��=:�:�_:__��..==__=__=��_R����.��:.-::�_�w���:��==_���__���
PERMITS EXPIRE 180 DAYS AfTER ISSUAiItE IF MO itORK IS STARTED. RESIDENTIAL AND 6RADIM6 PERMIT5 EXPIRE ONE YEAR AfTER DAiE OF ISSUANCE.
I CERTIFY THAT TNE IMFORMATIOR fURMISNED BY ME IS TRUE AMD CORRECT TO THE BEST OF MY KNOkLED6E AND TNE APPLICABLE fITY Of FEDERAL YAY REQUIREMENTS MILL BE MET.
` �.__ '
0l�,YER OR RGENT _.. �'� -..:. �� � _ DATE �-�..-%�`�".��'
y.ur _ _;__ . . ;,.0 _. _,._....__._..._.._
__...........�.. ._ ...._._. _.___-
r
�rtlE C�C1SyV
�� G City of Federal Way
•
� ��� . � ,___ APPLICATION FOR BUILDING PERMIT
- .. a
.�.,'�`<�1v +...�.. ','�"'"� i
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, }" � ?9 �Q(x�
PLEASE PR/NT APPL/CAT/ON #:j�C-���'"" ���C�
SITE LOCATION ` - " Address
Tenant (if known) Lot N ssessor's Tax tl
� > � C�S��� �CG�7-- ��'��
Building Owner Name Address r
''x� � �r� L,��' (� =-�� �G��,� ��,�.-�/�i/�� ��% ,
City �- � State Zip GS�IG�� Phone ,-�n_ ��'Q
Nature of Work
APPLICANT
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUILDING CONTRACTOR'''
Company Name
�
���' �� U 5 - �����
x Address
! �j�y . � ' L/r� s CJ �� �
City , �.,cl f'',"�t- ' /�i-�-r State f� Zip �✓CX �
Contact Person Phone Fax
� � ��"" �� - L �� - � ���-77�
Contractor's # card must be presented) Expiration Date Verified O Yes ❑ No
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
�GAL DESCRIPTIO ' �
G� �- .3�
�._
Please Comp/ete Reverse Side .
. CDOa92 IRev 4/931
STRUCTURE ' Existing Use Proposed Use
Permit includes: ❑ Building ❑ Plumbing O Mechanicai ❑ Other
Type of Work: � Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
�,� ❑ Commercial ❑ Addition Garage ❑ Shed ❑ Other
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 ;,r�sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availa i [s.7 rr� Project Valuation S
Zoning Lot Size Existing Bldg Valuation $
L�NDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Neaters Sumps
Lavatories Washing Machine Drains Totat Fixture Count
MECHAIVICAL UNIT COUNT MECHANICAL VALUATION ONLY $
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 1 5-30 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 Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit Count
DISCLAIMER: I certify under penalty of perjury that the information furnished by me�s 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 harmfess the City of Federal Way as to any claim(including costs,expenses,
and attornays'fees incurred in investigation and defense of such claiml,which may be made by any person,including the undersigned,and filed against the City of Federai Way,
but only where su:;h�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.
__.-----�..
�wnerlAg'ent:_� y� D � '/� ���
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