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04-103706 � r 11) deral Way Con nunFeDevelopment Services Building - Single Family Permit #:04 - 103706 - 00 - SF 33530 1st Way S Federal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: DOVGALYUK • Project Address: 31435 12TH AVE SW Parcel Number:416810 0150 Project Description: ALT-Coverting existing storage area in basement to create a new 3/4 bathroom,including plumbing and mechanical. Owner Applicant Contractor Lender Vitality DovgAa yuk &Liliya Dovgalyt Vitality Dovgalyuk Vitality Dovgalyuk NONE 31435 12TH AVE SW 31435 12TH AVE SW FEDERAL WAY WA FEDERAL WAY WA 31435 12TH AVE SW 9801.3-4505 98023-4505 FEDERAL WAY WA NONE Includes: Census category: 434-Reside #1 ll #2 #3 #4 Occu anc Group:P YP ' R-3 Construction Type Type V-N Occupancy Load: ii Jr— Floor Floor Area(Sq Ft.): Census Category 434-Residential alt/add •no• Mechanical Yes Occupancy Group#1 R-3 Plumbing Yes Zoning Designation RS 7.2 Plumbing Fixtures Description Quantity Description Quanti Description Quantity; I Lavatories 1 Showers 1 1 Water Closets I Mechanical Fixtures Description Quantity' Description jQuantity Description Quantityl, Ir Fans 1 PERMIT EXPIRES March 14,2005. Permit issued on September 15,2004 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and the City of Federal Way. Owner or agent: e5)71V) Date: e (S—av FINALED) y Ci3 THIS CARD IS TO MAIN ON-SITE ' CITY OF illi � `- it ommunity Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 04-103706-00-SF Owner: VITALITY DOVGALYUK Address: 31435 12TH AVE SW FEDERAL WAY, WA 98023-4505 This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. 0 Temp.Erosion Control (4365) Plumbing Groundwork(4190) 0 Underfloor Framing(4285) To be done prior to breaking ground Approved to cover Approved to sheath floor & y By `tib` 444)B Date � DateByDate •0 Floor Sheathing(4105) •❑ Shear Walls(4245) , •❑ Roof Sheathing (4220) Approved to install flooring Approved to install siding Approved to install roofing By Date By Date By Date •Rough Plumbing(4230) - Mechanical Rough-in(4165) �❑ Gas Piping(4125) Approved Approved Approved to release test B�y t.� Date \ 'Z„ By / Date Z By Date Fire/Draft Stops(4095) NOTE: Prior to scheduling a Framing(4120) Framing(4120) Approved inspection;Electrical,Plumbing&Mechanical Approved to insulate Rough-in and Fire/Draft Stop inspections must be 13... 7 Date c f � signed-off and approved. IBC 109.3.4/UBC 108.5.4 B �'� • I IZ R5 �� Date V FA Insulation (4150) ❑Gypsum Wallboard Nailing (4130) 0 Final- SWM(4• 375 ) Approved to install wlallboard Approved to install mud&tape Approved ..r r f ,� A By��� Date ... ' / ,�/ By /4 Date / //f 1./41- By Date Final-Mechanical(4065) Final-Plumbing(4075) ' El Final Final-Building(4050) ) Approved Approved / Approved t By Date By Date By L Dates /�' t/ J • ['Temp. Erosion Maintenance(4370) Approved J, By Date ic.. S. Ni. crrro, _ Federal Way ' CB — a (47 COMMUNITY DEVELOPMENT SERVICES PERMIT (4 F CO ME EL PL DE EN FP 33530 FIRST WAY • BOX 973,8 5 2°'' APPLICATION FEDERAL WAY,,WA WA 98066 3-9718 kD / 253-6614115•FAX 2536614129 I O (/�'i^_ www.etuoirederalwalfc rn lAf The ollowin. is re.uired in oFthation-an inco •tete a.•lication will not be acce.ted. Please •rint le•ibl (in ink)or ' PROPERTY INFORMATION • SITE ADDRESS 3 3 S f /fIQcu./! Cea,(2 j-` w..., w/ UITE/UN T# ASSESSOR'S TAX/PARCEL# 1 t 4) ill 1 Q- 0 -Vic V LOT SIZE(sf ..i LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) �1.06 /1 jCQ Lih/Q 2 ( 0 I (Attach separate page for lengthy legal descriptor) - PROJECT INFORMATION TYPE OF PERMIT BUILDING VPLUMBING MECHANICAL 0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlq) Bi.c t l d Ck 3`y 14 I-�o;,r.1 ,t,t cite_ e sas e t..-, 4". .cwt✓.- f; 6.ez e. V a('o t, N i re_� 4 pa.+-�-. -,s -e-4 , 4 - - _ ---- '___ -- • /, 4. / PROJECT NAME(Name of Business or Owner Last Name) b o t PEOPLE INFORMATION . • PROPERTY NAME V t b011 JJ� ICPRIMARY PHONE (owNER S (2 S 3 ) Q LI S1 OV Z. MAILING ADDRESS Vtil CITY,STATE,ZIP 31(i 3S- is k c,e_ 5k) (�e>-,i w x„ 1/4 ?i 3 CONTRACTOR COMPANY AME APPLICANT NAME OFFICE PHONE 0 44., e O,t, (,•-ems-- ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER - B L / / ( ) CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE / / APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE 0°(,..t e- ®il/ "1-42-4"--- ( ) MAILING ADDRESS CITY,STATE,ZIP CELL PHONE RELATIONSHIP TO PROJECT /� FAX NUMB ER 0 Architect ❑ Tenant 0 Agent /'ther(Describe) o-'--_ oc.'h 11 ( ) CONTACT NAME [PRIMARY PHONE E-MAIL ADDRESS I ( ) - LENDER Per RCW 19.27.095: Lender information is NAME required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP DETAILED BUILDING INFORMATION • EXISTING USE S F4S, PROPOSED USE S F K EXISTING ASSESSED/APPRAISED VALUE $ /6061.. 000 VALUE OF PROPOSED WORK $ So Co O. t0,0 SPRINKLERED BUILDING? 0 YES , `i NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES NO WATER SERVICE PROVIDER LAKEHAVENH ❑ HIGLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE n PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA D CRIPTION EXISTING SQ.FT. _ PROPOSED SQ. FT. TOTAL BASEMENT S ` /`.r I '.,_ ^ 2e ( � SO C FIRST P �.��."` ©0 SECOND 6(Ll"`"'" THIRD FOURTH • , . ... ',t ADDITIONAL FWORS(DESCRIBE) DECK(COVERED?) 1(0 GARAGE/CARPORT -Z 10 HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOT -•STING AND PROPOSED "NEW HOMES ONLY'" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ • FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work st / 1, 0 0 0 .001 AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS LJ FAmml HOODS(Commercial) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES K MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS lite DUCTS GAS PIPE OUTLETS dam_Q PLUMBING al.. BATHTUBS(or Tab/Shower Combo) f SHOWERS 1 WATER CLOSETS(Toilet) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS ' LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS • DISCLAIMER/SIGNATURE BLOCK 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 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. {7 6 NAME/TITLE (1( -4.--(Il boo/tr.-Iv-4,k— i � z �y DATE 0 Q 2 3— 0 L(Sign t re) / (Title) RELATIONSHIP TO PROJECT Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other FOR OFFICE USE ONLY ii'' C Ce G(GA) t('^'e V""`^ ' a NEW ❑ADDITION XALTERATION a REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES O BASIC PLAN? ❑YES A.0 ZONING DESIGNATION . �- . CHANGE OF USE? ❑YES a 0 NEW ADDRESS REQUIRED? ❑ NO UP/SEPA/SU? ❑YES 0 PLATTED LOT? ES ❑NO DEMO PERMIT REQUIRED? a YES a,0 s. e. ,t .� c Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application