05-101822t J y f
City of Federal Way
Community Development Services Building - Single gamily Permit #: 05 - 101822 - Of- SF
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -7000 Fax: (253) 835 -2609 Inspection request line: (253) 835 -3050
Project Name: HENDRICKS
Project Address: 119 S 317TH PL Parcel Number: 337530 0460
Project Description: ADD - Add 2nd story addition with plumbing/mech. Also adding front and rear entry porch (covered).
REVISED 10/10/05: Switched Master Bathroom and Walk -in Closet location.
Owner
Applicant
Contractor
Lender
Mark A Hendricks & Sharon L Hendr
ROLLUDA ARCHITECTS
Mark A Hendricks
FIRST HORIZON
119 S 317TH PL
103 S MAIN
Height of Structrt� ..
4000 HORIZON WAY
FEDERAL WAY WA
SEATTLE WA 98104
119 S 317TH PL
IRVING TX 75063
98003 -5241
.4 p{o� .., s... ; ...., ......
FEDERAL WAY WA
Includes:
Census category: 434 - Reside 1 #1 #2 #3 #4
---.._..._.---- -
Occupancy Group: _ R -3
Construction Tale: TVDe V - B
Floor
2ndr ose+t�
1 157
�P �� a
esl �_ d
.'"
Deck Prop,
b
h� >re Sp lRegmredta
!q�
5�
Height of Structrt� ..
.... ..22.5
�o ti
ecitamcal �....
es
ti
Occupancy # 1 - Class... ;:.:::...
R-3
.4 p{o� .., s... ; ...., ......
es
Total Building Sq. Feet ............ ...........................3100
Total Proposed Sq. Feet .......................................
1163.56 `
Zoning Designation .............. ...............................
RS 7.2
Plumbing Fixtures
Description Quantity] Description Quanti Description _ Quanti
-- -- - - —
Bathtubs 1 Lavatories Showers
Water Closets ! 2
I
Mechanical Fixtures
Description -lQua_ntityl i Description Quantity Description Quantityl
Ducts �, 1 Fans 2
PERMIT EXPIRES April 10, 2006.
Permit issued on October 12, 2005
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: ` /J�_�� ,/ /� Date: Z A�
i
City of Federal way
Community Development Services Building - Single Family Permit #: 05 - 101822 - 00 - SF
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -7000 Fax: (253) 835 -2609 Inspection request Mile: (253) 835 -3050
Project Name: HENDRICKS
Project Address: 119 S 317TH PL Parcel Number: 337530 0460
Project Description: ADD - Add 2nd story addition with plumbing/mech. Also adding front and rear entry porch (covered).
Owner
Applicant
Contractor
Lender
Mark A Hendricks & Sharon L Hendr
ROLLUDA ARCHITECTS
Mark A Hendricks
FIRST HORIZON
119 S 317TH PL
105 S MAIN
Height
4000 HORIZON WAY
FEDERAL WAY WA
SEATTLE WA 98104
119 S 317TH PL
IRVING TX 75063
98003 -5241
"`
FEDERAL WAY WA
des
Includes:
Census category: 434 - Reside 1 #1 #2 #3 !i #4
Occupancy Group: �_ s R -3
Construction Tvpe: Tvoe V - B�
Floor
,� .
2nd�oor Prop ......................�,
11 Sr1=
Census Category .. ...... _ :....
�4I2esidtial alt/add - no
D , Sed Sq Ct
X6.56
m
Fit ri ►kl $ Req d
+
Height
�.9 d
Mecllaal w a
Us
Occupancy # 1 - C1
e R -3
"`
umbin..:..
g
des
Total Building Sq. Feet ..:.... ........
.............3100
u,
Total Prtlposed Sq. E ...:..
163.55'
Zoning Designation .............. ...............................
RS 7.2
Plumbing Fixtures
Description
�IQua_ntlt
I
Description
Q uantity
Description
Quanti
_
Bathtubs
I
LLavatories
3
_
Showers
�
Water Closets
2
Mechanical Fixtures
Description JIA uantity I Description Quantity Description Quantity
Ducts - -1 j Fans
CONDITIONS:
This parcel is located within a Wellhead Protection Area (Capture Zone 5) and must comply with FWCC, Chapter 22,
Article XIV "Critical Areas" and fill out a Hazardous Materials Inventory Statement, if applicable.
PERMIT EXPIRES December 28, 2005.
Permit issued on July 1, 2005
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: L'� Date:
DATE INSPECTOR AIIEA AND,ryPE OF INSPECTION
Q((' 73 �G112_
4 S
THIS CARD IS TO JJMVN ON -SITE
CITY OF fommunity Develo m nt Inspection Record
Federal Wa y IVR INSPECTION RE Q UEST PHONE # (253 ) 835 -3050
PERMIT #: 05- 101822 -00 -SF
Owner: MARK A HENDRICKS
Address: 119 S 317TH PL
FEDERAL WAY, WA 98003 -5241
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.
❑ Temp. Erosion Control (4365) ❑ Footings /Setback (4110) ❑ Foundation Wall (4115)
To be done prior to breaking ground Approved to place concrete Approved to place concrete
By Date By tj Date $0 oe By Date
❑ Drainage/Downspout (4040)
Approved to backfill
By Date
❑ Plumbing Groundwork (4190)
Approved to cover
By Date
❑ Slab /Concrete Floor (4255)
Approved to place concrete
By Date
❑ Underfloor Framing (4285) ❑ Floor Sheathing (4105) P
Approved to sheath floor Approved to install flooring
By Lj Date & fS.- D S By Date s - ZZ By
❑ Roof Sheathing (4220)
Approved to install roofing
By rGf Date 11/z,
�`✓/
❑ Gas Piping (4125)
Approved to release test
By Date
❑ Framing (4120)
Approved to insulate
By Date G 'Y_3 . C
❑ Rough Plumbing (4230)
Approved
By Date %
❑ Fire/Draft Stops (4095)
Approved
By Date 10-1-3-
Shear Walls (4245)
Approved to install siding
Date 7/Z
Mechanical Rough -in (4165)
Approved
By Date Z�O/4'7ld
NOTE: Prior to scheduling a Framing (4120)
inspection; Electrical, Plumbing & Mechanical
Rough -in and Fire/Draft Stop inspections must be
signed -off and approved. IBC 109.3.4/UBC 108.5.4
❑ Insulation (4150) ❑ Gypsum Wallboard Nailing (4130)
Approved to install wallboard Approved to install mud & tape
By Date By •`" Dat 3 - Q
❑
Final - SWM (4375)
❑
Final - Mechanical (4065)
❑
Final - Plumbing (4075)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Building (4050) , I UTemp. Erosion Maintenance
Approved i Approved
By ®,mil Date/ /'Z.. -7jg rl By Date
5 -101 02�-
eralWay PERMIT
.NAMDEVELOPMENTSERVICES 2 v 2005
8^ AVENUE SO77f•PO �4DERAL WAY, WA 98063 -9718 C F
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PLI CATI O N
3- 835- 2607•FAX253 -835 -2609 A
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MF CO (VIE) EL/,(PIV DE EN FP
The following is required information - an incookalete application will not be accepted. Please print legibly (in inkl or
SITE ADDRESS I �� � 7' �L SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # 3 T - �}- C J LOT SIZE (sf) O 2
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) 0 T 1% 6, llS io E k E 1(s hT S
(Attach separate page for lengthy legal desaipd-)
TYPE OF PERMIT BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
A o o PA 2T1 rA L- 2 ° STV 2 v TO 6y i.3 Tf j 6 12 t= 51,E c -- d i f 'FO. /,.I C L L., DE'
NeLi '"'.9ST6 2 �L OQ u,?`. -i. A 6L'&-ST GC a(tyorwt A"jo
f? 11 nwl. QEvISC fCn.jT t a. &Pr 0- C- '1'7'2v f) 0V /fs
PROJECT NAME (Name of Business or Owner Last Name) �ROAICIVC7
s
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
NAME PRIMARY PHONE
M SPAR -cN r/o>z c (263) 994,-Y/28
MA7/0/ NG ADDRESS CITY, STATE, ZIP
S —7 L fE L LJq y Litc) 99vo-7
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
� 1 -
MAILING ADDRESS
CITY, STATE, ZIP •
CELL PHONE
1 -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
( 1 -
RELATIONSHIP TO PROJECT
B L
Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
CONTRACTORS REGISTRATION NUMBER (copy of cud required with each application) EXPIRATION DATE
MPANY NAME
(i IIL'o Aac ,
APPLICANT NAME
OFFICE PHONE
(UL,) -I/ zzz
MAILING ADDRESS
CITY, STATE, ZIP -
CELL PHONE
/05- S /►7 A I
S`C- -T Tt 6 U t o
( 1 -
RELATIONSHIP TO PROJECT
FAX NUMBER
Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
(201� ) [, Z Y - L/ 2 2 G
NAME PRIMARY PHONE E- MAILADDRESS
LE (Za -ilk _
er (W Y9 2x 95 ndeT (n Or!ltation iS'
NAME
MAILING ADDRESS
CITY, STATE, ZIP
/-/000 o,A; %j
Ta%'I,-j U
c If
EXISTING USE J/ ! t_ C rA t n I c i. ,c C' 1 1 s r J( a PROPOSED USE G L L % il^ sr\ I L.
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK >$ / d C) O
SPRINKLERED BUILDING? ❑ YES WNO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ALAKEHAVEN ❑ HIGHIdNE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER )KLAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED ?)
GARAGE A CARPORT ❑
n
exisnKa
NUMBER OF FLOORS Q N C= ?
"NEW HOMES ONLY " NUMBER OF BEDROOMS
EXISTING I PROPOSEL 16
TOTAL
ESTIMATED SELLING PRICE
57?
' N•
Indicate number of each type of f xture to be installe&or relocated as part of this project. Do not include existing fixtures to remain
MECHAHICAL )
Value of Mechanical Work $ ✓�-"�
i'( 66 �
l
� to l et/
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
BBQS
FANS
HOODS (comm,miaq
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Describe)
COMPRESSORS
FURNACES
GAS WATER HEATERS
DUCTS
GAS PIPE OUTLETS
PLUMBING i
J
f
4ER
BATHTUBS (or Tub/Sho— Combo) �_
HOWERS 2
CLOSETS (Toikq
MISC (Describe)
DISHWASHERS
SINKS
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
RAINWATER SYST
WASHING MACHINES
URINALS
HOSE BIBBS
-3 LAVS (Bathroomsiat,Il I
VACUUM BREAKERS
ELECTRIC WATER HEATERS
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.
NAME /TITLE DATE
(Signature) (Title)
RELATIONSHIP TO PROJECT Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
Bulletin # 100 — January 7, 2005 Page 2 of 4 k\Handouts\Permit Application