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�'e�2ra1 Way, WA �£3f]U:� Buildi.ng Inspect,ion ftequests 661-4140 BY: �C
F6�.--4QClQ EXPIRF�S: Q9/�0/9�5
ADDR�.�'sS: 2�39 S 2847N PL . �
N0. : 422220-0�.6U
PRfJJECT D�SC�RIf�I'IUN:FIRf REPAIR - RECONSTRUCTION Of BURNED HOUSE. FOUNDATION AND ONE WALL NAS LEFT STANDING.
= OWNER _ __________________.___________.._.__._______�.� CONTRACTOR -----______________--------r___________---__....r� LENDER ====_________=___==__==__-_--=====-=__-__=__-_=�
_____..______._�.____________.____------__.._....__...__._._.___ _____________________.__._-----.----_______._____
DARLENE PETERSON QURLITY NORTHMEST CONSTRUCTION FLEET MORTGAGE �
2339 S 284TH PL 32102 5TH AVE SW PO BOX 1169 �
� fEDERAI WAY WA 98003 FEDERAL WAY WA 48023 MIIWAUKEE WI 53201 i
838-11�8 I
QURLINC141DR I
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.....___-.----____._____...___.._......__.....�_.__..._.....�......__.__._...______..__._.._________________..____..__________._____._.____._____.__._.___--.----�_=_==_=_=__=-==_====-___..-r,=_���_=�-_==_=_====_====�_�d
i=� COMTRACTOR5, NLkASE USE LOCATIOM CODE 1732 ItHEN REPdRTIl16 SALES TAX FOR PROJECTS MITHIM THE CITY Of FEDERAI MAY. TAX RATE = 8.2� *�x
------------------___...___�..___.__ s:W.� ...:w.._ ___...____.�__._.�________-----.---......_::.,...._....._._..._.__..._..__._______._...__...__�___--------------------------------______..______-----------------------
_..___----____...______._�--.--.......___s �.._..._.:�-,._____..__...__._....-------_._.____._. . ......... _.._._.._______._...�._,__._____...__----------------------------- --------____---_____--------_------________
BLD?:X MEC?:X PLI1?:X FLR--EXIS?--PROP--- DWELLING UNITS: 1 F COMP PLAN.........:? � FEES: �
TYPE OF WORK:REP USE:RES 1ST.: Q: 1146:sf STORIES........: 1 REQUIRED PRRKING..: 0 SPRINKLERS?...,.,:? PLAN CNECK fEE $ 374.13
CENSUS CATEGORY.....:101 2ND.: 0: O:sf NEIGHT.....: 0.00 ft Nfl1ARD CLASS..,:? � PUB WKS PLCK(SF).,93 $ 40.00 !
OCCUPANCY GROUP---------- 3RD.: 0: O:st VALUATION---------- REQUIRED SEIBACKS------- �IRE FCOW....: 0 gp� fINAI PLAN CHECK...� $ 0.00 ( �
:R3 :U1 :? :? : OTNR: 0: O:st EX?ST,.$: 0 FRONT.....,...: 0.00 ft BUILDING PERMIT....� $ 576.50 (
TYPE OF CONSTRUCTION----- BSMT; 0: O:sf PROP.. .$: 954'Jb SIDE..........: O.QO ft WATER SER'lICE..:FED � SBCC SURCHARGE.....# $ 4.50 �
:5N :5N :? :? : DECK: D: �;sf REAR..........: O.00:ft SENER SERVICE..:FED � PLUMBING FIXT....93� $ 63,00 �
OtCUPANT LOAD------------ GAR.: 0: 341:sf RfCE:VE�..02J28/96 ( Methanical Permit� $ 54.00 (
. 0: 0: 0: 0: TOTL: 0: 1543:sf � IMPERV SURFRCE: 0 sf SENSITIVE AREAS?.:? � ;�
_-����::-w.::;-��w_��_�__�_�����_-_�_s�,�:_::_�=�,::=�:_�--=_-::-�..:�::::.�__.�::��._�.��_�::-=�=_���==_:-��==_���___======_=-��_��_�_����::»__W::��_�� ,
.........: Z BOILERS/COMPRESSORS � WATER CLOSETS......: 2 URINRLS........: 0 TOTAL FEES S 1112.73 � �
� FUEL TYPES.:GAS ? FANS. �
GRS PIPING.: 60 ft HOOD..........: 1 0-3 HP......: 0 I BATH TUBS..........: 1 DRINKIN6 FOUNT.: 0
FURN<100K... 1 DUCT NORK...... 1 3-15 HP...... 0 � SHOWERS............. 1 SUMPS........... 0 �
� GAS HWT....: 1 WOOD STOVES...: 0 15-30 HP....: 0 j LAVATORIES.........: 2 VAC BREAKERS...: 0 � �
CONV BURNER: 0 FURN>100K...... 0 30-50 HP..... 0 SINKS............... 1 DRRINS.......... 0 �
BBQ........: 0 MISC..........: 0 5+ HP.......: 0 DISN WASHERS.......: 1 LA�IN SPRINKLERS: 0 �
GAS DRYER.,: 0 AIR NRNDLING UNITS FUEL TANKS--------- ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RAN6E......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0 � LAUN WSHR OUTLTS...: 1 � �
s GAS LOGS...: 1 > l0,OD0 CFM: Q UNDERGROUND.: 0 � ` �
�_.._-----.____---___._._..___.....__._�._..__.__,._....._..._._...___,......�_.y_�___...._..,___._._-------______..,,.._..�._._._......�.._...._..._..._�._..__.._____..__.__._�_.._...__.-----------__J._---------------.--_...._,.___________________--
_.__._._----,._________..__...__._._._._�......_..___..__._..._._..._._._._.__..._.._�_..._..__.__...____.___...--.-.---._.....__.�.....__....._..._.____.._.______,_..___._.___._.______._.._----_....._.__________.___---______._______.___..__________________..�
PERMITS EXPIRE 180 DAYS AFTER ISSUAMCE IF MO MOR[ IS STARTED. RE5IDEMTIAL AND 6RADIN6 PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUAMCE.
I CERTIFY TNAT THE ORMRTI011 fURNISNED TRUE D CORRECT TO THE BEST OF MY KMOYLED6E RMD TNE APPLICABLE CITY OF FEDERAL MAY REQUIREMENTS MIII BE MET.
�. , � " .
OANER OR AGENT ... ._ ����...._..._..__'-�. __�._.....:.:�'..`?:''_ '` . _ DATE _�:I.�,.� �.lJ
�
� ;.,
FI�E COPY ��y 6,,a � 9 a
�� G . City of Federal Way
� �� APPLICATION FOR BUILDING PERMIT
;'LEASE PR/NT APPLICAT/ON #: F��
SITE LOCATION ' Address 2 S Z�u 1�h �,
� `
Tenant (if kno�n�n) Lot # Assessor's Tax #
� � �2Z � --o��0 -c� 6
Building Owner Name Address
��V
City State Zip Phone
Nature of Work � �f � "�" � P
APPLICANT
Name (F,M,L)
�� �f . �. �2 -
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUILDING CONTRACTOR '
Company Name
`-f- .� �n s�
Address , n ,
�� U � < �--C./'
City C V� Ge - 3 State � Zip �
Contac Person �_ > . Phone Fax
` � ��cf'-i!C��
Contractor's # (card must be presente Expirati n Date Verified ❑ Yes ❑ No
� ���
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
i LEGAL DESCRIPTION I l q) / � )
I f�--C�� � �i� !�`Ck C.0( �-/�.Q.J d C/ /��J Y��'f /.v�" �
P/ease Complete Reverse Side
. CD0492 1Rev 4/931
STRUCTURE ting Use �.�5 �� _�` posed Use s' �� � . • �
Permit includes: '� Building [�Piumbing [� Mechanical ❑ Other
Type of Work: �Residential ❑ New ❑ Remodel ❑ Number of Units_ ❑ Deck
❑ Commercial ❑ Addition ❑ Garage O Shed Other �Y
� 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 Total Area sq ft
Water Availability � Sewer Availability On-Siie Septic System Availability ❑ Project Valuation $
Zo�ing Lot Size 7 ��jZ Existing Bldg Valuation $ ��� `�
�
L�NDER
Name �r��� � � � .� � � A ress
� � �� o � f� � r 11 � Y
\ City Y Y t ' f.'X C e State�( �, G c� 3 1 � Z�p .� � �
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 ITXTURE COUNT
Water Closets ' Sinks , Urinals Lawn Sprinklers
Bathtubs Dish Washers / Drinking Fountains Other
\ Showers Electric Water Heaters �f Sumps
Lavatories Washing Machine 1 Drains Totai Fixture Count
MECHANICAL UIVIT COUNT MECHANICAL VALUATION ONLY $
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 Boilers Above Ground il
Conv Burner Duct Work ,S 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Tota1 Unit Count
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is 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 harmless the City of Federal Way as to any claim(including costs,expenses,
and attorneys'fees incurred in investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,
but only where such aim arises out of the reli e of tt�e City,including its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application. �
r �
�wnerlAgent: __,__ Date: �/ — ��— ��