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95-102407 CITY OF ��DERAL WAY PERMIT N0: BLD9S�-07�5 335�t7 Fi rst Way South ,��� �,,.��'� �"'�� �'�.�"".���I ..�.� ISSUED: 10/0�/9S Fecieral Way, WA 98q0� Building Inspection Reques�s 661--4140 BY: �C 661-4000 � EXPIRES: 0�/31/96 ADDRESS:33702 21ST AVE 5W NO. : 242103-9099 PROJECT DESCRI P7ION:TI - RELOCATE EQUIPMENT AND REPAIR ROOF/HVAC p= OWNER aaasaa=aaeeaaesaaaaseeaaaesam�aamaQaaemaaaaomaaaase a COHTRACTOR a=aacema�=acessssaesasms�sasmemamsasxmmaaaex a �ENDER =aseeceeac�ma=Ca��aa�ssmmssaeossx�Csmam�lmmeesa�� � FRED MEYER S D l CORPORATION � 33702 - 21ST AVE SM 3150 RICNARDS RD SE � � FEDERAL NAY WA 98023 PO BOX 1685 � BELLEVUE WA 98009 ( I 503-232-8844 649-9000 ( �_ SDLCO##231BQ � ^x�e=�ro��ea�ase�a�_an�e__oveoc�_ec^_os�ecos�exocase�ce,=s..se�acma�aa�es:=asx�as�aaa_�aaeaaeac�-.�xs=as�ssc�:xmmeaaxa�a�c_xosrves__�aea_caoo^�esac_ae_x_n=mcaeoeax�ecasaxse�xo #_= CONTRACTORS, PLEASE U5E LOCATION CODE 1732 NHEN REPORTI116 SALES TRX FOR PROJECTS NITNIM THE CITY OF FE�RAL MAY. TAX RATE = 8.2� xY* �-aamece�mesasmsmmaaamaxa=aex_saasaoma_msmemmaass=exme-�ea_cs_m__em�c=c�_o_o: �oo�xmmaasa�a��aa�xex_e_x=aaa�mexes��a�_oo�esaaaosxs emvxaavacecssa�eseos=xxoaam�reaa��aesaa�sq � BLD?:X MEC?: PLM?: FLR--EXIST--PROP--- DNELtING UHITS; 0 COMP PLAN.........:B FEES: � TYPE OF NORK:TEN USE:COM 1ST.: 0: O:sf STORIES........: 1 REQUIRED PARKING..; 0 SPRINKLERS?......:Y PLAN CHECK FEE � 330.85 � CENSUS CATE60RY.....:437 2ND.: 0: O:sf HfIGHT.....: 0.00 ft NAIARD CLASS...:ORD FIHAL PLAN CHECK...# S 0.00 � OCCUPANCY GROUD---------- 3RD.: 0: O:sf VALUATION---------- REQUIRED SEIBACKS------- fIRE FLOW....: 0 gp� PLCK-FIR co��l only� S 25.45 ' :M :? :? :? : OTHR: 0: O:sf EXIST..$: 7890100 fROMT.........: 20.00 ft BUILDING PERMIT....� $ 509.00 � TYPE OF CONSTRUCTIOH----- BSMT: 0: O:sf PROP...$: 71000 SIDE..........: 0.00 ft WATER SERVICE..:fED SBCC SURCNAR6E.....� = 4.50 :5N :? :? :? : DECK: 0: O:sf REAR..........: O.00:ft SENER SERVICE..:FED � � OCCUPANT LOAD------------ 6AR,: 0: O:sf RECEIVED.:09/15/95 � : 0: 0: 0: 0: TOTI: 0: O:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:N � �aaer,ss=x_axxsamsxxemmmaaass�amex=asaae�amseaaaexxmaaeaasaa��assxa��aamAcxmmmae msxaxsmmaamaaaaaaasaxanmsaaaamamxsmam�aaaeamama�aasn ' FUEL TYPES.:? ? fANS..........: 0 BOILERS/COMPAESSORS MATER CLOSETS......: 0 URINALS.......,: 0 TOTAL FEES 3 869.80 � , 6AS PIPING.: 0 ft HOOD..........: 0 0-3 NP......: 0 BATH TUBS..........: D DRIHKING FOUNT.: 0 ( � FURN<100K... 0 DUCT NORK...... 0 3-15 HP...... 0 SHOWERS............. 0 SUMPS........... 0 ( I 6AS HWT....: 0 WOOD ST04ES...: 0 15-30 HP....: 0 IAVATORIES.........: 0 VAC BREAKERS...: 0 � � CONV BURNER: 0 FURN>100K...... 0 30-50 HP..... 0 SINKS............... 0 DRAINS.........: 0 I � BBQ......... 0 MISC........... D 5+ HP........ 0 DISN WASHERS........ 0 LAHN SPRINKIERS: 0 ( � GAS DRYER..: 0 AIR HANDLIN6 UNITS FUEL TAHKS--------- ELEC NTR HEATERS...: 0 OTNER FIXTURES.: 0 � � RAHGE......: 0 <=10,000 CFM: 0 ABOVE 6ROUND: 0 LAUN NSHR OUTLTS...: 0 � GAS L06S...: 0 > 10,000 CFM: 0 UNDERGROUND.: D �n=n�neaaaenaaa_�_==o =aco_=occov=^sxcsas�sr.,-ca�aaxr.vaxa=msme=ee==sec=xvea==s.•____cc�=c=cam=s_==an�=r.s»aoczm.-se�eee=aas=xxsa�s�a�xs=z=eaaaoa==�=�=e�=e=ae==ceamaa�=c==osaa=+� PERMITS EXPIRE 180 FTfR I E I I10 i�RK IS STARTED. RESIDEMTIAL AM9 6RADIN6 PERMITS EXPIRE ONE 11EAR AFTER DATE OF ISSUAMCE. I CERTIFY TNAT TH INF M NISHE BY S T D CatRECT TO TAE BEST Of !IY KI�NLED6E AND TNE A CABLE CITY OF FE�RAL MAY RfQUIREMEMTS IIICL BE MET. � - �' � 15�fi5 OWNER OR AGENT _______ � -- - -------------- - _______-__----------------------- ---`------ �+-------- FtLE COPY _ _._ ��-� —____,a.���..—____ t. l �l Y UF� �� 1-�i)l�t�i��l.. 1�1��Y "t.��l`�t a� f I���lt_r: k31 t�'?'�� +-��/`�,`� � ���;w-�f:� H��� r��t w�v �o�at�r, :I�'� �.� �.._������ �°��:.� �'' I�.�'�� .�. ���' �r.�>:���a��_c�: �r���a:�.���� fF'CiFai"c�,.�. 41l.:�1`y', (�il �,If:�UI.J�� ��.I1 _�.t�1.i'1C1 �.I1"a�tE?f'��lqtl f+, .P_�1IEa�:'.t.�: Ea�`,, �. _1.�.�t(.1 L�`Y: f��_� �E>a ��-�c,rm � �:xua:�a�:��: o:a/:��.f���. h1 T>Z�F�2�:,:'y G;: ;�"�a l)t� A.��� � i a V C: `3�+l rrr�,M : �?����.rt�-��r��t�a F'F2r���7C�_C1� 1�[::��t�:RTI"�l� � l)N:TI - REL�CATE EOUIP't1E�T AMt+ F'EPAIP k00FJNVRf P� t�MMfR ,:��,���.r�,�R��,u:�..�..�-.�o�.�....,.��..�.....�:..�,�.,.��.r�,�,�..�W_ �. CONiAA(i0R r u .a--.:_,:�, :�La„s..r.�,..���::.:n�.._�.,...:....,Fe.,...,,. IENDER =-:_�:.�.�.�:::,..:. , ,:.�:,..�� ...�:.:, .. �.:�: � FREG MIYER S D l. COF.F'UP;AI tON _ .. -. ', .R.-..Y � ' ' � 2151 AVE SN � 3150 RICNAkU� ftD Sf ! � ��l NAY NA 980?3 V�1 BOIi 1h85 � �ELLE6+UE NA �!A004 � • '-8844 b<9-?OQO � � �'pl:nr��;11+G � � � - -....e.m....,..:.:n_v.,...,:ttM.c.,.x��_s.s.... . .. :.�cc..... .. ��, _�:.x �:.. .u..,..;^.u.....:.�s.::u.s:�c.�. . .. .. ._.,__.... ..._.. ,..... ,... ,_..x.., ... -._..___.. .... _._ .� . _ . . ..... ..:.�.....�r- ..:._�.:-__.. __. .,..s�-.s:..vua:.me., ..�+...:xi . .. .,_ . . .xm�,:.....r��:a,. ........:, 'kS.:Y.:::.... �..A.,., "m.:.5..-...5.. ... .4;.1.�x ss: C�i1�tAGtQ�,�.��E t� Is��([�� C���k 1132 �3�.� E;�FtIFTiMG S�t.ES 1Alt Ftl� lM�OJECI� ��(�lM 1� CIfY OF FC�RA! IY1Y. IA1t �A(E = 8,2� tt: �sksuuFOC.t�smnmmm!xnr.. .��._..�.,... ....r.:...:._':46�AIt�',�rarq� r.�:?A'� x;:Csr _H����� •, �.r.c:z: .�,..::�r�...r �. � -� . .. e.:�.... .�.._......:.c:..:..:��:,_.c.._r..,:..�._... �r. .:• �u......c�.:.._. ��.:_:.x.�-..s.:�_,.:...�c.nse...-�.,.:::, ... �. rr.:o;v:�r-snteq ( BLD?:X MEC?: l�lM?. FIp--E3(I�� -PFOR .. ������ t�£ttlll6 +�f��T" �� �"�'CUMP PLAN ...,...8 � � FEES. � � iYPE tf{� MQkK:TEN USE:C4M 1S1 _ ��; 0:,��� �T�C�'5...: ..� �'� � �ffl!�tR�s� �`t,RYI►��: .: 0 SVhIk�IER�° .... .� � FLAN CNE�K FEE � 330.85 �:EN�I!S CATCG4RY....,;43! 2ND.: � � �." O:Sf !#F1' l�1.,.... (+.+�G' tt � � 'y� �'� ; #4t�tAD C4�� ��s� � ftNAl DIAH CHECK...t S 0.00 #` � j Ot:CUDANCY 6k0UP__=__----- ��.: ���� ,��..., .� �<����, ���U���Qt� - P�Ql�l�t�� 5�'���� ��__ �"� E l4�k� �t!�[ ; �� ,. .�� � Flt� FTR eow�l enly� 3 25.45 � 'M ;? :? :? : ��THR' 0' O:S� ��!I�f,.�: ��Ira�ltlx.�i FR�.�tt�.� �� f� �� , s ��ri�H� PERMIT....� S 50�.00 � fYPk. �JF CONSTP,UCTION- �� ���T: tI� �:s€:_ �?�JP.. "�� � "��t��9 � ���"�`��.:. .... .�� �j 1`t �:�+iEk =:E�'�If�:::ft�U ��'� � ``���tNAR6E.....� S 4.54 :5N :'? :? :? � : G�� ,�,Q. ��f � ........... 0.0�):t t SEWER 5EkV10E..:FEA � \ � OCC�JaAHT IOqD-..._____. _ �1"�R � �� ����` , �EC�Tt�Ei�„�►�,�la� ,y�� � h, , a � 0 0: 0: E� f � � ��� .� � IMPERU StlRfACE; 0 sf SENSITIYi AkEAS� N � ����;� �.� � . •, �::zuramscerunnr�emxaramnrmaaartrrts.sss;ro.:¢mr..._.��:r....aa�xsws:caw�cvx�ar:.ec.:.:r,:rzn smx �• x ..:.�..,.�..xprs}rfcs•rxmnmpswtamxu... ._:.,.:.. ...c. �za:, a :::�:s � :r.c..�.n�.xrs.�..,_ � s �YF'f5.:? ? iNNS.� ......: BOILERS/tOMPRESSORS WAXER CIOSETS......: 0 UR1RAlS........: 0 iOTAI FE:ES � 8b9.80 � �'�IN6.: 0 ft H09U........... q 0-3 NP....... Q BRiH 1UBS........... U DRIHKING F4UkT.. 0 � �itK... Q GlltT MURK...... 0 3-15 NV...... �] SiiOiIERS............. 0 SUMPS........... 0 �{�....: U WOOD ST�VES...: 0 15-30 HP.,,.: tl LAVATORIES.....,...: 0 VflC Bf?EAKERS...: 0 � i��tl' �tlkNER: 0 FURN>lOQ�...... 0 30-50 HP..... Q 5IHKS............... �► DRAINS.......... 0 ! �8�......... 8 �115C........... Q 5+ HR........ 0 DI�N IfASNEkS........ U LANb �PR1HkLERS: U � 6AS DRYER..: 0 flik NANl1tING UNliu FUEI. TAMKS-------•- ELEC NiR. HCATtiRS...: 0 OTMER FIXTUkES.: 0 ( P,ANGE......: 0 <-t4,OQ0 CfM: 0 R�OVF 6ROUND: 0 LAUN 4l5HR O�JILTS...: 0 � 6RS IQSS 0 > kb,pUO f.f�! 0 I�NDEkGaUUHD.: 0 , .. �._.� ti_..�_� __..v..._ _.....,... � ,. ..» . �.-�..R., _c:r:ca.�_. .....�.:.- ,�... r.wr.:>:..rc.::x�_... .�.. ^:•-ir.ra..xr�,>-r... .. ,.,.::r�w..:s::�sazcxr;atr..-�::zs:.�.�......e:._eci...c-..:.scszWa.��:.,..:1sc:.:n.��,::�.:.....m....�tt�a ...;saY::.._� ..r..:..c�.n.� �:�.s-�, zr...�:� �._i �::..s�.r-;e�,ti-� ?�ItM1TS EXPCRE 18t! 11��'� �j�f tF.� IS"Sll�i��� RO 110n[ !S S lC�. RESt�ENiIAL Alt� &ttA0IN6 9ERlIIiS EJ(�1RE 01� YEA� AfiER �AiE QF IS5tlA�lC[:. i tE�tIFY TII�T TN�'lktilJ�llAT�N! Fti�MI�Hf� �'� � S T N C�It�ECT 10 iit� BESi Of MY Ki1�WlED6f AN) TNE A��l�A�IE CItY OF FElERAL 1��' REqUI�ElfE�i5 Mlll � MET. � � , �, r; r��./ ONHER tltt A6EN1 ; �''�, _ •ti_�_ _.. . _ ,__ _ . . _ . � .. .._ ___ . DATE t �L=�' ;,��..�.% �) ,,,�:_ _ .. i�,_��,_,,,,•'�"`� __ _ .. ;' �._:; FtEI.D COPY �,_-<,� ��-����,�w. V E� City of Federal Way � a^°F G � � �-�'�:� a � 19�PPLICATION FOR BUILDING PERMIT r � z.:�e Y OF FEDEFiP,i. J'�F�Y � RtJil�51C�a(� k�?E�'T PLEASE PR/NT �r APPL/CAT/ON #: ��j��X-1 i �� �'J� SITE LOCATION Address J:� 7�-� Z r ,� .,5, c�..�; . �� Tenant (if known) L.ot tf Assessor's Tax # J-�k�� {��..�F f _____��—�____ � �t.,; _ �- C'�.���� Building Owner Name � Ad ress �-=��.� � ,..- '�Jv SF � 2 r.;� �...2,��:.x� CitY -J— � State e:��,.�-- Z�P � � L-U"�_ Phone 'cJ 1� Z � Z ' ' `) L `�� Nature of Work � Z; � 1—'— C���G�l_Y� /��.(�'Y�� N �� t ;;�� ��i ,2.�� �., v APPLICANT '' Name (F,M,L) Sc.�,v,— c;.: r-- Address City State Zip Contact Person Day Phone Other Phone Fax BUILDING CONTRACTOR Company Name �t�� �- Address � i C�c� �'_.� �-.�-��� ,_ S� ; City (" State i-..;).� Zip `�L',�:�"t Contact Person Phone Fax 1 ��.-, ;,. �- 1—[c:- � C: - `t�:�;v i�c-t- 5 S c_:� Contractor's # (card must be presented) � ,,,y Expiration Date Verified ❑ Yes ❑ No � L - - L. - - `'` %��-I ARCHIT�CT ' --- '� Name ,1 ,� Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION P/ease Comp/ete Reverse Side CD0492(Rev 4/93) STRUCTURE xisting Use ���`� Proposed Use ��,.� Permit includes: � Building ❑ Plumbing ❑ Mechanical ❑ Other Type,�f Work: ❑ Residential ❑ New �] Remodel ❑ Number of Units O 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 Ai��a Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft Water Availability `e-' Sewer Availability �3� On-Site Septic System Availability ❑ Project Valuation S + ��: Zoning Lot Size Existing Bldg Valuation S '7,�f�� `� � L�NDER Name Address �% . City State Zip MECHANICAL CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified O 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 Fucture Count MECHANICAL UNiT COUNT 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 DISCLAIMER: I 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 claim),which may be made by any person,inciuding the undersigned,and filed against the City of Federel 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. �,��,,� � ('�, c? Owner/Agent: /'`-�i�.1 v�� �.___ Date: 1 l � S / �,�