08-104032City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: TARRIN
Project Address: 30146 16TH AVE SW
Building - Single-Fa>rrily
Permit #: 08-104032-01-S F
Inspection Request Line: (253) 835-3050
Parcel Number: 515320 0397
Project Description: ADD - Expand existing single family residence by adding a 3,257sgft 2nd story; 1,198sgft
bonus room above both thp. evvertedce, whic going to be a shop; an
ttachf**RE
d 2 r g rager, and n oval 6 sq eck. Includes
mbin a anica S to clu a addition 440 sq re feet above shop
additi bedro d b thr
Owner on tender
DENIS & LORRAINEL00000701a/T"DfiESIGNSES 46 O1 6TH AV S DEN LORRAINE TARRIN
30146 16TH AVE S PO D L WAY WA 0 34 146 16TH AVE S
FEDERAL WAY WA 98023-3451 •B NNEY�we ffff F RAL WAY WA 98023-3451
Census Cat ory: 4tial al /add - no change in number of units
New/ Additional Sq. Feet - 1 st Floor .................... 532
New / Additional Sq. Feet - 3rd Floor....................0
Occupancy # 1 - Area (Sq. Feet).............................7411
Occupancy #2 - Area (Sq. Feet).............................1065
New / Additional Sq. Feet - Basement...................0
Occupancy # 1 - Construction Type ........................Type
V - B
New / Additional Sq. Feet - Deck ..........................
640
Mechanical to be Included?....................................Yes
Number of Bedrooms.............................................4
Total Number of Dwelling Units ............................1
Number of Stories..................................................2
Occupancy # I - Class.............................................R-3
Occupancy #2 - Class.............................................0
New / Additional Sq. Feet - Other ..........................1198
Plumbing to be Included? ......................................
New / Additional Sq. Feet - Total ..........................
6371
Occupancy #2 - Use ............................................... Private Garage
Fans................................................
GasLogs ........................................
New / Additional Sq. Feet - 2nd Floor...................3257
Occupancy # 1 - Area (Sq. Feet).............................7411
New / Additional Sq. Feet - Basement...................0
Occupancy #2 - Construction Type ........................Type
V - B
New / Additional Sq. Feet - Garage .......................
744
Number of Bedrooms.............................................4
Number of Stories..................................................2
Occupancy #2 - Class.............................................0
Plumbing to be Included? ......................................
Yes
Occupancy # 1 -Use ...............................................
Residence (1 or 2
Zoning Designation ............................
Fireplace Inserts ............................
Bathtubs ......................................... 3 Dishwashers................................... 1 Laundry Washer Outlets................ 1
Lavatories ....................................... 8 Showers.......................................... 2 Sinks............................................... 2
Water Closets ................................. 6 Hose Bibbs..................................... 2
CONDITIONS: 7 t 7 =45
1.Occupancy for t e structure will not be granted until the permit for the mini -waiter umbwaiter) and the
elevator has been given final inspection approval by the Department of Labor and Industries.
2. Lot coverage of impervious surface areas for this parcel is limited to 50% of lot size. The amount of
impervious surface on the approved site plan shown to remain and to be removed shall be verified at Final
Building Inspection.
r
I hereby certify that the
the occupancy and the
Owner or agent:
PERMIT EXPIRES Tuesday, September 22, 2009
Permit Issued on Thursday, March 26, 2009
nation is correct and that the construction on the above described property and
in accordance with the laws, rules and regulations of the St to of Washington
and the City of Federal Way.
nnfo• � �� /99
1
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. 11
Tenant Name: TARRIN
Address: 30146 16TH AVE SW
Permit #: 08 -104032 -01 -SF
Includes:
# 1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- B
Type V- B
Occupancy Load:
Floor Area (sq. ft.)
7,411 1
1,065 0 0
Owner Name: DENIS & LORRAINE TARRIN
DENIS & LORRAINE TARRIN
Owner Name:
Owner Address: 30146 16TH AVE S
FEDERAL WAY WA 98023-3451
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.
THIS CARD IS TO REMAIN ON-SITE
f
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 08 -104032 -01 -SF
Owner: DENIS & LORRAINE TARRIN
Address: '30146 16TH AVE SW
FEDERAL WAY, WA 98023 -3451 -
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.
Approved
By
Date
❑
SWM Precon Site Mtg (4400)
❑
Initial Erosion Control (4365)
❑
Footings/Setback (4110)
Approved
To be done prior to breaking ground
Approved to place concrete
By
Date
By
Date
By
Date
—
❑
❑
❑
Foundation Wall (4115)
Drainage/Downspout (4040)
Plumbing Groundwork (4190)
Approved to place concrete
Approved to backfill
Approved to cover
By
Date
By
Date
By
Date
❑
❑
❑
Slab/Concrete Floor (4255)
Underfloor Framing (4285)
Floor Sheathing (4105)
Approved to place concrete
Approved to sheath floor
Approved to install flooring
By
Date
By
Date
By
Date
❑
❑
❑
Shear Walls (4245)
Roof Sheathing (4220)
Rough Plumbing (4230)
Approved to install siding
Approved to install roofing
Approved
By
Date
By
Date
By
Date
❑
ElGas
E]Fire/Draft
Mechanical.Rough-in (4165)
Piping (4125)
Stops (4095)
I
Approved
Approved to release test
Approved
By
Date
By
Date
By
Date I
❑ Interim Erosion Control (4370)
Approved
By Date
❑ Insulation (4150)
Approved to install wallboard
By Date
❑ Final - Mechanical (4065)
Approved
By Date
E
: Prior to scheduling a Framing (4120) Framing (4120)
tion; Electrical, Plumbing & Mechanical Approved to insulate
n and Fire/Draft Stop inspections must be
ff and approved. IBC 109.3.4/UBC 10&5.4
By Date
❑ Gypsum Wallboard Nailing (4130)
Approved to install mud & tape
By Date
❑ Final - Plumbing (4075)
Approved
I By Date
For inspector reference
❑
Final Erosion Control (4375)
Approved
By
Date
❑
Final - Building (4050)
Approved
By
Date
Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
$u,lding Single Faily-
City of Federal Way
Community Development Services Permit #: 08 -104032 -00 -SF
P.O. Box 9718
Federal Way, WA 98063-9718 Inspection Request Line: (253) 835-3056
Ph (253) 835-2607 Fax: (253) 835-2609
r:
Project Name: TARRIN
Project Address: 30146 16TH AVE SW Parcel Number: 515320 0397
Project Description: ADD - Expand existing single family residence by adding a 3,257sgft 2nd story; 1,198sgft
bonus room above both the converted garage space, which is now going to be a shop; an
additional 744sgft attached 2 car garage; and an additional 640sgft deck. Includes
plumbing and mechanical.
wner
AvOicant
Contracto
Lencler
R-3
DENIS & LORRAINE TARRIN
BRANDT DESIGN SERVICES
30146 16TH AVE S
DENIS & LORRAINE TARRIN
2,ccu ancX Load:
30146 16TH AVE S,
PO BOX 7785
FEDERAL WAY WA 98023-3451
30146 16TH AVE S
1,065 1 0 1 0
FEDERAL WAY WA 98023-3451
BONNEY LAKE WA 98390
FEDERAL WAY WA 98023-3451
6371
Census Category: 434 - Residential alt/add - no change in number of units
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- B
Type V- B
2,ccu ancX Load:
Mechanical to be Included?....................................Yes
-,
Floor Areas . ft.
7,411 1
1,065 1 0 1 0
New / Additional Sq. Feet - 1 st Floor ....................
532
New / Additional Sq. Feet - 3rd Floor....................0
Occupancy #2 - Area (Sq. Feet).............................1065
Occupancy 41 - Construction Type ........................Type
V - B
New / Additional Sq. Feet - Deck ..........................
640
Mechanical to be Included?....................................Yes
-,
Total Number of Dwelling Units ............................1
Occupancy #I - Class ........................................ .....
R-3
New / Additional Sq. Feet - Other ..........................1198
New / Additional Sq. Feet - Total ..........................
6371
Occupancy #2 - Use ............................................... Private Garage
New / Additional Sq. Feet - 2nd Floor...................3257
Occupancy # I - Area (Sq. Feet).............................7411
New / AdditionaI Sq. Feet - Basement...................0
Occupancy #2 - Construction Type ........................Type
V - B
New / AdditionaI Sq. Feet - Garage .......................744
Number of Bedrooms.............................................4
-,
Number of Stories..................................................2
Occupancy #2 - Class.............................................0
Plumbing to be Included?.......................................Yes
Occupancy # I -Use ...............................................
Residence (1 or 2
family)
Zoning Designation................................................RS
15.0
Fans ................................................ 10 Fireplace Inserts............................. 2 Furnaces......................................... 1
GasLogs ........................................ 2
Bathtubs ......................................... 3 Dishwashers................................... 1 Laundry Washer Outlets................ 1
Lavatories ....................................... 8 Showers.......................................... 2 Sinks ................... ............................ 2
Water Closets ................................. 6 Hose Bibbs.......................
CONDITIONS:
1. Occupancy for the structure will not be granted until the permit for the mini -waiter (dumbwaiter) and the
elevator has been given final inspection approval by the Department of Labor and Industries.
2. Lot coverage of impervious surface areas for this parcel is limited to 50% of lot size. The amount of
impervious surface on the approved site plan shown to remain and to be removed shall be verified at Final
Building Inspection.
PERMIT EXPIRES Wednesday, April 22, 2009
Pe it Issued on Friday, October 24, 2008
1 hereby certify that the above in rm n is correct and that the construction on the above described property and
the occupancy and the use w i, ccordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent:' -'� - Date:
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: TARRIN
Address: 30146 16TH AVE SW
Permit #: 08 -104032 -00 -SF
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction T
Type V- B
Type V- B
Occupancy Load:
Floor Area (sq. ft.) 1
7,411 1
1,065 1 0 1 0
Owner Name: DENIS & LORRAINE TARRIN
DENIS & LORRAINE TARRIN
Owner Name:
Owner Address: 30146 16T14 AVE S
FEDERAL WAY WA 98023-3451
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.
DATE
INSPECTOR
AREA AND TYPE OF INSPECTION
Uff//N
I rM, i M. M
►�' l
✓/
I , All
Wall %V PIT
M \
-A
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 08 -104032 -00 -SF
Owner: DENIS & LORRAINE TARRIN
Address: 30146 16TH AVE SW
❑ Final - Mechanical (4065) (❑ Final - Plumbing (4075) 110 Final - Building (4050)
Approved I Approved Approved
Date I I By Date I ( By Date
For inspector reference only
❑ Rough Electrical O FINAL - Electrical
Appwved App vvcd
By Date By Date
FEDERAL WAY, WA 98023-3461
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.
❑
SWM Precon Site Mtg (4400)
❑ Initial Erosion Control (4365)
❑
Footings/Setback (4110)
Approved
To be done prior to breaking ground
Approved to place concrete
By
C Date /p
By CDate 2
By
Date
❑
Foundation Wall (_4115)
❑ Drainage/Downspout (4040)
❑
Plumbing Groundwork (4190)
Approved to place concrete
Approved to backfill
Approved to cover
By
Date
By Date
By
Date
❑
Slab/Concrete Floor (4255)
❑ Underfloor Framing (4285)
❑
Floor Sheathing (4105)
Approved to place concrete
Approved to sheath floor
Approved to install flooring
By
Date
By Date
By
Date
❑
Shear Walls (4245)
❑ Roof Sheathing (4220)
❑
Rough Plumbing (4230)
Approved to install siding
Approved to install roofing
Approved
By
Date
By Date
By
Date '3
❑
Mechanical Rough -in (41.65)
❑ . Gas Piping (4125)
[]
Fire/Draft Stops (4095)
Approved
Approved to release test
Approved
By
Date
By Date
By
Date
❑
Interim Erosion Control (4370)
NOTE: Prior to scheduling a Framing (4120)
❑
Framing (4120)
Approved
inspection; Electrical, Plumbing & Mechanical
Approved to insulate
i
Rough -in and Fire/Draft Stop inspections must be
By
Date
signed -off and approved. IBC 109.3.4/1JBC 108.5.4
By
Date
I
❑
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
❑
Final Erosion Control (4375)
Approved to install wallboard
Approved to install mud & tape
Approved
By
Date
By Date
By
Date
❑ Final - Mechanical (4065) (❑ Final - Plumbing (4075) 110 Final - Building (4050)
Approved I Approved Approved
Date I I By Date I ( By Date
For inspector reference only
❑ Rough Electrical O FINAL - Electrical
Appwved App vvcd
By Date By Date
r
`CITY OF
Federal Way
CORRECTION NOTICE
Building Division
33325 Eighth Avenue South
PO Box 9718
Federal Way, WA 98063-9718
Phone 253-835-2607
Fax 253-835-2609
IF YOU HAVE ANY QUESTIONS CALL f4104 ON14 (253) 835- Ago
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
� pi if
D E 1 INSPECTOR
DO NOT REMOVE THIS NOTICE
Page __1 of J—
`CITY OF
Federal Way
CORRECTION NOTI E
ADDRESS: 3 O PERMIT#: 3 1
IF YOU HAVE ANY QUES14ONS CALL
Building Division
33325 Eighth Avenue South
PO Box 9718
Federal Way, WA 98063-9718
Phone 253-835-2607
Fax 253-835-2609
(253) 835- 2-1b 2�
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
Building Division
CITY OF' 33325 Eighth Avenue South
Federal WayPO Box 9718
Federal Way, WA 98063-9718
Phone 253-835-2607
Fax 253-835-2609
CORRECTION NOTICE
ADDRESS: �i O) N � I E t o AVl SW-PERMIiN.
IF YOU HAVE ANY QUESTIONS CALL (253)835-
WHEN
253)835-
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WI IN 15 DAYS.
Z1__,lpllllo
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
cmro.'
Fe&miw ECEI$-
DPER
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MF CO ME EL PL DE EN FP
(?01[AlUiVfiY PEVBLOPAtBNP SERYlCBS
933'i EDsa, ice, WA 9 o 3 971 971QU G 2 6 20
953.835.2607• AU253-US-2609 A P P LI C AT I O NF/
WnL WAY
/09
Tito foliowi��d - an incomplete application will not be accepted. Please print legibly (in inN or type.
SITE ADDRESS _ 3 0 -TH A\) e S,L-J SUrrE/UNIT # .
ASSESSOR'S TA%/PARCEL i S 1 S 3 Z o- ej 1_ LOT SIZE (sn
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) 9 - 4- t-1 pat.l P w- V y W-".) Ic 9 r &-rw-. A V.> C) 1-3 3 $ I
(►nacn+weepweArmea0wkvdd J
PROJECT•• •
TYPE OF PERMIT KBUMDING >FLUM DIG EIANICAL
D DEMOLITION 0 ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only
Cf%s TI C.s'E: n. . -z. f `STo
C' �rM1 �Er --C 54- 0 v 4 /-1-L->0 z. GAR it.A-6�- - ' 4, Al_c /L — [moi'o
si,R i !►' i• ♦ `I I / Iii
PROJECT NAME (Name ofRugaggs or OwnerLagLftme
PEOPLE INFORMATION
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
NAME
PRIMARY PHONE
v>c-y- I S
80'b) "(-37
MAILING ADDRESS
CITY, STATE, ZIP
EMAIL ADDRESS
k 4-(0 — ! G t� �►�- . s �.
1=1ero wiLA t.- wnm
CONTRACTOR'S- REGISTRATIONNUi[BZR
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAIIJNQ ADDRESS
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S- REGISTRATIONNUi[BZR
ZXPIRATION DATE
E-MAMADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
vee t �.p SS eTU V l C -S
-11"
(7-5.3 $ L.. - 9 2L
MAILING ADDRESS
P - o - TSC) -1-7 bg
CITY, STATE, ZIP
T3oN N" ' g$39lI
CELL PHONE
z,S3 Ito - Z.00$
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect O Tenant 04gent D Other
( ) -
NAME PRIMARY PHONE E MAQ. ADDRESS
NAME per RCW 19.27.095.-
Lander
9.27096:Lender !ft
MaSTING USE SFR PROPOSED USE
�� VALUE OF PROPOSED WORK IST
ERISTIN-AEBESSEDJ PRAISED VALUE $� D � �
BPRINKLERED BUILDING? ❑ YES 1*NO FIRE, SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES XNO J
WATER SERVICE PROVIDER *1 LAKFaAVF.N O HIGHLINE o TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER *LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTICI
/ormadon is regreired #tP%%et value exceeds;5,000
MAILINQ ADDRESS
CITY, STATE, Z>P
PHONE
MaSTING USE SFR PROPOSED USE
�� VALUE OF PROPOSED WORK IST
ERISTIN-AEBESSEDJ PRAISED VALUE $� D � �
BPRINKLERED BUILDING? ❑ YES 1*NO FIRE, SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES XNO J
WATER SERVICE PROVIDER *1 LAKFaAVF.N O HIGHLINE o TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER *LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTICI
V
„• -; APIFA DESCRIPTION
W
EXISTING
$ . FT.
PROPOSED
SQ. FT:
TOTAL
So. FT.
BASEMENT
AIR HANDLING UNITS
EVAPORATIVE COOLERS
OAS PIPE OUTLETS WOODSTOVES
FIRST
-Z n8O
_1_ GAS WATER HEATERS MISC (Describe)
Z G In—
SECOND
1 HOOD9Ic�maaq
COMPRESSORS
( FURNACES
T 616 T�o,Jv S
0
► r `� S
`�
ADDITIONAL FLOORS (DESCRIBE)
_..
DECK (O COVERED OR UNCOVERED?)
Z ^3f6
4.0
GARAGE g CARPORT O
3 Z)
—74-4-
O �pij
NUMBER OF FLOORS
tea'
70TAL
ror csnsmwsr
AF
tonareororsnu
MUM
"NEW HOMES ONLY” NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fudure to be installed or relocated as part of this project. Do not include existing fvrtures to remain.
MBC6MITCAL
!(ALTERATION
.
Value of Mechanical Work $
(A r PY OF BID OR ESTYMATE MUST BE INCLUDED WnW APPEIC.ATIUN)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
OAS PIPE OUTLETS WOODSTOVES
BB
.QS
/ FANS
_1_ GAS WATER HEATERS MISC (Describe)
BOILERS
Z FIREPLACE INSERTS
1 HOOD9Ic�maaq
COMPRESSORS
( FURNACES
_�_ RANGES
DUCTS
"L- GAS LOG SETS
REFRIG. SYSTEMS
L7T s - (r.
BATHTUBS tecn,e/mwww cxmLAVs ffi lb m awn) URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS Z SHOWERS _�_ WATER CLOSETS f.9.4
EL$CTRIC WATER HEATERS _ L SINKS I _ WASHING MACHINES .
HOSE BIBBS SUMS
N TTTr
I dill under penalty of perjury that I am the property) owner or authorized agent of the property owns: I eertVy that to the best of my
knowledge, the b{/ormatlon submitted in support of this permit application is true and corrooL I certUk that Lwin 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 dgfinse of such claim/, which may be made by any person, including the undersigned, and filed against the city, but only
where such claim ads" 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 2 ��
Property Owner and/or Authorized Agent
o NEW ADDITION
!(ALTERATION
o REPAIR a. TENANT IMPROVEMENT
BUILDING SHELL ONLY.?
o YES YNO
BASIC PLAN? o. YES
NO
ZONING DESIGNATION
CHANGE OF VSE? o YES
VNO
NEW ADDRESS REQUIRED?
o YES )6 NO
VP/SEPA/SU? o YES
NO
PLATTED LOT?
YES o NO
DEMO PERMIT REQUIRED? o YES
NO
Bulletin #100 —January 1, 2008 Page 2 of 4 MHandoutsWermit Application
-,lag
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