03-100297City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph:253,661.4000 Fax:253.661.4129
Building - Single Family Permit #:03-100297 - 00 - SF
Inspection request line: 253.835.3050
Project Name: - : CHEN
Project Address: 30816 36TH CT SW Parcel Number: 058755 0350
—Project-Description:-Water-damage-repair-to-d rywa 11,-insulation,-carpet,-paint,-trim,-detatch-and-reset-plumb-&-mech
fixtures.
Owner
Applicant
Contractor
Lender
Hsi Hsuan & Mei Huei Chen
SIMCO CONSTRUCTION
SIMCO CONSTRUCTION
NONE
30816 36TH CT SW
SIMCO CONSTRUCTION
SIMCOC*05207 (9/15/01)
FEDERAL WAY WA
P.O. BOX 99566
SIMCO CONSTRUCTION
98023-2156
TACOMA WA
P.O. BOX 99566
NONE
Includes:
Census category: 434 - Reside #1 #2 #3 #4
Eco--CTUSSPI-C---tc��-
Group: R-3
n Type: Type V - N
Occupancy Load:
Floor Area (Sq. Ft.):
Census Category........— ...................................... 434 - Residential alt/add - no, Mechanical ....... -......... ,...... -.....-................... No
Occupancy Group#1......... .............. .......... ..- ...... R-3 Plumbing..................... ............ Yes
Plumbing Fixtures
Description Quantity- Description Quantity, Description Quantity!
Water Heaters 1
PERMIT EXPIRES July 21, 2003, IF NO WORK IS STARTED.
Permit issued on January 22, 2003
I hereby certify that the above information is correct and that the constr. on on the above described property and
the occupancy and the use will be in accordanceLwithe ws le d r tliations of the State of Washington and
the City of Federal .
Owner or t: Date:
Ns� t: � o
S"m � X c Ltt
cP
CONSTRUCT. A PERMIT APPLICXAC
CITY OF �� PPLICKRON NUMBER: 00
Federal Way APPLICATION NUMBER: -
APPLICATION NUMBER: - -
"The following is required information - Please print (in ink) or type*"
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. I `(
PROPERTY■. ■
SITE ADDRESS: 7t 4 B6—nr A&,!5 CT 5a--2 ASSESSOR'S TAX/PARCEL #: - -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT zkoonMATI6N
TYPE OF PROJECT (This application): o BUILDING o PLUMBING o MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): F. '
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
NAME: DAYTIME PHONE: i
MAILING AA+DDRESS (STREET AOMESS; CITY, STATE, ZIP): r
NAME:
DAYTIME PHONE:
I
��teLfCCa ��i��TR11G4 /I!�
(ois ) 5
MAILING ADDRESS (STREETAJ)DRESS: Cn"Y, STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
//
(copy of card required)
i / S
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS (STREEETT ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PR09CT: FAX NUMBER:
o ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER- ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ON,
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
FLOOR
EXISTING S . FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
_
— -
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture1"W
I
MECHANICAL - _.�� ViAtury 1.i7�✓�
EVAPORATIVE COOLER(S)
FAN(S)
FIREPLACE INSERTS)
FURNACE(S)
GAS PIPE OUTLET(S)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC. ( }
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) , ;i " WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC "AS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( ]
]TSCLATMFR/STC,NATIIRF RI_C
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 the permit application is made. I
further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees Incurred in the
Investigation and defense of such claim), which may be made by an an, including the undersigned, and filed against the City of
Federal Way, but o where such claim arises out of the reliance th city, including Its officers and employees, upon the accuracy
of the Informatior�u0plied to the city as apart of this a,�pii
w
❑ PROPERTY OWNER ❑ APPLICANT
FOR.OFFICE. USE ONLY:
DATE:
_NE1hf y ADI)Mok - o ALTERATION '.:0 REPAIR . id•TENANT IMPP.6VEMENT '`-
CENSUS CODE: ' :r : - .:.- :::.. ,-"-.;.:... ....:
LOT SUE: -. - . _ .
ZONING DESIGNATION. , ;:� =' :•," :':.. ''' .::".::=_
BUILDING SHELL ONLY?' ❑ YES -- ❑ NO
COMP'PLAN DESIGNATION -
BASIC PLAN?.' ` ❑ YES - ❑ NO�—
SECTION •: -,TOWNSHIP RANGE'_
NEW ADDRESS RE!2UIRED? • o YES n NO
PLATTED LOT? ' ❑ YES O'NO
CHANGE OF USE? 6 YES -d NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
6M.ci(xQlfederalway,com