07-104355City of Federal Way
Community Development Services BuilOn - Single Family Perm #: 07- 104355 -00 -SF
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835 -3050
Project Name: COZY HEARTLAND ADULT FAMILY HOME
Project Address: 2654 SW 330TH ST Parcel Number: 894520 0320
Project Description: STFI - Installation of (3) windows. Modify wall to accept currect standards for openings.
Owner
Applicant
Contractor
Lender
NHOGIE BATIN
WEST COAST VINYL INC
WEST COAST VINYL INC
2654 SW 330TH ST
4023 S ORCHARD
WESTCV *280KD
FEDERAL WAY WA 98023
TACOMA WA 98466
4023 S ORCHARD
TACOMA WA 98466
Census Category: 434 - Residential alt /add - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
cuvancy Load
I' Area (so. ft_) 1 0 # 0 I 0 I 0
A
itio r °
New / At It nal S4 `�» 3rd Floor „ ...........0
New / Additional : q. >�+ t -
Mechanical tt � It d ?'» :...... ..; No Plumbing to be I lud6d?....
CONDITIONS:
SUBJECT TO FIELD INSPECTION
I hereby certify that the a
the occupancy and the,
Owner or agent:
PERMIT EXPIRES Thursday, August 6, 2009
Permit Issued on Monday, August 6, 2007
iinformation is correct and that the construction on the above described property and
ill be in accordance with the laws, rules and regulations of the State o Washington
and the City of Federal Way. ` F
6 � / `I
Date:
City of Federal Way
Certificate of
Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: COZY HEARTLAND ADULT FAMILY HOME Permit #: 07- 104355 -00 -SF
Address: 2654 SW 330TH ST
Includes:
#1
#2
#3
#4
Occupancy Class:
Construction T e:
Occupancy Load
Floor Area (s q. ft.)
0
0
0
1 0
Owner Name: NHOGIE BATIK
NHOGIE BATIN
Owner Name:
Owner Address: 2654 SW 330TH ST
FEDERAL WAY WA 98023
Building Official
Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner / occupant or to any otherperson that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
THIS CARD IS TO MAIN ON -SITE
CITY OF tommunity Develo m nt Ins ection Record
p P
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104355 -00 -SF
Owner: NHOGIE BATIN
Address: 2654 SW 330TH ST
FEDERAL WAY, WA 98023 -2890
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
❑ SWM Precon Site Mtg (4400)
Approved
By Date
❑ Initial Erosion Control (4365)
To be done prior to breaking ground
By Date
❑ Underfloor Framing (4285)
Approved to sheath floor
By Date
❑
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
❑ Fire/Draft Stops (4095)
Approved
By Date
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
❑ Framing (4120)
Approved to insulate
By Date
❑ Insulation (4150) ❑ Gypsum Wallboard Nailing (4130) ❑ Final Erosion Control (4375)
Approved to install wallboard Approved to install mud & tape Approved
By Date By Date By Date
❑ Final - Building (4050) ❑ Interim Erosion Control (4370)
Approved Approved
B �e ;� By
By Date
For inspector
❑ Rough Electrical
Approved
By Date
reference only__
❑ FINAL -Electrical
Approved
By Date
CITY Of — .
Federal Way RECF -IVE � PERMIT � � �
COMMUNITY DEVELOPMENT SERVICES (i�a CO ME EL PL DE EN FP
33253-835-2607- FAX 253-835-2609 71IM - ° 6 20'A p p L I C AT I O N TD
FEDERAL WAY, WA 98063 -971
wu/u. cif t ede. ral`
ula
My OF FEDERAL WAY
The following is reiii"Ii1WO"imn -an incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY ,
�(( • •
SITE ADDRESS -- 2 6 5 t-1 'SW 330*" -Pd' w(,(' , q p
l 8 n� SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # 1 - / 't S7- 2—L t - D_ 3 O LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page far lengthy legal description)
PROJECT • •
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, Gk �.0n CA w�nC�OwS
3 - CJ� C`Dli� Y�•S
PROJECT NAME (Name of Business or Owner Last Name)" " l-F-� w"` L-
PROPERTY
OWNER .
CONTRACTOR
COPY of a
with aac ap
APPLIC
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
N3kMie- �- J h oa nlnc� 'i�Q 1-� e r►�
PRIMARY PHONE
(s )-i - (13
MAILIN DRESS
AtQ5
CITY, STATE, ZIP
1P
E -MAIL ADDRESS
SLA.3 3.30-i"1
C1 ,wo D23
EXPIRATION DATE
COMPANY NAME
WkSi C -� hn
AP LICANT NAME
C -REV-t sxacx-
OFFICE PHONE
(;Z53) 5i 5 -. 4Q2-0
M ILING ADDRESS
02 or6xay-a S
CITY, STATE, ZIP
Q.0 aKO WA, q 8.5 21
CELL PHONE
aS-v 7 - 0 �
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
-7
( ) -
ONTRACTOR'S REGISTRATION NUMBER
TCV' �8 K0
EXPIRATION DAT
0 I / 09 a•6D
E -MAIL ADDRESS
ns+ ilaiicXt ,`"'�s +c
COMPANY,,NQME
v Y r1iar
-
Q__
APPLICANT NAME -
OFFICE PHONE
( ) -
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
NAME PRIMARY PHONE E -MAIL ADDRESS
NAME
Per RCW 19.27.095.
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE $
PROPOSED USE _
VALUE OF PROPOSED WORK $ L 51 —71 9
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 (SEPTICI
11�)'
tom
AREA DESCRIPTION
EXISTING
S. F
ROPOSED
Q
S . FT.
TOTAL,
S. FT.
BASEMENT
qW'
WOODSTOVES
BBQS .
FIRST
GAS WATER. HEATERS
MISC (Describe)
BOILERS
.SECOND
HOODS (commerdw .
COMPRESSORS
THIRD
RANGES
DUCTS
ADDITIONAL FLOORS (DESCRIBE)
REFRIG. 3Y3T1;M3
PLUMBING
DECK•(❑ COVERED OR ❑ UNCOVERED ?)
BATHTUBS (or Tab /shower combo)
GARAGE ❑ CARPORT ❑
URINALS
MISC (Describe)
DISHWASHERS
NUMBER OF FLOORS
mug""
xorosa°
Tor u
nc EX07 O or
•rorAL rsor°eso sr
rordL BY
"NEW HOMES ONLY" NUMBER OF BEDROOMS E D SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part'of this project: Do not include existing fixtures to remain.
Value of Mechanical Work $'
(A COPY OF BID OR ESTIMATE AIUSZBE
INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
I EVAPORATIVE COOLE
GAS PIPE OUTLETS
WOODSTOVES
BBQS .
FANS
GAS WATER. HEATERS
MISC (Describe)
BOILERS
REPLACE ERTS
HOODS (commerdw .
COMPRESSORS
RANGES
DUCTS
G SETS
REFRIG. 3Y3T1;M3
PLUMBING
BATHTUBS (or Tab /shower combo)
LAV.S isathro . b*.)
URINALS
MISC (Describe)
DISHWASHERS
RAINWATER SY
VACUUM BREAKERS
DRINKING FOUNTAI
SHOWERS
WATER CLOSETS p'oneq
ELECTRIC A T HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
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 authorised 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 it j'ormation supplied to the city as apart of
this application. (j(�,, ,�, �'� n� /_�� ,-� I� t 1 —7
NAME /TITLE c ►WIA, lk CL � I Y1S�A L 101_TI OY'\ � 0 ita �,Q�• DATE _ I cP I o /
(Signature) (Ti
RELATIONSHIP TO PROJECT O Owner O Agent Contractor 11 Architect O Other
II
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO . BASIC PLAN? o YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP /SEPA /SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? 6 YES o NO
Bulletin #100 -April 2, 2007 . Page 2 of 4 k \Handouts \Permit Application