07-100145Cj" of
Federal way OPERMIT
COMMUNITY DEVELOPMENT SERVICES O XPFLICATION)"'�'(i* � CO ME EL PL DE EN FP
33325 8- AVENUE SOUTH • PO BOX 971 qN 1
FEDERAL WAY, FAX 53-8 98063-9718 -260 FAX 253 - 835 -2609 wACITY OF FEOERAL
pjJ &PING DEPT.
The following is requir n ormation - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS 0�; 2, --�>7 7 -7` � SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # _ - LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page far lengthy legal desorption)
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICALVO+1r
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
P JECT DESCRIPTION (Provide detailed description of included on this permit only)
PROJ T ea oQisiness or OwnerAst a `�
PROPERTY
OWNER
CONTRACTOR
COPY of .—d required
with eaeh application
APPLICANT
AME
PRIMARY PHONE
OFFICE PHONE
;;�,
G � c
MAILING ADDRESS
CITY, STATE, ZIP
E-MAIL-ADDRESS'
IS
CIk T�Y,STATE, ZIP
l c c`, /)1)
CELL PHONE
zap -tea 3S
COMPANY NAME
zw- 1l
APPLICANT NAME
OFFICE PHONE
;;�,
G � c
c=am r .-
C45-5 -17-V
MAILING ADDRESS -
) 4- 4 . v�rr✓ t_
G:v-
CIk T�Y,STATE, ZIP
l c c`, /)1)
CELL PHONE
zap -tea 3S
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION D TE
FAX NUMBER
t`�f -icl- 7��.. �3 /z
(� X03 = r -7� �k,
CONTRACTORSR A
F
TION ATE
E-MAIL ADDRESS
12- -NN
M!94 /
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
f
-
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Ten O Agent 1i Other
( -
PROJECT NAME PRIMARY PHONE E -MAIL ADDRESS
CONTACT ( -
LENDER
EXISTING USE
NAME
Per RCW 19.27.095,
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
/PHONE
1
EXISTING ASSESSED /APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED USE
VALUE OF PROPOSED WORK $
` G
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER O LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
�4
Indicate number of each type of facture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHAA7CAL
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUM "'01 G
BATHTUBS !or Tub /Shower combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVS (Bathroom Sinks)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (comm<rdaq
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS Romp
WASHING MACHINES
WOODSTOVES
MISC (Describe)
MISC (Describe)
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 lincluding 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 flied. 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 .
(Signature)
RELATIONSHIP TO PROJECT o Owner ❑ Agent
9
o Other
/0-7
.ol //o
o NEW o ADDITION
o ALTERATION
PROPOSED
S . FT.
TOTAL
S . FT.
AREA DESCRIPTION
EXISTIN
SQ. FT:
BASEMENT
BASIC PLAN? o YES
a NO
ZONING DESIGNATION
FIRST
CHANGE OF USE? o YES
o NO
SECOND
o YES o NO
UP /SEPA /SU? a YES
THIRD
PLATTED LOT?
o YES o NO
ADDITIONAL FLOORS (DESCRIBE)
a NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
-
NUMBER OF FLOORS
EIOSTINO
PROPOSED
TOTAL
TOTAL HOSTING Sr
TOTAL PROPOSED SF
TOTAL SF
" "NEW HOMES ONLY " NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of facture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHAA7CAL
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUM "'01 G
BATHTUBS !or Tub /Shower combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVS (Bathroom Sinks)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (comm<rdaq
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS Romp
WASHING MACHINES
WOODSTOVES
MISC (Describe)
MISC (Describe)
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 lincluding 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 flied. 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 .
(Signature)
RELATIONSHIP TO PROJECT o Owner ❑ Agent
9
o Other
/0-7
.ol //o
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? a YES
a NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
a NO
Bulletin #100 —January 1, 2007 Page 2 of 4 k \Handouts\Permit Application
4 City of Federal Way Building - Single Family Permit #• 07- 100145 -00 -S
Community Development Services •
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: THOMPSON
Project Address: 1933 S 375TH ST Parcel Number: 7212651150
Project Description: REP - Repair roof trusses per engineering., replace damaged plywood (OSB) sheathing.
Replace damaged sheet rock. Replace master bath n, window and possible shower
and bath depends on damage. * ** *Treed UP u due wind storm * * **
Owner
lic t P34SOPROCT act Lender
DAN THOMPSON fACOMA 1W840% R UI R DAN THOMPSON
1933 S 375TH ST R 9 313 0 19 S 375TH ST
FEDERAL WAY WA 98003 -7567 9 OR AY WA 98003 -7567
Census Category: 434 -
no change in number of units
Includes: I #1 � � #2 I #3 #4 -�
r. ccui)ancv Class:
Load:
so. ft.
5.
Itilrrl olia.
New / Additional Sq. Feet - 3rd Floor ...................0 New / Additional Sq. Feet - Basement ................... 0
Mechanical to be Included ? ....... ............................Yes Plumbing to be Included? ...................................... Yes
Mechanical Fixtures
Fans................. ............................... 1
Plumbing_ Fixtures
Bathtubs ......................................... 1 Other Plumbing Fixtures ............... 1 n`�S
1. Subject to Field Inspection
CONDITIONS: 051
S0
PERMIT EXPIRES Saturday, January 10, 2009
Permit Issued on Wednesday, January 10, 2007
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
,� n (end the City of Federal Way.
Owner or
l'-')l 2D( I (0 - G c�vnv�nPlAv5r-'�
Date: O (--(,O — O�
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: THOMPSON
Address: 1933 S 375TH ST .
r.
Permit #: 07- 100145 -00 -SF
Includes:
#1
#2
#3
#4
Occupancy Class:
,
Construction T e;�.
Occupancy Load:
Floor Area (sq. ft.)
0
f 1 0
0
0
r
Owner Name: DAN THOMPSON..
DAN THOMPSON
Owner Name:
A
Owner Address: 1933 S 375TH ST `
FEDERAL WAY WA 98003 -75`67
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 other person 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.
R
THIS CARD IS TO REMAIN ON -SITE J .
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 100145 -00 -SF
Owner: DAN THOMPSON
Address: 1933 S 375TH ST
FEDERAL WAY, WA 98003 -7567
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)
❑
Plumbing Groundwork (4190)
❑
Underfloor Framing (4285)
To be done prior to breaking ground
Approved to cover
Approved to sheath floor
By
Date
By
Date
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
❑
❑
Rough Plumbing (4230)
Mechanical Rough -in (4165)
❑
Gas Piping (4125)
Approved
Approved
Approved to release test
By
Date
By
Date
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
By
Date
signed -off and approved. IBC 109.3.4/tJBC 108.5.4
By 4:::-- Date Z — (.. &
❑
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
❑
Final - SWM (4375)
Appr`oved to install wallboard
Approved to install mud & tape
Approved
By
C L of Date Z - t W. 07P
By
g:::, wJ Date Z,2,9-
By
Date
❑
❑
Final - Mechanical (4065)
Final - Plumbing (4075)
❑
Final - Building (4050)
Approved
Approved
Approved
By
Date
By
Date
By
Date
[]Temp. Erosion Maintenance (4370)
Approved
By Date