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09-102871 ilding - Single F'amify ffr ciof Federal Way Q cornrnZeeervices Permit #: 09-102871-00-S F P.O.Box 9718 Federal Way,WA 98063-9718 Ph.(253)835-2607 Fax (253)835-2609 F I 6T3 Inspection Request Line: (253)835-3050 Project Name: UNIQUE ADULT FAMILY HOME Project Address: 31613 8TH AVE S Parcel Number: 858800 0095 Project Description: OCCUPANCY PERMIT ONLY-NO WORK DONE ON THIS PERMIT Providing care for residents active daily living,meals,medication and assist with personal care Owner Applicant Contractor Lender LOANA PERDE NINA BORDLEY 31613 8TH AVE S 31613 8TH AVE S 31613 8TH AVE S FEDERAL WAY WA 98003 FEDERAL WAY WA 98003-5322 FEDERAL WAY WA 98003 Census Category: 999 -Unknown Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load: Floor Area(sq. ft.) 0 0 0 0 �4 � , New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0 Mechanical to be Included? No Plumbing to be Included9 No , d rNo Fi ure Ats0CiatedVittiIhiS% ermit tt,t, k PERMIT EXPIRES Sunday, January 24, 2010 Permit Issued on Tuesday, July 28, 2009 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 and the S e A pflcat' ion Owner or agent: Date: ;JUL 2 8`2009 l Nkl,�i� ?7'3q'O9 rao 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: UNIQUE ADULT FAMILY HOME Permit#: 09-102871-00-SF Address: 31613 8TH AVE S Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load: Floor Area(sq. ft.) 0 0 0 0 Owner Name: LOANA PERDE LOANA PERDE Owner Name: Owner Address: 31613 8TH AVE S FEDERAL WAY WA 98003-5322 7/30/Qq 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. /111 r • • # • r , RECEIVED JUL 28 ?Q!.)9 CITY OF FEDERAL WAY CDS Yi9kv Ce n9 eaRb©1-1k vrAdi Roof`/ Gc �s2 t Bel-rtir3 8 eaPanqii g RotAft *Co Nisi ncl M.1 11' DO Al RdoN1 MAiN Liolux4DR,/ TC�e►�� l�fim pad P,ob m aMp f1 Z ti.t- 4 U a A DU ri tin 1 I tt�rhea 31k, 13 Sttl p.ttz `�n, STN 1-Eo of 1.i hno , LL)ct. qs6o,n EL,Li V ERMIT �@rdl y F CO ME EL PL DE EN FP COMMUNITY DEVELOPMENT 7 2 S 09�L 2 8 20APPLICATION / / unu .4114912Z4Mhuau.2181 �/ r e*. lb A A I SITE ADDRESS 31U (3 Ai �3 j m-►- r 9 SUITE/UNIT S ZONING ASSESSOR'S TAX/PARCEL• NAME OF PROJECT ti ‘-e, or Homeowner Name) Q t Ho t ❑BUILDING ❑ PLUMBING ❑ MECHANICAL TYPE OF PERMIT ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER ' PP Rao p ( ) - (1a MAILING ADDRESS,CITY,STATE,ZIP ��,„L t,1 K 1 / A/A E-MAIL 15?®i 6. LLB+� 3-r OWNER IS ALSO: ❑ CONTRACTOR ❑ APPLICANT 0 PROJECT CONTACT NAME PRIMARY PHONE ( ) - CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP / FAX ) - WA STATE CONTRACTOR'S LICENSE• EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE NAME * t� L BO PRIMARY PHONE APPLICANT (All J�1 BO ) - MAILING ADDRESS, STATE,ZIP FAX 3 lip 13 ADDRESS, 4-1_)•6 6o. - i3) ))"t ) - PROJECT CONTACT NAME PRIMARY PHONE (The individual to receive and ( ) - respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX concerning this application) ( ) - ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL ( ) PROJECT FINANCING NAME 0 OWNER-PINANCED Required for projects with value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE (RCW 19.27.095) ( ) - I certify under penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the best of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. 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 r city,but only when 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 f this application /�' SIGNATURE: �" D I PRINT NAME: I A.I Q 4-. V OICL-1,�-` Bulletin#100—4/17/2009 Page 1 of 4 k:\Handouts\Permit Application •