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96-101358 i - _ � 9�,�013s8 y <:;.: �, � . � '1" lJf i� i�.�.J��� f^, �t.. .�� � i ��� i� �.r t..i �,�� f.a. _i�,�`���. �1.7 � I..i L_� ' f� ��..�_��� ��:�� �=i r�t ��a�,� �a�u t n "�°;'��,�� ��:. �.�:q��:�:. #'�h�,;:�; �G�::���Cnr:,r","��,�h�r��`;!IG;, ,,.hC' .z s5u���: o� �� �� I�- / � -.��er�al Way, WA �8�0:� BuilCir�g Tr�ar�ert,i�n Ftequc�st� 6r�1 41�U �Y: F�C2 ��-�oaa �x�:cR��: ��/��./�� ' ..`I7R�'��:�(:l'�2 7 121'Ei S�L �iW !�? .. : 17�#33C�._G17'fJ �'���'C)J�C7� DESCR:[P�I�IC)i�I:RES ALT - CONSiRUC1I0N OF A 100 SQFT PORCN COVER. ;_. O�INER ::��-=-_��_�_�-�..-_-��=�:_-�-._�.-=._..==_:.m.-:-�:=��:r=�.-:.:��_:_��:� CONTRACTOR =�-____==_=���_„=,_�-w�-==��������.�_::,���_=T� LENDER -r===_______________________����-w-���::.-�_��-; . fLOYD PRZYBYLSKI � 06JNER IS CONTRflCTOR � i � 30127 12TN PL SW � FfDERAL WAY WA 98023 J . � � � i3�-3721 � ..........._ � � � � .. , __. :,: .' , -- -- - - - -- ._.__... _.._... ._ ... .. . . ... .... .�_ - ,. __ ---_r___. .___ -..._.-__...___-...,__._...___ ---=-.-_.-. .-_�___...._:_-__.__-..._.....� _._.. ._ .___________......� �*; COiIiRACTORSy l�IEASE U5E LOCATIOM CODE 1732 NHEN REPO(t�IlIG SALES TAX FOR PAOJfCT5 WITHIN THE CITY OF fEDERAI ilAY. TAX RATE = 8.2� �_* : _:.�.:.: .... .::--_ :�---•��.-__.._.. �._�.____.__-___-__ .__.. ---._-.�_.__.__._.�__...�..._,.-_..._.____.__-__--_��_..-��-=-_--__-�-_--._.._M__�..._._�.._._____-_--_-.._�:___ ..__.: ._._ .__._._...----.....___..� .__�._: ___._=___ _....____ ___ .._ _ _..__._.___._ _ _ __ _ _� _ __ .__.__ �__..___. __. � ; L�D?:X M€C';; PLM?: FLR--EXIST--PROP--- D61ELLtNG UNIfS: 1 � � � l'OMP PLAN.....,...:SFHD � FEES; f ; iYPE OF WORK:flDD USE:RES 1ST.; 0; �:sf SIORIES...,...,; l�� ��� REQUiRED PflRKING..: 2 SPRINKLERS?......:? � PLAN CHECK FEE $ 14.30 $ �fNSUS CATEGORY.....:434 2ND.: 0: O:Sf �EIGH� ... .: O.JO ft � HAIARD C'Py5 .:? ` BUIIDING PERMIT....� $ 22.00 � . OCCUPANCY GROUP---------- 3RD.: n: O:sf VA'lUArTON--�------- � RE4U':RED SEt9ACCS------- �IRE �IOW....: Q gp�a � SBCC SURCHAR6E.....� $ 4.50 � : :R3 :? :? :? : 4INR: 0: 100:sf EXIST..$: 44000 ` FRONT....., ..,� ?!�.OQ ft � � t TYPE OF CONSTRUCTION----- BSMT: �` O:sf PROP.,.$: 500 � SIDE..........: S.OQ #t WRTEP ;ERUICE..:FED � € '� ( :5N :? :? :? : DECK: 0: O:sf '. REAR........,.: 5.��:f' S��d�R SERVI�E..:SEP � � I ; OCCUPANT LOAD------------ GAR.: �l: O:sf RECEIV��.:JS,�11/qd �' � � ( : 0: 0: 0: 0: f�JTI; 0 lOQ sf � IMPERV SURFACE: 2386 sf SENSITIVE AREflS?.:N � � �����-:-_�_:.,:�_,�-;�-��=4�__:-�:.___�,�,�r �- ._ __.______,:�. ..:_. ... ._...._.... .. ..z .:��-,�=-=_==__-;-�---:->;-���-_�.:�_-_�__--_-_w�-�-�,-��-� � , s FUEL TYPES.:? ? FANS.......,... Q BO:LERS/COMPRESSORS �Y WATER CLOSETS......: 0 URINALS.. ....: 0 � TOTAL FEES $ 40.80 � � GAS PIPING.: 0 ft HOOD........,.: 0 0-3 HP......: 0 ( BATN TUBS..........: 0 DRINKING FOUNT.; 0 I I N<;QOK... 0 DUCT WORK...... 0 3-15 HP...... 0 � SNOWERS............. 0 5UI1PS........... 0 � f � un� MIVT....; 0 WOOD 510VES...: 0 15-30 HP....: 0 � LAVATORIES.........: 0 UAC BREflKERS...: 0 � ( j CONU BURNER: 0 FURN>100K,..... 0 30-50 HP..... 0 ; 5INKS............... 0 DRAINS.........: 0 � j � BBQ......... 0 MISC........... 0 5+ NP,..,.... 0 DISH WASHfRS........ 0 LRWN SPRINCLERS: 0 �' � GAS �RYER..: 0 AIR HANDLING UNITS FUEL TANKS-------- ELEC WTk HEATERS...: 0 OTHER fIXTURES.: 0 � � '`` S RANGE......: 0 <-10,000 CFM: 0 ABOVE GROUND: 0 LAUN IJSHR OUILTS...: 0 I t ; GAS LOGS...: 0 > 10,000 CFM: D UNDERGROUND.: 0 � � } - - - _,.._ _ __3._ - - - -` " �_._._..---. ._._�.__. _......_. .. ..__..._�.._,..----�..___.._�.__._._......... _ ._._�—... .......... ,.__�._.._,....---...___. .._..__... ____,�___-�w:.._.-_.__._-_._.._�..____._________.______.._._...s��_------._.� PfRMITS EXPIRE IHO DAYS RfTER ISS!lRMCE IF NO NORK IS 5TARTED. RESIDEMTIAL AMD 6RADIM6 PERMIT5 EffPIRti ONE YERR AF1ER DATE OF ISSUAMCE. T CERTIFY fkAf �Hf O�t?fATION ` S E ME IS iRUE AMD CORRECT TO TNE BESf OF MY CIi01iLED6E ARD THE APPIICABIf CI11f Of FEDERAL YAY REQUIREMEMT5 AILL BE MET. OWNER OR AGE T �����,�J , � r, � �� _ � �� �,6� ��/.5(����l� N �'�,�,,`'.- �„��''tt��........: � .. ; _ ._ _ _-----�- DATE . .._. ./.�Z t'_�'`,f � ; _._._._._ ......_._. ..__._.. . __- � � % � ; �„.- - . d,,,�. G City of Federal Way • � �� - -� �~�;"A��.ICATION FOR BUILDING PERMIT -"��:::.�---�,�.. ; ��,`� 17 199'� �_� �- PLEASE PR/NT � �'.5 APPL/CAT/ON #: ��C I�� [ ��( �-% SITE LOCATION `��:lit�'���' ` � Address J � _, _, , . ,,. °. <r _' �: ' . - ', Tenant (if known) Lot # Assessor's Tax # � � Building Owner Name Address , " .�' _ o�r , . r `,- J, %. . . � , City �r^ '�`�� :�i' ,'��, State � ��'� Zip � "' •�' � Phone ? •- , Nature of Work lo � ,.. � ' APPLICANT , Name (F,M,L) ^ �. - . . Address , , City - - .. . ' State �� .� Z�P Contact Person Day Phone - Other Phone Fax f ; BUILDING'CONTRACTOR Company Name Address City State Zip - Contact Person _ Phone Fax Contractor's # (card m�st be presented) Expiration Date Verified ❑ Yes � No ARCHITECT Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION I ����I���� �' . .1��;��"�`�. �t . � � , �- �� � P/ease Comp/ete Reverse Side - CD0492 IRev 4/93) - S'PRUCTUR� isting Use _ ;.��.�""""-� � r._;� o roposed Use � ' , � '�y__.._... X,.0 �.�. Permit includes: y� Building ❑ Plumbing ❑ Mechanical ❑ Other _ Type of Work: �l Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck ❑ Commercial „QII Addition ❑ Garage ❑ Shed ❑ Other Enter 1 st Floor sq ft 2nd Floor sq ft y3,f.-d�Fi��sq ft Existing Floor Area sq ft Area Basement sq ft Decks � `-sq ft- �y 2"� u�aFng (� � sq,ft Proposed Total Area sq ft Water Avai!ability S n-Site Septic'System AvailaLility Project Valuat�on $ "��� �, Zonin9 ������ \ Lot Size * ' �--------- � 1`.� f . ,��' Existing Bldg Valuation $ �� C7LL - ��,Q kGF�i L�NDER Name Address City State Zip MECHAIVICAL CONTRACTOR' Contractor Name Address City State,/� Zip Contact P/hone Fax License # Expiration Date Verified ❑ Yes ❑ No PLUMBING CONTRACTOR ; Contractor Name � Address r City State Z�p Contact j Phone Fax /� License # Expiration Date Verified ❑ Yes ❑ No �/ PLUMBING FIXTURE COUNT � Water Closets Sink Urinals Lawn Sprinklers Bathtubs D� h Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains Total'Ficture'Count MEGHANICAL UNIT CO MECHAIVICAL 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 Conv Burn Duct Work 0-3 Tons Underground BBQ�S Wood Stoves 3-1 5 Tons Total 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 oniy where such clpim arises ouk o�the�efi��of the City,including its officers and employees,upon the accuracy of the information supplied to the City as a part of this application. 1 % - ��/ C, � .✓ f ` � Owner/Agent: ���, ��� �L�L � Date: � �l� � -�� �'r� /j � � - _--�-�