02-101080� 73�
City ofF;devel Way Building - Single Family Permit E
Community Development Services tt :0� � 1�1U8� — oo � �j
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: LESKOVAR
Project Address: 30712 16TH AVE SW SUBJECT TO FI Parcel Number: 514930 0080
Project Description: RES REP - Repair masonry chiminey damaged by re . INSPECTION.
Owner
Applicant
Contractor
Lender
John A Leskovar
John A Leskovar
John A Leskovar
NONE
30712 16TH AVE SW
30712 16TH AVE SW
FEDERAL WAY WA
FEDERAL WAY WA
30712 16TH AVE SW
98023 -3430
98023 -3430
FEDERAL WAY WA
NONE
Includes
Census category: 434 - Reside #1 #2 #3 44
Occupancy Group: R -3
Construction Type: Type V - N
Occupancy Load:
Floor Area (Sq. Ft.):
Census Category .................. ............................... 434 - Residential alt/add - no cl Mechanical.................. ............................... No
Occupancy Group # 1 ................... ............................R -3 Plumbing.................. ............................... No
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes, policies, or standards relating to
the subject proposal.
Subject to field inspection.
PERMIT EXPIRES September 8, 2002, IF NO WORK IS STARTED.
Permit issued on March 12, 2002
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 accoEdaHcTVqth the laws, rules and regulations of the State of Washington and
the City of Fed a
Owner or agent: Date:
0 0
INSPECTION LOG
Pf THIS CARD ON THE FRONT OF BUIL G
BDING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE #: 253- 835 -3050
PERMIT #: 02- 101080 -00 -SF
OWNER'S NAME: John A Leskovar
SITE ADDRESS: 3071216TH SW
O FOOTINGS /SETBACKS / 110 _ FOUNDATION WALL
3 ._, ADO NOTOUR _BOPPROVD A NA,
( ) DRAINAGE: Line
( ) Connection '
() UNDERFLOOR FRAMING
O ROUGH PLUMBING: DWV Water piping
( ) ROUGH MECHANICAL Gas
( ) SHEATHING Roof Floor.
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH -IN Ditch
( ) FIRE/DRAFTSTOPS
SAM
() FRAMING/FIRESTOPPING
MIS mwo:ft
() INSULATION: Floors Walls Attic
OffillOOM � E
-C., _ 0
( ) WALLBOARD NAILING.
( ) ELECTRICAL FINAL
( ) PLANNING FIN
( ) PUBLIC WORKS
( ) FIRE FINAL
( ) BUILDING FIN
( ) SUSPENDED CEILING
STA"%1LT „N,UIi.�N��
Im
® ® MI6 o
ar♦or G RCEIVED CONSTRUAN PERMIT APPLICATION
�� APPLICATION NUMBER:
MAR ]. 2 2002 APPLICA RON NUMBER:
APPLICATION NUMBER: - _ _ _ - - -
_ -
CITY OF FEDERAL WAY -
* The folloBUtLUNh$a(DEWlinformatiori — Please print (Ih ink) or type * *.
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
O.
SITE ADDRESS: �'�'Z ° � <`Q� • ASSESSOR'S TAX /PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
`PROIECTINFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): VAyLMy, x SLy..a d qt Q 1
"-U c
r 4- ''a`�L
PROJECT NAME:
z -: PEOPLE INFORMATION
PROPERTY OWNER: I NAME:
CONTRACTOR:
MAILING ADDRESS
(STREET ADDRESS; CITY, STATE, ZIP):
DAYTIME PHONE:
cm-3 )(=�4- \--5
NAME:
DAYTIME PHONE:
\
V O
-
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE: I
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
APPLICANT: .I NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP);
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
EXISTING BUILDING ASSESSED /APPRAISED VALUATION $
EVENING PHONE:
FAX NUMBER:
E -MAIL ADDRESS:
PROPOSED VALUATION FOR IMPROVEMENTS: $ �� _+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 (SEPTIC)
* *NEW RESIDENTIAL CONSTRUCTION Y **
NUMBER OF BEDROOMS:", ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
- FLOOR
EXISTING S . FT.
PROPOSED S2. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)'
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
]TCCI ATMPOIA ,NATURE RLC
WATER HEATER(S)
El ELECTRIC ❑ GAS
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 claim), which may be made by any person, including the undersigned, and filed against the City of
Federal Way, but only where such cia_i .a ''shout of the reliance of the city, including its officers and employees, upon the accuracy
r
of the infomatiao-Guoolied to-the ci -_q a na of thisannlication_
NAME /TITLE:
❑ PROPERTY OWNER
APPLICANT 11-CONTRACTOR
DATE- 1
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063 -9718 - 253-661 -4000 - FAX: 253 -661 -4129
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