09-102452 City of Federal Way • building - Single Family
Q
Community Development Services Permit #: 09-102452-00-SF
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph (253)835-2607 Fax:(253)835-2609 p q 1
Project Name: POLING A �. .. ,
Project Address: 32400 11TH AVE SW ; Parcel Number: 926493 0260
Project Description: REP-Re-roof remove shake,install plywood and comp shingles.
Owner Applicant Contractor Lender
KEITH A POLING HORIZON CONTRACTORS INC HORIZON CONTRACTORS INC
32400 11TH AVE SW PO BOX 24449 HORIZCI110KR (05/19/11)
FEDERAL WAY WA 98023-4910 FEDERAL WAY WA 98093 PO BOX 24449
FEDERAL WAY WA 98093
� l
Census Category: 555 -Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Area(sq.ft.) d 0 0 0
New/Additional Sq:Piet-;3rd Floor a. 0 New/Additttti niaf: Filet-Base ,
Mechanical to be nel tt'`. ...No Plumbing to.be Inc uded?
lmw t ' I NO Figures ASS i , With rhls Permit tl *�
PERMIT EXPIRES Saturday, December 26, 2009
Permit Issued on Monday, June 29, 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 City of Federal Way.
Owner or agent: / Date: 4/2 c )a 9
ts)041.1.0), vio/c;t9
THIS CARD IS TO MAIN ON-SITE - -
CITY OF S Construction In ection Record
Federal Way INSPECTION REQU TS: (253) 835-3050
PERMIT#: 09-102452-00-SF Address: 32400 11TH AVE SW
Owner: KEITH A POLING - FEDERAL WAY, WA 98023-4910
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.
Q SWM Precon Site Mtg(4400) - Initial Erosion Control(4365) Underfloor Framing(4285)
Approved To be done prior to breaking ground 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 roofin
By Date By Date By Date 7://a
O Fire/Draft Stops(4095) Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in and
Fire/Draft Stop inspections must be signed-off and
By Date By Date approved. IBC 109.3.4
•
O Framing(4120) Insulation (4150) Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard .Approved to install mud&tape
By Date By Date By Date
Final Erosion Control(4375) Final-Building(4050)
Approved • Approved
By Date By .- C�1 Date 7.C.0 a Q
•
•
J
• i
For inspector reference only
❑ Rough Electrical ❑ • FINAL-Electrical
Approved Approved •
By Date By Date
. ., A RECEIV - / ° 2 �� .
Federal Way FNMA'
COMM1Nlrr DEVELOPMENT SERVI S MF CO ME EL PL DE EN FP
• 33325 sTM AVENUE SOUTH•PO BOX 9TIE1N
2920,
FEDERAL WAY,WA 98063-97I8 APPLICATION
+ 253 8352607•F y r
F FEDERAL,. WAY
The following is require ation-an incomplete application will not be accepted. Please print legibly fin inld or type
II PROPERTY INFORMATION
SITE ADDRESS_ 329 0 0
11441 Avt SW Filly I 1-'-14.1_ SUITE/UNIT It
ASSESSOR'S TAR/PARCEL• q 2 62 A 3 02- 6 v
LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
path •P Io•len9th4,het descriPek4
• PROJECT INFORIVIATION
TYPE OF PERMIT 1'IBULDING ❑PLUMBING ❑MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
—16)-("No i l 1.6.iuj i"3401 111,) �J cb G11Pri 6" s II'^ I tr
PROJECT NAME(Name of Business or Owner Last Name) �L` ,V
• PEOPLE INFORMATION
PROPERTY NAME I �G ►k C , PRIMARY PHONE
OWNER /1, _
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
ScV•i_
•
CONTRACTOR COMPANY NAME , A CANT N//AME OFFICE PHONE
GAUD 11r,nzo„ Ct'*fAc-+-rs c & c_rc 1( _
N CITY,STATE,ZIP CELL PHONE
orO�X 2`�M4 1 Ftdv�) t.rs., WA �isz011 (2. t �251 _ 2`1fri
cry CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
( )
CONTRaCCOR'S REGISTRATION NUMBER
EXPIRATION DATE -E-MAIL ADDRESS
Hv122cS IIoIcR 5 1 i I
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑Tenant ❑Agent ❑ Other ( ) -
PROJECT NAME PRIMARY PHONE- ' E-MAIL ADDRESS
CONTACT ( ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value accords 55,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ G 16 G, c D
SPRINILERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑HIGHLINE ❑ TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑LAKEHAVEN ❑HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS •
AREA DESCRIPTION EXISTING PROPOSED TOTAL
BASRMF.NT SQ FT. SQ.FT. SQ.FT.
FIRST
SECOND - I
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑UNCOVERED?)
GARAGE 0 CARPORT ❑
NUMBER OF FLOORS sasses PROPOSED TOTAL TOTAL 11201M310 TOTAL PROPOSE/er reviler
•
"NEW HOMES ONLY"' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
■ FLXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
LEIAIICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Descriie)
BOILERS FIREPLACE INSERTS HOODS(Communise
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
i {
PLUMBING
BATHTUBS(ern b/SbWComb,) LAVS(Bathroom Bbl URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS ( ,
DRINKING FOUNTAINS SHOWERS WATER CLOSETS fro1ep
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
•
SIGNATURE
I cert ftj under penally of perjury that I mu 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 Wag 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, 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.
SIGNATURE: DATE z Gy
Owner and/or Authorised Agent
a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUMMING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2009 Page 2 of 4 lAHandouts\Permit Application