02-102019City of Federal Way
Conmmnity Development Services
33530 I st Way S
Federal Way, WA 98003 -6210
Ph: 253.661.4000 Fax: 253.661.4129
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Building - Single Family Permit #:02 - 102019 - 00 - SF
Inspection request line: 253.835.3050
Project Name: CLOVER
Project Address: 37114 4TH AVE SW Parcel Number: 218820 2805
Project Description: MH SETUP - Mobile home setup on private lot & establish (2) on -site parking spaces accessory to one
family dwelling; NO GARAGE OR CARPORT UNDER THIS PERMIT.
Owner
Applicant
Contractor
Lender
DAMIAN CLOVER
LANCOR DEVELOPMENT INC
LANCOR DEVELOPMENT INC
DAMIAN CLOVER
20016 32ND AVE S
LANCOR DEVELOPMENT INC
LANCODI144B7 11/3/01
20016 32ND AVE S
SEATAC WA 98198
LANCOR DEVELOPMENT INC
SEATAC WA 98198
Includes:
Census category: 113 -New rr #1 #2 #3 #4
Occupancy Group: R -3
Construction Type:
Occupancy Load:
Floor Area (Sq. Ft.):
1 st Floor Proposed Sq. Feet .. ............................... 1566 Census Category .................. ............................... 113 - New manufactured /fact(
Height of Structure ............... ............................... 12 Occupancy Group # 1 ........................................... R -3
Total Building Sq. Feet ............. ...........................1566 Total Proposed Sq. Feet ....................................... 1566
Zoning Designation .............. ............................... RS 15.0
CONDITIONS:
1. No building shall encroach onto any building setback line or easement shown or not shown.
2. Maximum driveway width is 20 feet. The driveway AND parking pad shall be paved. The driveway /parking
pad material shall be paved from the existing roadway pavement edge, or curb.
3. Building setbacks are: 20 feet front; 5 feet side; 5 feet rear.
4. Per FWCC, Sec. 22- 1133(4), eaves, chimneys or awnings, & similar elements of a structure that customarily
extend beyond the exterior walls of a structure may extend up to 18 inches MAXIMUM into the required yard
setback.
5. Service connections for electrical & communication facilities shall be placed underground (Ord. #16 -48).
6. Tree replacement required. There are 15 significant trees; 13 are proposed to be removed. The number of
retained and replacement trees shall equal to 25% of the amount of on -site significant trees which existing prior
to development. Therefore, four replacement trees are are required. New trees may be either a 10' tall evergreen
or 3 -inch caliper deciduous trees.
7. Prior to any clearing or grading on a lot, the owner /builder shall install temporary erosion /sedimentation
control facilities approved by the City. These facilities must ensure that dirt or sediment laden water does not
enter the public drainage system, adjacent lots or public streets. The owner /builder bears the responsibility to
maintain the facilities in proper working order, replacing as necessary. The facilities may be removed only after
such time as construction is complete & landscaping is installed. See attached for standards.
8. A City Right -of -Way Permit is req'd. for installation of the driveway approach and to widen and improve the
gravel shoulder to 5 feet of gravel.
9. This decision shall not waive compliance with future City of Federal Way codes, policies, or standards relating
to the subject proposal.
PEA EXPIRES March 4, 2003, IF NO WORK IS STATED.
a '4
Permit issued on September 5, 2002
I hereby certify that a above information is correct and that the construction on the above described property and
the occupancy an the a will be in accordance with the laws, rules and regulations of the State of Washington and
the City of Fede al W
Owner or age t: r Date: (�
INSPECTION LOG
POST THIS CARD ON THE FRONT OF BUILD T
BUX ING DIVISION
r INSPECTION RECORD
INSPECTION REQUEST PHONE #: 253 - 835 -3050
PERMIT #: 02- 102019 -00 -SF
OWNER'S NAME: DAMIAN CLOVER Z 7 /�'t--- �J9'�i
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SITE ADDRESS: 37114 4TH SW
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() FOOTINGS /SETBACKS / J () FOUNDATION WALL
() UNDERFLOOR FRAMING
O ROUGH PLUMBING: DWV Water piping,
( ) ROUGH MECHANICAL
( ) SHEATHING
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH -IN
( ) FIRE/DRAFTSTOPS
Gas piping
Roof Floor
Ditch Cover
k
�s
( ) FRAMING/FIRESTOPPING_
( ) INSULATION: Floors.
( ) WALLBOARD NAILING
y.
IM
Walls
Attic
( ) SUSPENDED CEILING
SITE ADDRESS: �✓ �, ! `� l t� 11-V1 514-) ASSESSOR'S TAX/ PARCEL #: L l g �2 Q -V
3-7 l I q -
LEG DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
1h 17 -3o gll! I!j, t5as* 27z-c, 14detr,2 .
PR03ECT INFORMATION
TYPE OF PROJECT (This application): `� BUILDING ❑ PLUMBING El MECHANICAL El DEMOLITION
b ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT
rovide detailed des option)
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PROJECT NAME: o (O 6-y
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
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NAME: 0 A I 9 0 � D / ` DAYTIME PHONE: _
MAILING ADDRESS (STREET ADDRESS; � ,STATE, ZIP): V �P1�1. � ' ` G V ✓ � � � Jfl
20 D I (o &Z '` a-e S.
NAME: S /i L V 1 iJ � l D
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DAYTIME
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rGjDRf.SS STREET ADDRESS; T ) S I T7�, ,
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: C
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V5� )Rg3S -1Z Z5-
CONTRACTORS REGISTRATION NUMBER-
(copy ����u L 1vC
EXPIRATION DATE:
L NAM / L "L.V /vL i"/ / ' s "1.1f� ! e/' ✓ 1 �� )f /� r 40
MM ING ADO (STREET ADDRESS; CITY, STAA, ZIP): , I I'll I EVENING PHONE:
R NSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT THER ( DESCRIBE): )
E -MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT. ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE: Vnvf!M j I EXISTING BUILDING ASSESSED /APPRAISED VALUATION
PROPOSED USE: _TI V � PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES )60 FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED: ❑ YES 4LQ-
WATER SERVICE PROVIDER: >4AKEHAVEN ❑ HIGHLIN PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 11 HIGHLIN ❑ PRIVATE (SEPTIC)
* *NEW RESIDENTIAL CONSTRUCTION ONLY **
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE: $.
FLOOR
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
FIRST
l(�
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
�(!
46 to 16,
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISH WASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS
FAN(S) H2OS
h4kgPLACE
FUR S)
GAS PIPE
L64- KTORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
REFRIG.SYSTEM(S)
WOODSTOVE(S)
MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URZTwA Lj.S WATER HEATER(S)
VACUUM B R(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
- _ - N 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 informa ' n plied to the ciVvias a part of this application.
15 /1
NAME /TITLE: DATE:
❑ PROPERTY OWNER
❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063 -9718 - 253 - 6614000 • FAX: 253- 661 -4129