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05-101499 - 1 A Al ii • . ,City of Federal Development Services e ay Communit Building - Single Family Permit#: 05 - 101499 - 00 - SF vel P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-7000 Pax:(253)835-2609 Inspection request line: (253) 835-3050 Project Name: NIELSEN Project Address: 406 SW 350TH PL Parcel Number: 132174 0100 Project Description: REM-New bathroom in family room w/plumbing&mech Owner Applicant Contractor Lender Clark D Nielsen &R Kristine Nielsen J K CONSTRUCTION J K CONSTRUCTION Clark D Nielsen 406 SW 350TH PL PO BOX 3354 JKCONKC975QC 11/03/05 406 SW 350TH PL FEDERAL WAY WA FEDERAL WAY WA 98063 PO BOX 3354 FEDERAL WAY WA 98023-8101 FEDERAL WAY WA 98063 98023-8101 Includes: �I Census category: 434-Reside #1 I_ #2 #3 L #4 Occupancy Group R-3 Construction Type i Type V-N i Occupancy Load: - Floor Area(�Ft.): Census Category „p,..., ' 434-Residential alt/add-no. Mechanical Yes Group#I � Occupancy " P . ,R-3 Fhimb3ng . Yes " Plumbing Fixtures _ Description _ (,,Quantity, Description Quantity Description Quantity [Bathtubs 1 -1 Lavatories 1 1 Water Closets J Mechanical Fixtures _. Description ;-Quantity Description Quantity Description Quantity, — . Fans I I PERMIT EXPIRES September 28,2005. Permit issued on April 1,2005 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy a the use will be in accordance with the laws,rules and regulations of the State of Washington and the City of Fed . Way. Owner or agent: - ,, . 1�AA L. Date: �� c 6(N/24-- /2 (P I°( \ Nqii THIS CARD IS T tY p ment MAIN ON-SITE CITY OF tommunl Develo Inspection Record p Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-101499-00-SF Owner: CLARK D NIELSEN Address: 406 SW 350TH PL FEDERAL WAY, WA 98023-8101 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. ❑ Temp.Erosion Control(4365) ❑ Plumbing Groundwork(4190) ❑ Underfloor Framing(4285) To be done prior to breaking ground Approved to cover 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 roofing By Date By Date By Date • Rough Plumbing(4230) ❑ Mechanical Rough-in (4165) •❑ Gas Piping(4125) Approved Approved Approved to release test By Ni , Date A �y �� By Date `By Date ❑ Fire/Draft Stops (4095) NOTE Prior to scheduling a Framing(4120) ❑ Framing(4120) Approved inspection;Electrical,Plumbing&Mechanical I Approved to insulate Rough-in and Fire/Draft Stop inspections must be signed off and approved. IBC 109 3.4/UBC 108.5.4; By Date �__._ �... _.. __. . _� .. By Date,5-.2.3- 0 ❑ Insulation(4150) ❑Gypsum Wallboard Nailing(4130) ❑ Final-SWM(4375) Approved to install wallboard Approved to install mud&tape Approved By Date B _(� Date 6p - By Date . . . # # ❑ Final-Mechanical(4065) ❑ Final-Plumbing(4075) ❑ Final-Building(4050) Approved Approved Approved By Date By ,1 Date 7/2,?/4.5— i-�d By ,�,', Date !% /% ai 4 ❑Temp.Erosion Maintenance(4370) Approved By Date f ' ,�.. RECE1V --- _IC_ -(- - 1 q Federal Way j��1p y PERMIT S MF CO ME EL PL DE EN FP 3�5 ST" D1VUE 1771••POSBOX 9718'1 IS 0 1 2 FEDERAL WAY,WA 98063-9718 A.P P L I C AT I O N ?D / / 253-835-2607•FAX 253-835- f www.cituofTederalway.co �'Y OF FEDERAL WAX BUILD! � The ollouri • is re•uired in on..-an inco •fete a••lication will not be acce•ted. Please •rint le•ibl (in in or . ■ PROPERTY INFORMATION SITE ADDRESS �t�/ /� 3��C,� pL, SUITE/UNIT# ASSESSOR'S TAX/PARCEL# / _i 2 / 7 . - C/ __L _a _0 LOT SIZE(sf) 2 ( ' Z 7} f LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) &7'7( / ' _, �i 10; P l - D (Attach separate page for lengthy legal desc ip[ion) ■ PROJECT INFORMATION TYPE OF PERMIT Cd BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu) P y 91"'t 4 t ' � � � {� lJ PROJECT NAME(Name of Business or Owner Last Name) /1i�S •/V ��/L • • PEOPLE INFORMATION PROPERTY NAME �� PRIMARY PHONE /'��'' OWNER Cie%4y N1 )� S )4 ( ) - MAILING ADDRESS CITY,STATE,ZIP s , 3 S7, t . 9t ' ? CONTRA CTOR COMPANY NAME P [CANT NAME OF ICE PHONE qIMALI DRESS CITY,STATE,ZIP /,, ��p ELL PHONE &f 4(3F FEDERAL WAY BUSINESS LICEN E NUMBER l •Ll II"EIEI XPI�RATT O ATE FAX NUMBER - B L / - CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE / / APPLICANT CO NY NAME PPLICANT NAME OFFICE PHONE MAILING ADDR S 4 Z,�" -�`e [TY,STATE,ZIP - CELL PHONE RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect ❑Tenant ❑Agent ❑ Other(Describe) ( ) - CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS ( ) - LENDER o 09 s e'rii or»ta on is -. N ) -.milli fec a xee 5000_. ("/n/J 1�--- MAILING ADDRESS CITY,STATE,ZIP ,/� • DETAILED BUILDING INFORMATION EXISTING USE fI L 7( PROPOSED USE $' 4" EXISTING ASSESSED/APPRAISED VALUE S$ VALUE OF PROPOSED WORK $ / ( SPRINKLERED BUILDING? ❑YES NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES �NO WATER SERVICE PROVIDER ' LAKEHA VEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER AKEHAVEN ❑HIGHLINE ❑PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL t. ■ SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD • I FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE ❑ CARPORT❑ E7DSTNG PROPOSED TOTAL TOTAL RSTR1O Si 'TOTAL PROPOSED SP ' 1°TOTAi,6i NUMBER OF FLOORS `� **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture fo be installed or relocated as part of this project. Do not include existing fixtures to remain. Value of Mechanical Work $ r 5. AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS 1 FANS _ HOODS(commerciaq WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLLING BATHTUBS(or n.b/shouerCombo) SHOWERS WATER CLOSETS(ioikq MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS ( LAVS(eam,00D,s;,ilcs) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK 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 applicaton is made. I further agree to ho id 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 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. /� NAME/TITLE / /` � - DATE / '�' IJ'Sn u \ (Title( RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent contractor ❑Architect ❑ Other +I t D ION AERATION o REPAIR ; EN2©K7EMENT` ' UII,1 1 HELLONL �TUy ;BASIC PLANP 4-'1'4 o YES NO �� I • t µe ESIGNATION _ . a ' :CHANGE OF USE? :-' .„,, o �??(O , � i r'1 ,,; +QUIRED?,.ry • „ ', 0 ` ' SUP/SEPA/ U?' t? Q .0 .DEMQF+RMIT. �On,1 1 l sw2 «„AI,'y. s® • fi < Bulletin#100—January 7,2005 Page 2 of 4 k\HandoutsWermit Application