11-101516 E wilding - Single Family
Y tiw
City of Federal Way • I L
Community Development Services Permit #: 11-101516-00-S F
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
Project Name: ABLE CARE ADULT FAMILY HOME
Project Address: 30620 8TH PL S Parcel Number: 174510 0150
Project Description: ALT-Inspection of existing approved adult family home for ADDITIONAL SLEEPING
ROOM only.
**No construction work approved with this permit**
Owner Applicant Contractor Lender
DELIA MORALES
30620 8TH PL S
FEDERAL WAY WA 98003-4137
Census Category: 434 - Residential alt/add- no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq. ft.) 0 0 0 0
kddionalPermit anoni , a 1 �
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0
Mechanical to be Included? No Plumbing to be Included? No
'' I 10 Fixtures Associated Watt Th s Per t 11 'T
PERMIT EXPIRES Monday, October 17,2011
Permit Issued on Wednesday, April 20, 2011
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: 0 1l //- % i%X,c-LP Date: C
F/NNi /
- -
0 4Z1
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City of Federal Way 0III
► Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International : ilding Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances o e City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff
Tenant Narne: Permit#:
Address:
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type: _
Occupancy Load:
Floor Area(sq. ft.) _ 0 .,,,_ 0 _ 0 0
Owner Name:
Owner Address:
Building official Date
The priority focus in the review and nspection made by the City prior to issuance of this .ertificate was on those matters which
experience has shown most sev 'y affect the health and safety of the general public. Alth...h the City has made as complete a
review and inspection as is rea:onably possible(within budgetary time and personnel limitation- the City neither guarantees nor
warrants to the owner/occu•ant or to any other person that this Certificate evidences strict compli. • e 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.
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ERMIT S ,v1F CO ME PL DE EN FP
COMMUNITY DEVELOP NT SERVICE�0 Cli iJ ��AF ,LICATION s` ~ ' ° - sr253-835-2607•FAX 253-835-26090 `
uznu.0tyr erierol_'fa OM I"` .
FILE
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SITE ADDRESS ('y, R,,..•" SUITE/UNIT#
,O(,2o -AP- 1, Pt S Fe± 144. w4 9 'oo3
PROJECTION�� ZONING ASSESSOR'S�PARC # 5 L_ a - 0 / 5 6
TYPE OF PERMIT .BUILDING IIPLUMBING CIMECHANICAL
El DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) Q C C -{ P E A Da
PROJECT DESCRIPTION / j • �' `- L'� �'�- '�' `
,),_. --6-,---
Detailed description of work to (�9 y 1S 1tc F Ft.
be included on this permit only
NAME / PRIMARY PHONE
PROPERTY OWNER OAC- A- or A/IDA/ r.65 0-s99460-s9946 .- rl?--
MAILING E-MAIL
'/010 2 0 /�.1/.J Pt S
. /VA
CITY STATE RP ,
eJ. R I. \ L ‘N As GI 4c'003
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME / /
PHONE/1- of ,loFAr ,s
MAILING.ADDRESS E-MAIL
APPLICANT
�,'0 bs1 G e4-.1) PG S
CI - STATE ZIP FAX
0< wy wA- v a3 ) e3q - zV. 1
PROJECT CONTACT ) /� i PHONE
(The individual to receive and LI �" • � � / 7� �� L s
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CI STATE FAX
)
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
D OWNER-FINANCED
Required value of$5,000 or more _
(RCW 19.27.095) MAILIt4G-AI}D3lLSS, C�Z.TfY,STATE,ZIP PRONE
I certify under penalty of perjury that I am the property owner or authorized 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 authorized 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 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: el // ,_. t-G�, DATE t 4t '°2'V -1
PRINT NAME: I r1 l4 D ' 4,0,e, 0
Bulletin#100—January 1,2011 Page 1 of 3 k:AHandouts\Permit Application
W 'b2-0 J
VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this oject. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS 111E OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
yp •
.. . �e,�..,. ,. ,. ,,,..• �..�m>'!s"'aa:�„ „�''% ,. .. .res ..�•,..,
Indicat- ow many of each type of fixture to be installed or relocated as part of this project. to not include existing fixtures to remain.
BAT UBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHW SHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM B' AKERS
DRINKING •UNTAINS SINKS(Kitchen/utility) WATER HATERS(Electric)
HOSE BIBBS SUMPS WASHIN' MACHINES 1*TAL F ,
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYO' VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE \OT SIZE(In Square Feet) EXISTING F 'E SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
CYes ❑ No E. Yes E No
RESEDENTIAL * :'VFW OI3 A 1)111't TON
AREA DESCRIPTION (in square feet) EXISTING 7.0POSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND;;FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
— — —
EXISTING pROPO"D TOTAL
Area Totals
**.NEw HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS _
COit IERCIAIjNENViA 1)I)IT 10.x'
— Area i Construction -r_ # of — —
AREA DESCRIPTION Occupancy Group(s) Additional Information
• in Square Feet Tyke Stories
NEW BUILDING
ADDITION
- u
COMMERCIAL-RE iN101)EIITENAN'I" IMPROVEMENTS
Area Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
in Square Feet Type Stories
TOTAL B[JILDINti. /I(J ��
TENANT AREA ONLY
PROJECT AREA ONLY �° s
Bulletin#100-January 1,201 1 Page 2 of 3 k\Handouts\Permit Application