97-102126 �- CTTY OF FEDERAL WAY PERMIT N0: BLD97-0361
3�530 F i rs� W a y S o u t h .,I�'�„�� .��,....,��.�,. ���? �'�,.�'�I�''�'.� ��� �S 5 U E D. 06/18/97
Federal Way, WA 98003 Building Inspection Requests 661�4140 BY: �'C2
I 661-4000 EXPIRES: 12/15f97 �
IPUDRESS:103 MIRRQR LAKE pARK G�7� ��� /a �
NO. : �721Q4-90Q3
PROJECT DESCRTPTTON:REMODEL INTERIOR
p= OiiHER �_�_��____________________________________====5====�= CONTRACTOR ===_=_==___====_===_===_________=______-= LENDER ==��a�a��^�����_=________________�_____________�
� BETNEL CHRISTIAN CENTER OWNER IS CONTRACTOR
� 414 SM 312TH STREET �
� FEDERAL NAY WA 98003
-"1-2486 f
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*=x CONTRACTORS, PLEASE USE LOCATI011 CODE 1732 NNEM NEPORTII� SALES TAX F�t PROJECTS MITHIN TNE CITr OF FfDERAL YAr. TAX RATE = 8.2� i*�
F=========�aa=���=��z�=��=____________________________________________________T=====_______===____==____=____________________=_=__=_-__==__===_=__________________=_______=====i
� BLD?:X MEC?:? PLM?:? FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAH.........:HDA �EES: �
� TYPE OF HORK:ALT USE:RES 1ST.: 0: O:sf STORIES........: 0 REQUIRED PARKING..: 0 SPRINKLEAS?......:? BUILDING PERMIT....� $ 22.00 �
� CENSUS CATEGORY..,..:434 2ND.: 0: O:sf HEIGHT.....: 0.00 ft NAIARD CLASS...:? SBCC SURCHAR6E.....# $ 4.50 I
� OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION---------- REQUIRED SETBACKS------- fIRE FLDW....: 0 gpw
:? :? :? :? . OTHR; 0: O:sf EXIST..3: 0 FRONT.......... 0.00 ft
� TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP.,.$; 500 SIDE..........: 0.00 ft WATER SERVICE..:?
� • �� •� •� • DECK: 0: O:sf REAR..........: O.00:ft SEWER SERVICE..:?
� .. .. .. .
OCCUPANI LOAD------------ 6AR.: 0: O:sf RECEIVED.:Ob/18/91
i : 0: 0: 0: 0. tOTI: 0: D:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:? �
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! FUEL TYPES.:? ? FANS..,.......: 0 BOILERS/COMPRESSORS WATER CLOSETS......: 0 URINALS........: 0 TOTAL FEES $ 26.50 �
� ��S PIPING.: 0 ft HOOD..........: 0 0-3 HP......: 0 BATH TUBS....:.....: 0 DRINKING FOUNT.: 0 �
N<100K... 0 DUCT NORK...... 0 3-15 HP...... 0 SHOWERS............. 0 SUMPS........... 0 �
+ �HS NkT..,.: 0 WOOD STOVES...: 0 15-30 HP.,..: 0 LAVATORIES.........: 0 VAC BREAKERS...: 0 �
� CONV BURNER: 0 FURN>100K...... 0 30-50 HP..... 0 SINKS............... 0 DRAINS.......... 0
� BBQ......... 0 MISC........... 0 5+ HP........ 0 DISN NASHERS........ 0 LAWN SPRINKLERS: 0
� GAS DRYER..: 0 RIR HANDLING UNITS FUEL TANKS--------- ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
� RANGE......: 0 <=10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CfM: 0 UNDERGROUND.: 0 ,
-=------- -- ------------ - ------------------ --=--------------- ----- ---------------------- ------ ------------- ---- ------ --
--------------------------------------------------------------=----------------------------------�_---_----------_----____-----_�__==_==__=__________=_-=_______=_
PERMITS EXVIRE 180 DAYS AFTER ISSUANCE IF 110 MOR� IS STARTED. RESIDERTIAL AND 6RADI1� PERMITS EXPIRE OME YEAR AfTER DATE OF ISSUANCE.
I CERTIFY TI�IT THE TI011 FURMISNED BY ME IS TRUE AlID CORRECT TO TNE BEST OF MY CNOULED6E AND THE AAPLICA&E CITY OF FE�RAL IIAY RfQUIREMEIITS YIII BE MET.
�
OWNER OR AGENT __ _L�w='�____�_C l��'_ ________________ DATE __�I� �_1 cl�
FtLE COPY
M �'
BUII.DING DN7SION
� �� {�,�\ 33530 First Way South
-�� � \�� Federal Way,WA 98003
������C;_,y (206)661-4000
Fax(206)661-4129c
-,ye�' 9 P" `��f�ra
AP'PLICATION FOR .�U.IL��,���PERMIT
PLEASE PR/NT APPLICATION#
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ress
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Tenant (if known) � �� Lot#
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Building Owner's Name Address � �
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Nature of Work , S � �d C („ lr�� � S
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Company Name
Address
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State Z�
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARG'�FfT.E.CT
Name
Address
Ci
State Z�
Contact Person Phone Fax
LEGAL DESCRIPTION
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�..�i��..... 9 roposed Use
Permit includes: p Buildin ❑ Plumbin ❑ Mechanical ❑ Other
Type of Work: `�Bf Residentiai ❑ New �Remodel ❑ Number of Units_ ❑ Deck
❑ Commercial ❑ Addition O Gara e ❑ Shed ❑ Other
Enter 1 st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement s ft Decks s ft Gara e s ft Pro osed Total Area s ft
Water Availabiii ❑ Sewer Availabili ❑ On-Site Se tic S stem Availabilit ❑ Pro'ect Valuation S C��. �-�CJ
Zonin Lot Size Existin Bld Valuation S
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Name Address
Cit State Zi
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Contractor Name Address
Cit State Zi
Contact Phone Fax
License # Ex iration Date Verified ❑ Yes ❑ No
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Contractor Name Address
Cit State Zi
Contact Phone Fax
License # Ex iration Date Verified ❑ Yes ❑ No
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Water Closets Si�ks Urinals Lawn S rinklers
Bathtubs Dish Washers Drinkin Fountains Other
Showers Electric Water Heaters Sum s
Lavatories Washin Machine Drains 7otel:�ixtUre Gou�Y
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..... . ��,�:�7���:�t�.i,��kT... ....:.:....:. MECHANICAL EVALUATION ONLY S
Fuel T e (electric/other) Gas D er Air Handlin < = 10,000 CFM 15-30 Tons
Len th of Gas Pi in Ran e Air Handlin > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Lo Unit Neater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Conv Burner Duct Work 0-3 Tons Under round
BBQ's Wood Stoves 3-15 Tons Tcrtal.�Jn�r Covnt
DIS CLAIM ER:I cectif'y under penalty of perjury that the infotmation fumished by me is true and comct to the best of my knowledge,and futther,that I am authorized by the owner of
the above premises to perform the work for which pernut application is made.I further agee to save harmless the City of Federal Way as to any claim(including costs,expenses,and
attomeys'fecs incurred in investigation and defense of such claim),which tnay be made by any pe�soq including the undecsigned,and filed against the City of Federal Way,but only
where such claim arises out ofthe reliance ofthe city,including its officers and employees,upon the accuracy of the infotmation supplied to the city as a part offlus applicatioa
Owner/Agent: -�ti ti�-' � ���U��� Date: � � �
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Rcvsco 11/11/98