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Feraeral Way , WR ��3Ui�:3 }3uilcai.ny .Ir���ect:�r�r� Rec�u�sts �d1.-4�.�«0 F3Y. FC2
E6Ea1-�o0QC7 EX(�IRCS: 0.5 i'�3/97
ADDRE55:1660 � 3�:3�ZD ST U�ti. �-,: � �
N0. : 79782C1-OU81
PRL�J E��T DC 5Cf�T P T ION:MOB HOME - INSTALLATI4N Of 878 SQFT MH. �
-___-_ �_ --___- -_ _ ___�_-- CONiRACTOR �_���_--==�_-�_�_��====��a�w��-,__:�_-���_��-� LENDER =____=_�,�=-____=====�R-�«x__����_�-�==������1
f= WNER =-"�---------- ---=��_���-,-��--�______-_,_-_�___ _T..
� TIFfANY DURGAN MAGNUM CONSTRUCTION INC i
� 1660 S 333RD STi�2�1 � 4623 FOXTRAIL DR NE �
� FEDERAL WAY WA 980Q3 ? 01YMPIA WA 48516 ;
� � �
i 838-9608 � 3b0-459-2172 360-951-6233 �
� MRGNUCI044K1
-�-��-���..____-�_--_.�__-�-----------==--=r.-==»��--._�_::-���...-:____.____m_.____----------=�::���___��-,»=-:�_�-���-==--_=�__-�---=-���r:�-:..��_--_��_-��_z=.._.W_==-----_-_��,_.._�__�_��
i*� CONTRAfTORS, PLEASE USE LOCATION CODE 1732 NHEiI REPORTIN6 SALES TAX FOR PROJECTS flIiNIN THE CITY Of FEDERAL NAIf. TAX RATE = 8.2� :s:
r�,���������-,-_�__,�-_�,�--�=-__�==�����,���::�����---�=���-v__�::_-:-:___-_���_-_�_=_�_�==-»>_���_��_:������==_==_______���==_��-_��_,-���--w.������«�:.����_�_��_���r;��::�===—=�
J BLD?:X MEC?: PLM?: FLR--EXIST--PROR--- DWE!LING UNITS: 1 Q COMP PLAN.........:M�F FEES:
� TYPE Of WORK:NEW USE:RES 1ST.: �: 878:sf STORIES........� 1 p REQUIRED PARKING..: 2 SPRINKLERS?.....,:? PLAN CHECK FEE 3 40.95 �
� CENSUS CATEGORY.,...:112 2ND.: 0: O:sf HEIGNT.....: 0.00 ft � NAiARD CLASS...:? BUILDIMG PERMIT....� $ 63.00 9
� OCCUPANCY GROUD---------- 3RD.: 0; O:sF VALUATIUN---------- M REQUIRED SETBACKS----�-- �IRE FLOW....: 0 gp� � SBCC SURCHflRGE.....� $ 4,50 �
:R3 :? :? :? ; OTNR: 0: O:sf EXIST..$: 0 i FRONi,..,,,...: 6.00 ft , ; FINAI PLflN CHECK...$ $ 0.00 �
�
� TYPE OF CONSTRUCTION----- BSMT: 0: O:Sf PROP...$: 38b3 � SIDE..........: 10.00 't E�ATE° SERVICE..:FED � ;
� :5N :? :? :? : CECY,: D: O:sf : � REAR.....,,...: IO.O�:ft 5EWER SERV?C�,,:fED ,
�
� �
I OCCUPANT LOAD------------ GAR.: 0: Q:sf '' RECEIVED:;05/20/96 -, �
� : 0: 0: 0: 0: TOTL: 0: 878�sf � ` IMPERU SURFACE: 0 sf SENSITIVE AREAS?.:N
t_----_____..__.._ __........__-__--_ ____�_�z��_.�a�R=�.:�_.M,�,-::_-_�:::.�::��_:-::::::��_,-���::��______==_=__��_.��..----=--- - - -
____ ..�_.__,_..,..._�..._�. ___=-==--•-_�-� f
�___.._...�.._..___.._...---------..____.___.._ _�.. __.._.__.. ._.__
� FUEL TYPES.:? ? fANS......,...� 0 BOIIERSJCUl1PRESSORS � WATER CLOSETS.....,: 0 URINALS,.......; 0 TOTAL FEES $ 108.45 I
� GAS PIPIH6.: 0 ft HUOD..........: 0 0-3 HP......: 0 � BATN TUBS..........: 0 DRINKING FOUNT.: 0
� FURN<100K..: 0 DUCT WORK.....: 0 3-15 NP.....: 0 . SHOWERS............: 0 SUMPS..........: 0
iS HWT....: 0 WOOD STOVES...: 0 15-30 NP....: 0 � LAVATORIES.........: 0 VAC BREAKERS...: 0
, �JNV BURNER: 0 FURN>100K...... 0 30-50 HP..... 0 � SINKS............... 0 DRAINS.......... 0 �
� BBQ........: 0 MISC..........: 0 5t NP.......: 0 DISH WASHERS.,.....: 0 LAWN SPRINKLERS: 0 �
� GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS--------- ELEC WTR HEflTEftS...: 0 OTHER FIXTURES.: 0 �
� RANGE......: 0 <-10,000 CFM: 0 ABOVE 6ROUND: 0 � LAUN WSNR OUTLTS...: 0 �
� GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
� _'--__-�x:c�rcncr'.�:--_=_.s^::�roccco�c�cr:_::co_::accax�sca�a:-�r_:�x-r- ccacc_�orc_=_m.._-=.�..-ca-x,-^�c:-ar=c-=�_r::c_=asc�-^accp cxcea___=='_ ax�:�cccccxxr.�c:cwcc-cc::r_.:-c:ccc�.:�._:_a�c_��
PERMITS EXRIRf 180 DAYS AfTER ISSUAilCE IF MO NORK IS STARTED. RESIDfNTIAI AMD 6RADIN6 PERMIT5 ERPIRE OME YEAR AFTER DATE Of ISSUANCE.
I CERTIFY THAT T ON FURMISHED BY M TRUE AMD CORRECT TO THE BEST OF MY KMOMLED6E AMD TNE APPLICA�LE CITY OF FEDERAL YAY REQUIREMEMiS ilIll BE MET.
�
OWNER OR AGENT G,i r,i-..-. _ _ _......_.. _ . ._ ._.__._.. .__........___ . __�'3�_,l. .
_ . ..___. ..__ .._. �
..... .. .... ... DATE .._._ _. .__...... _...�
FiLE COPY �/ Y S L � a'�g.�
�„�. G City of Federal Way
• �
� -���� APPLICATION FOR BUILDING PERMIT
,- ., :�,
1 x
` 7 >
PLEASE PR/NT =� ��� '� � � � �
' APPL/CAT/ON #: �� L � , i' L,� � c
SITE LOCATION _ Address � -
� � / �(;c` � �'3�c�'iJ � —
Tenant !if known) BUfLD'Yt�iG DE�`s�
Lot # Assessor's Tax #
�.1 / i�v - , - /CG/ -� � %�/"</n t�2'i-,'Ci?�� �`/ �/�'� �zU'., �;c=F'�
� Building Owner Name Address �'^
`.S/�/s'f7L+� /,/'�L't� Ji1�?c ifs ��s<�
City �;-�����,y� ��.�j State u�n Zip �j�. C2�_y' Phone _ c.�-� �_ �' �
��._ �� . ��:
Nature of Work c'�j� L� l / �, ��� ;�.: '-�'.:�i ��� �,�L� h ? !�
L,"� �SG�!T j/.</�� Li.' //G.�7�'- r i_ L��' /;" �l ,ryf:.: .�/ l� ��/C- �S, 'IL.L' -�� ,
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C, �.�'� � „ / ^ ����i
APPLICANT ' l� 77 /�G. X �� -— � 7-� /~L L-L_=7C�Y:.s>
� �c� �lyc 7 /�'z f-� - . �,�r ,�,.ls'e����,
Name (F�v1;L�_-�
%"!�� `c;/� "L.�
Address
1�%�S' �.�I: -�iL /<<- i��
City t�:� V���j/i State L c-.�=� Zip �-;1�:�%�
Contacl�Person Day Phone Other Phone Fax
/�.r
}i�� ij/�Jc :fGc: `�S� - l/ / �- J,S�—SyZ�?'i
BUILDING CONTRACTOR
Company Name
�/
�i'i�"G�G�G��. _ �G-S,',c d:C✓���.
Address�
�� L.� �G;t'?"�'-%C ,�"' ��c-=
.,
�' CitY (�L y �,,�'/ii State ���G Zip ;�S'i�
Contact Person.—� Phone Fax
� y L-t�/'�%��_�� Lt' `�5'� -c//�'< _s�- ys�i c. / /L_
Contract ['s #�card m�st be prese ted) Expiratio{� Da e Verified �''Yes ❑ No
/��,�C-/�G�G� ��.� s i �'"
ARCHIT�CT '' �� `/�
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION ���,;���'����i �lYµ��'
� � AE
P/ease Comp/ete Reverse Side
- CD0492 IRev 4/93)
�'%�`�jy c�
'STRUCTURE � ing Use �' ' / __"; ,_ ,/ �-. iosed Use��✓L=�i�G.�/G�L-'%�t�1�E—� /--.,:��
Permit includes: Q'" Building ❑ Plumbing ❑ Mechanical ❑ Other
` Type of Work: ❑ Residential � New ❑ Remodel ❑ Number of Units ❑ Deck
� ❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
1 Enter 1 st Floor�sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
i
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability [D� Sewer Availability O On-Site Septic System Availability ❑ Project Valuation S
Zoning ;�'�;%._ �'��<<� i �. , 1 Lot Size ��� x ��� Existing Bldg Valuation $
LENDER
Name Address
,
City State Zip
MECHA;NICAL'-CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR'.
Contractor Name Address
City State Z�p
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 Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHAlVICAL`UNIT COUNT MECHANICAL VALUATION ONLY $
Fuel Type (electric/other) Gas D.ryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Ra�ge Air Handling > = 10,000 CFM 30-50 Tons
Fum <100K BTUs �as Log Unit Heater 50+ Tons
Furn >100 BTUs `f Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Conv Burner Duct Work 0-3 Tons Underground
BBO�s Wood Stoves 3-15 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�nvestigation 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 c18im arises ut of the reliance o th�i ,including its officers and employees,upon the accuracy of the intormation supplied to the City as a part of this
application. ' �/>
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,�//,�' <-�" /
�OwnerlAgent: �� G� ����'!� Date: �� Z c �C-