03-105103City of Federal Way Building - Single P'amil� Permit #: 03 - 105103 - 00 - SF
Community Development Services
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: BELTRAN
Project Address: 30146 16TH AVE SW Parcel Number: 515320 0397
Project Description: ADD - Construct 407 square foot living room addition and 60 square foot porch addition, including
' —'= "'�'�' �--• e, ;icco is n:I ^a. No plumbing.
Owner
Applicant
Contractor
Lender
Ernesto D Beltran & Adelaida P Beltra
Ernesto D Beltran
NONE
Ernesto D Beltran
30146 16TH AVE S
30146 16TH AVE S
_
Cons'
30146 16TH AVE S
FEDERAL WAY WA
FEDERAL WAY WA
No
FEDERAL WAY WA
98003
198003
198003
Includes:
Census category: 434 - Reside
#1
#2
#3
#4
Occupancy Group:
R -3
R -3
Yes
Occupancy Group #1.......... .... .....
_
Cons'
Type V- N
Type V- N
Plumbing......: .. ......
No
Occupancy Load:
Total Proposed Sq. Feet...... ......... .............467
Zoning Designation ............... .............................RS
Floor Area (Sq. Ft.):
1 st Floor Proposed Sq. Feet .... ...........................407
Census Category y.: ........... ................ 434 - Residential-jilt/add ;- no c
Construction Type t :.....,.,, ........................
Type V - N
Deck Proposed Sq Feet......, .........
...........60
Mechanical ......:. .......♦ ....,... .........
Yes
Occupancy Group #1.......... .... .....
.......:....R -3
Occupancy Grout ?2 . .............. ...........................
R -3
Plumbing......: .. ......
No
Total Building Sq. Feet ............. ...........................2935
Total Proposed Sq. Feet...... ......... .............467
Zoning Designation ............... .............................RS
15.0
Mechanical Fixtures
� matr}}^^l t1t}�`l��g � ,. ,,, ``� ,. �..�� I' � r►� ,�:, U i# � ` ���1� 1 tt�
Ftreplace Inserts 1
CONDITIONS:
1) Service connections for electrical & communication facilities shall" be placed underground per FWCC, Sec. 16 -48.
2) Prior to an), clearing or grading on a lot, the owner /builder shall install temporary erosion/sedimentation cont'731
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 site plan for location of silt fencing.
PERMIT EXPIRES June 19, 2004.
Permit issued on December 22, 2003
I hereby :ertify that the above information is corrbclt and that the construction on the above described property and
the occupancy and the use will be in accordance wiNthe laws, rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date:
INSPECTION LOG
CITY OF
federal Way
POST-THIS CARD ON THE FRONT OF BUILDIDik
,
BUI ING DIVISION ,
INSPECTION RECORD
INSPECTION REQUEST PHONE #: 253- 835 -3050
PERMIT #: 03- 105103 -00 -SF
OWN'ER'S NAME: Ernesto D Beltran & Adelaida P Beltran
SITE ADDRESS: 30146 16TH SW
O FOOTINGS /SETBACKS " <3 " O y Cw O FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
j BIR a IlVAGE: Line O Connection _
DO NOT POUR SLAB UNTIL THE ABOVE t^ AFPROVEL•
/ Tj dMERFr ,1R T'R.AMry J
' .i :OTJGF' r'i rJ; ^/It ING: '_ :VIV
-CAL
Water -,:Find
Ditch
At', t-.T.L ABOVE is:ii.ES 133Z. AF 1. "' V ;T1 P 111CR 10.1, 1-`�AMINC i
THE ABOV_ MUST sBE ??PROVED I ° ?Icy:' TO 1NSULAiI.11G Ott S1IEETROLY_'v,
T HE ABOVE MUST BE APPR7 ✓V D PRIOR TO APPLYING SIIE ETROCK /
( j WALL ?�G�u.,D I�AiLING %_ ( ) SUSPENDED CEILIL?G
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALL;INC CEILING TILE,
) '.:LEC _' CAL FINAL
( ) ?fJBLIC WORKS FINAL
( ) [RE FINAL
THE ABOVE MUST BE APPR VE PRI R TTO/ BU 4IG DEPARTMENT FINAL
BUILDING FINAL`'
DO NOT-OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
t ioo V 14 [+ U
CONSTRUCAN PERMIT APPLICATION
CITY OF �./ PPLICATION NUMBER: - 1 Q
Fe d e ra I Way CITY - �Y PPLICATION NUMBER: - -
- � C'i 1� [ iC. mil. _ y�J �4
BliILDINIG U1LLP� — — — — — — — — —
PPl1CATI0N NUMBER: - -
* *The following is required information – Please print (in ink) or type **
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMATION
SITE ADDRESS: ,J� `Y� ' �0 T14 Add S I^' ASSESSOR'S TAX /PARCEL #:
LEGAL DESCRIPT ON OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): _
9 Mts12) � V i to -1b
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ,O'6UILDING ❑ PLUMBING o MECHANICAL o DEMOLITION
❑ ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed delcription):
6100 10-3-TV -UC7 1'?� X 'Z2 1 -1JkP6 F-0CM - - &-PPV %00 ,
PROJECT NAME:
:. .;_WPEOPLE INFORMATION
PROPERTY OWNER: i NAME:
i UAYI1Mt PHONt'
0322
MAILING
(STREET ADDRESS; CITY, STATE, Z�I,P).. 2_3
CONTRACTOR: NAME: � DAYTIME PHONE:
17) Off P e -re g-� I tY S ; ( ) -
i MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: j EXPIRATION DATE:
(copy of card required) /
APPLICANT: I NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
'3 01-, la 1(v T_' S -v3 FP IW V0. I- xW f
RELATIONSHIP TO PROJECT: ,cp
o ARCHITECT ❑ TENANT OTHER ( DESCRIBE): d0NF_Z-
CONTACT PERSON FOR THIS PROJECT: PROPERTY OWNER ❑ APPLICANT o CONTRACTOR
DAYTIME PHONE:
i -o(a) 2 4,1 - -;44
�153PHONE:
FAX NUMBER:
(4W) -1013 -5-z l
i
E -MAIL ADDRESS: I
DAtJ 0 f7AI,YIq, •
EXISTING USE: �(h� Mtvn L`i EXISTING BUILDING ASSESSED /APPRAISED VALUATION
PROPOSED USE: S1 W6 1f f-A}•A1 Lnj PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? ❑ YES ,FiliO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED- ❑ YES ,O'NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE o TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE o PRIVATE (SEPTIC)
* *NEW RESIDENTIAL CONSTRUCTION O * �-
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
- ■ PRO3ECT FLOOR AREAS
FLOOR
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
FIRST
' v
/1 0�
-T
SECOND
THIRD
FOURTH
OTHER FL ORS DESCRIBE)
DECK
%
GARAGE
HOW MANY FLOORS?
TOTAL:
(� IE5 2�
L� '�j
d
1z l ok �5 S
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S)
BBQ(S) FAN(S)
BOILERS) FIREPLACE INSERTS)
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
'fixture
Value of Mechanical Work:.!
GAS LOG(S)
HOOD(S)
RANGE(S)
REFRIG. SYSTEM(S)
WOODSTOVE(S)
MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
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 da' ), which may be made by any person, including the undersigned, and flied against the City of
Federal Way, but only where such dz l ises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information su to the city as a 'ftj�t of this application.
DATE: /�
�PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063 -9718 • 253 -661 -4000 -i FAX: 253 -661 -4129
YyWW Cltvoffedera1WaV &—