95-102598 95� �o a �9g
CI7Y OF FEDERAL. WRY 1��:�2hIIT N0: BLD9.5-Q8q2
��S�a Fi rst w�v sdutn :�:�����. �,�.�:�',h:� �y��� '�'` �.����. � ISSU�:D: 1.0/31/95
Federal Way, WA 9�300� Building Inspection Requests 661-4�.40 BY: FC
661-4000 EXPTftES: 04/28j96
ADDR�SS:�Q80� 28TH AVE 5
NO. : 092104-9�.88
pFtQJECT DESCRIPTION:RES ADD - FOUNDATION REPAIR.
p= ONNER =====�--=====-=-=--======SSG�A�=====�==x=====______ � CONTRAfTOR a,_��xxaes=eaxce_xx�ae�aaa.-aaee�__=�_aamaeae s LENDER an_ae=e=�a_xaaaa¢e.r.cxza���m^sv�_xscaco�aaasasee
� JUDY NACK � AL LIND COMPAHY
{ 30803 28TH AVE S. ( 25130 358TN AVE SE
i FEDERAL WAY WA 48003 ( RAVENSDALE WA 98051 ]
�
39-0359 874-2728
� ALLINC�089QP !
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�=f tOMTRACTORS, PLEASE USE LOCATION CODE 1732 MNEM REP�tTIii6 SALES TAX FOR �tOJEfTS YITNIN TNE CITY OF FEDERAL NAY. TAX RATE = 8.2� _;;
���� .._-.. _...........__ _••_••__-�_�_.�_�-_•,__��__v ___ - �-aemmxo�^es�xsaa7t:�zvm���o��aaaao��.:es^��acsaceoe���Ce�c����ce���__^coe�cax�exse�saa
F_^..�a a =aoa�^��—__��� � �oaa=ce=xxx�sa=a__� ^�.�smae..a�c=.______..^--_________T__ a� + _____ �_.
� BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 1 COMD PLAN......,..:SR FEES:
� TYPE OF NORK:REP USE:RES 1ST.: 0: O:sf STORIES........: 1 REQUIRED PARKIHG..: 2 SPRINKIERS?......:? PLAM CNECK FEE S 87.75
� CENSUS CATEGORY.....:434 2ND.: 0: O:sf HEIGHT.....: 0.00 ft HAIARD CLASS...:? FINAL PLAN CHECK...� S 0.00
OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATIOH---------- REQUIRED SETBACKS------- FIRE FLON....: 4 gpn BUILDING PERMIT....# 3 135.00 �
:R3 :? :? :? : OTHR: 0: O:sf EXIST..S: 119000 , FRONT.........: 20.OQ ft SBCC SURCHAR6E.....x a 4.50
� TYPE OF tONSTRUCTION----- BSMT: 0: O:sf PROP...a: 115Q0 � SIDE..........: 5.00 ft WATER SERVICE..:FED
� :SH :? :? :? . DECK; 0: O:sf REAR.........., 25.00:ft SEWER SERVTCE..:FED
( OCCUPANT LOAD------------ GAR.: 0: O:sf RECEIVED.:10/04/95
, : 0: 0: 0: 0: TOTL: 0: O:sf IMPERV SURfACE: 0 sf SENSITIVE AREAS?.:Y
�o=e=======a=amx===aa�esons��cc�_amenaaa_�seacemtrmac�Saxasmz���c�a�ne.s^a==�am ==_=_====�v,cas=c�ma=a=�a==�aee=m=ac=s==sesamaemms.aa ' �
! FUEL TYPES.:? ? FANS.....,....: 0 BOILERS/COMPRESSORS iVATER CLOSETS. ...: 0 URINALS..,.....: 0 TOTAL FEES E 227.25 �
� �AS PIPING.: 0 ft HOOD..........: 0 0-3 HP......: 0 BATH TUBS..........: 0 DRINKING FOUNT.: 0 '
RH<100K.,: 0 DUCT WORK.....: 0 3-15 HP.....: 0 SHOWERS............: 0 SUMPS..........: 0 (
� GAS HWT....: Q YlOOD STOVES,..: 0 15-30 HP....: 0 LAVAiORIES.........: 0 VAC BREAKERS...: 0 I
� CONV BURNER: 0 FURN>100K...... 0 30-50 HP..... 0 SINKS............... 0 DRAINS.......... 0 �
� BBQ......... 0 MISC........... 0 5+ HP........ 0 DISH NASHERS......., 0 LAiIN SPRINKLERS: 0 I
� GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS--------- ELEC NTR HEATfRS...: 0 OTHER FIXTURES.: 0 �
I RAHGE......: 0 <=10,Q00 CFM: 0 ABOVE 6ROUND: 0 LAUH 41SHR OUTITS...: 0
GAS LOGS...: 0 > 10,000 CfM: 0 UNDERGROUND.: 0
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PERNITS EXPIRE 180 BAYS AfTER ISSUAfICE IF NO iIORK IS STARTED. RESI�NTIAL AND 6'RADIN6 PERMITS fXPIRE OME YEI�t AfTER DATE Of ISSUAIICE.
I CERTIfY TNAT TNE INFORMATION flNt NED BY ME IS TRUE AKD CORRECT TO THE BEST Of MY IfI�MLED6E AMD THE APPLICABLE CITY OF FEDERAL I�IY REQUIRfMEMTS YIII BE MET.
.,
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SETBACKS & FOOTINGS
' Date �- �— By
FOUNDATION WALLS
Date — � — C Cj By
PLUMBING GROUNDWORK
Date By
UNDERFI.�OR FRAMING
Date By
SHEAR WALLS
Date By
PLUMBING ROUGH-IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER) �
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1 ST LAYER
Date By
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL
Date � — � By
OTHER
Date By
OTHER
Date By
CD0193
�„� G City of Federal Way
� �'�'°�^������� ��`��PLICATION FOR BUILDING PERMIT
'�+CT � 4 `��9�:
. n,-;�� ,-
PLEASE PR/NT ��r' L `— ���-
APPL/CAT/ON #: J u�
SITE LOCATION ' ''" Address
Tenant (if known) � Lot Jf Assessor's Tax #
. -—- -��.�^ � �l
Building Owner Na e � Address
-�..c�. 1\I a c 3c��:3 , ��`` n�e s
City '`-CC�f� �.:j'�� State W;}5`, Zip Phone � — Q 3 ^
Nature of Work ��;u�C(��f ��,� ��� ����C�
C
APPLICANT '
Name (F,M,L) �
(����I ��:t�� �,����
Address
6�l j `��-� � U C ,S Cr�
City I e2A� v"'(�' State c._l�S� Z�P �j�� �3
Contact Person Day Phone Other Phone Fax
As - e� � - 8 �G� �7�1- � i(o sr��e �� �/ �/
� �i:a�TRtI' (t/`
BUILDING CONTRACTOR `
Company Name
l �,- d � aw.
Address
3Gr� 2, r�c�h /}�e s�w
c�tY =z 2A( ��,� State U..,�sh ziP t�o 2. 3
Contact Person Phone Fax
L� � � , j�-��� � �'��` �- 7 0
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
�v �s
ARCHIT�CT _��! - --'—��
Name
:.�c� ( �` A� �v�
Address
S� ^ PJ�C 1 v C e�,l
City -, � PS State C,—(�5� Zip (f�/� '
Contact Person � Phone Fax
-�` � ��%�66<�
LEGAL DESCRIPTION n
_ C``�Y� �-"��'n�
P/ease Comp/ete Reverse Side
� CD0492 1Rev 4/931
STRUC7['URE : isting Use roposed Use ' ,
Permit includes: a Building ❑ Piumbing ❑ Mechanical ❑ 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 sq ft Proposed Total Area sq ft
Water Availability 0" Sewer Availability 0 O�-Site Septic System Availability ❑ Project Valuation S S�Sci
Zoning � Lot Size Existing Bldg Valuation S �jy<-.
L�NDER
Name Address
x�.r�2 O ` C��c
City State Zip
M�CHANICAL>CON'TRACTOR
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 Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Coun�
MECHAI�ICAL UNTr'COUNT
Fuel Type (electric/other) Gas Dryer Air Handiing < = 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 Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Und Count
DISCLAIMER: 1 certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowiedge 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 claiml,which may be made by any person,including the undersigned,and filed against the City of Federal Way,
but only where such 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. �
�Owner/Agent: Date: �L� / ��