96-101156 g� 'lo)l y�
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����a F i rs t w�v ��o u t r, :�',"w����.�.���.�, �....,.."h,,..,�.�:.. �"«��,:�N �.,,��,�..�°�,,� .,�i,.. � z�s u�.l�: a����;t��
Fed�ral Way, WA 9800� f3uilc�ing Tnspectinn f;equests 6�1-�G7.40 BY: FC
66�.-'+000 EXP:IF��S: 11/12/96
Al�l`�RESS: 35116 �.11'H F�L SW
NO . : 50Z860•-1Z70
F�ROJECT DESCR�PTION:RES ALTERATION - ALTERATION TO EXISTING RESIDENCE. MOVE DOOR AND INSTALL iJINDOW TO MRIN fL00R REAR WALL. (MADRONA MEADOWS, lOT #127)
�- OWNER ==����=:._�-_�-��y��-w�_,���:=,-w,__�::r�-:..-.:�-,_=�_::.-,..� CONTRACTOR �::_==���=_�r=�=����-�-_��M::=�_=__��_��_��_--,= LENDER =__,_�_�_,�==_=_��,=_=___��_:_�w�-����M�,==_=���
RICHARD 9LOUNT � O�INER IS CONTRACTOR �
( 35116 11TH PL SW � �
� FEDERAL WAY WA 98023 �
38-5380 813-1034 �
j ! �
............
�__�-____________..__..,.----_..._...�_._��_�.___....__..__.____�_...v__...,�.,---.._;.._.._.___._... -_. _.---- ----. - - ----- - --- - - - - --- -- - - --- - - -- ==
_____________.__....._.._._.______�..._.__.......___...__.�__....__...__..�...... ....__.__�..__... ._..._...... .:____::__.._�_���_�:.____.�-�__��---===_--___..-.----.___..___________----••----___________..--------_____ 1
�=x CONTRACTORS, FLEASE USE LOCATION CODE 1732 kHEM REPORTI116 SALES TAX FOR PROJECTS YITHIN TNE CITY Of fEDERAI RAY. �TAX RATE = 8.2� �*#
�---...___.____.._...___.._____.____.__....__..._.._.__.._...._.__.�...__�._.___�._.___._..__...._.._..__....,...........�_._.__..�_._.�_._�_�._..___...__.___._..__-..-__...._�.__.._.___._____:.--,--_______..._.._____..___-----.----__.._-..---__..___�
_..___..--------________._---._,.....__..___..,.__._.__._...__..._.____......�._,__..___._._._.._..._.�__.__._._.................��_...._.____--------...___..__....__._....__._____.�____._�----__.._____.,_.-t---__.._____----...__._._._____________.__-------
BLD?:X MEC?: PLM?: FLR--EXISr--PRQP--- D4lfLlING UNITS: 1 � COMP PLAN.........:SFHD � FEES: (
TYPE OF WORK:ALT USE:RES 1ST.: 0: O:sf STQRIES.,......: 2 � REOUIRED PARKING..: 2 SPRINKLERS?......:? � PLAN CHECK FEE $ 22.10 �
CENSUS CATEGORY.....:434 2ND.: Q: O:sf NEIGNT.....: O,OO ft � MAIARD CLA5S...;? � BUILDING PERMIT....� $ 34.00 �
OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION---------- I REQUIRED SETBRCKS------- FIRE FLOW....: 0 gpm � SBCC SURCHARGE.....� $ 4.50 �
:R3 :? :? :? : OTHR: 0: O:5f EXIST..$: 91800 � FRQNT.........: 20.00 ft � fINAL PLAN CNECK...# $ 0.00 (
TYPE Of CON5TRUCTION----- BSMT: 0. O:sf PROP...$: 11D0 SIDE... ..: 5.OQ ft WATER SERVICE..:ftD � �
:5N :? :? :? : DECK: 0: O:sf � REAR... ...: S.00:ft SEWER SERVICE..:FED � (
OCCUPANT LOAD------------ �A�.: 0: O;sf RECEIVED.:04/24/46 � ( �
. 0: 0: 0: 0: TOTL. 0: O:sf � IMPERV SURFACE: 0 sf SENSITIVE AREAS. N i I
___-__-_�:---_�____�________�_�___��---- :._ - -���____.___.�---�_.�____.._.._.__�.��__--=-.M=--___�..�_._�,_�__�_r___.___..r___._�_-W'-=w�w��-� �
_ _.�_._ _ _,__._
FUEL TYPES.:? ? fANS....,.....: 0 BOILERS/COMPRESSORS WATER CLOSETS......: 0 URINALS........: 0 � TOTAL FEES $ 60.60 �
' ^"S PIPING.: 0 ft HOOD.......,..: 0 0-3 HP......: 0 BAiH TUBS..........: 0 DAINKING FOUNT.: 0 { �
RN<100K... 0 DUCT WORK...... 0 3-15 HP...... 0 SNOWERS............. 0 SUMPS........... 0 � �
j GAS HWT....: 0 WOOD STOVES...: 0 15-30 HP....: 0 LAVATORIES.........: 0 UAC BREAKERS...: 0 � �
� CQNV BURNER: 0 FURN>100K...... 0 30-50 HP..... 0 SINKS............... 0 DRAINS.........; 0 � �
BBQ......... Q MISC........... 0 5+ HP........ 0 DISH WASHERS........ 0 LA�IN SPRINKLERS; 0 �
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS--------- ELEC WTR NEATERS...: 0 OTHER FIXTURES.: 0 � �
RANGE......: 0 <-10,000 CFM: 0 ABOVE GROUND: 0 � IAUN WSHR OUTLTS...: 0 � �
� GRS LOGS...: 0 > 10,000 CfM: 0 UNDERGROUND.: 0 � �
�..,___...__.__......_____�.__w___.____.-------_____.__.______..___..._..______.._�._..__._._..�....��_..___,.�1..__...,��______.______----...._______�...�._....�.____..___.---._.�_l..--------------------________-------____.._.._�
PERMITS EXPIRE 280 DAYS AfTER ISSUANCE IF NO MORK IS STARTED. RESIDENTIAL AMD 6RADI1� PERMITS EXPIAE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY TNAT THE IiIFORMATION fURNISNED BY ME IS TRUE AMD CORRfCT TO THE BEST OF MY KNQNLED6E ARD THE APPLICABLE CITY OF FEDERAL YAY REQUIREMEMTS NILL BE MET.
OWNER OR AGENT `
. _ __._._ .f. ....._...__._.________.._...................._..___.....__.._._..�._�....___......._..._�_...__ DATE ,_.J�j(o/!�_._.
FII.E COPY
�.
, ,
a,,,�. G ,n.�; ` City of Federal Way
• ,_ .n, �
� �-�'�� APPLICATION FOR BUILDING PERMIT
,
PLEASE PR/NT APPL/CAT/ON #: I;��li��lQ � 1 � I
SITE LOCATION Address "', � /j�. - �� i?, �� ..
Tenant (if known) Lot /t ss ssor's Tax
, ���1 Ja���pO - �-�
�/ Buil �ng Owner Name Address
�\, : 1 tl �'�//� �- l l ��' Qi- S
City �f�� State (�,/1y.� Zip �� Phone
S3�-S3 ��
Nature of Work � • � ���
E�PPI,ICE�T
Name (F,M,L) ,
_ �= � .- �C /�_
Address
City State Zip
Contact Person Day Phone Other Phone Fax
BUILDING CONTRACTOR
Company Name
��
Address
XCity State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT ,
Name �
Address
�i 1
City State Zip
Contact Person
� Phone Fax
LEGAL DESCRIPTION
� L��- /2 � ,����v� ,�r �owS
P/ease Comp/ete Reverse Side
- CD0492(Aev 4/931
S7 JCTURE � � � �ng Use , ,_ , � � i.,<�r_ ;/ �osed Use � . �� �-�i/�
ermit includes: J�Buiiding ❑ Plumbing ❑ 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 i `�!�(J sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area $.�M£ sq ft
Water Availability � Sewer Availability CL7� On-Site Septic System Availability ❑ Project Valuation $
I (C�U°`'
Zoning '=� `, % j' ( Lot Size __, f' ,(�. �� Existing Bldg Valuation S � (
-_� �E� >. l�� ; �. �� i��� , ��_�-,�
LGNDER
Name Address
City State Zip
'MECHANICAL CONTRACTOR
Contractor Name Address
City State
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name Ad ess
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 Wa Heaters Sumps
Lavatories Washin achine Drains Total Fixture Count '
MECHANICAL iJNIT COiJNT 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
Conv Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit Count
OISCLAIMER: 1 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
ot the above prernises to perform the work for which permit application is made.I further agree to save harmless the City of Federal Way as to any ciaim(including costs,expenses.
and attorneys'fees incurred in mvestigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the CitY of Federal Way,
�ut 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.
�)wner/Agent: �/J �� Date: -/f Z���p
APR 3� '96 d8�33AM AU�AT C��!iMUPIICATION PR�:?Ul',CT:� INC P, li1
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