04-102019 •
a
•
C'ty of Federal Way
Community Development Services Building - Single Family Permit #:04 - 102019 - 00 - SF
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.335.3050
Project Name: HERNANDEZ
Project Address: 1021 S 324TH PL Parcel Number: 150240 0390
Project Description: REM- In existing attached garage,enclose laundry area,storage area and replace garage door with
window to create unheated rec room. Subject to field inspection.
Owner Applicant Contractor Lender
LUIS CARLOS HERNANDEZ LUIS CARLOS HERNANDEZ LUIS CARLOS HERNANDEZ NONE
1021 S 324TH PL 1021 S 324TH PL
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 1021 S 324TH PL
FEDERAL WAY WA 98003 I NONE
Includes:
Census category. 434-Reside #r #2 #3
Occupancy Group R-3 lL
L Construction Type: _ — II Type V-N
Occup ncy Load
r Floor Area(Sq Ft.):
Census Category 434-Residential alt/add-no Mechanical No
Occupancy Group#1 R-3 Plumbing No
PERMIT EXPIRES November 17,2004.
Permit issued on May 21,2004
I hereby certify that the above infoI nation is correct and that the construction on the above described property and
the occupancy and the use will e in` cordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
4-1
Owner or agent: i& ,1N Date: d 5 Z, ._ 0
I 41N
4t, tyki N1/4,t)
4.\\(„5
\111410s
p
• •
..k THIS CARD IS TO REMAIN ON SITE
CITY OF f v COMMUNITY DEVELOPMENT INSPECTION
F' deraI Way RED
IVR INSPECTION REQUEST PHONEI #(253)835-3050
PERMIT#: 0(1-100101 ' -- 00 PROJECT NAME: fie.,vo,o e -6avale, keit-ace
❑TEMP.EROSION CONTROL(4365) I I ❑FOOTING/SETBACKS(4110) ['FOUNDATION WALLS(4115)
To be done prior to breaking ground Approved to place concrete Approved to place concrete
By Date By Date By Date
1 ❑DRAINAGE/DOWNSPOUT(4040) ❑RE-STEEL(41 , r:., „ ❑GROUNDWORK PLUMBING(4190)
Approved to backfill Approved to place concrete or grout Approved to cover
By Date By Date By Date
I D SLAB ON-GRADE(4255) ❑UNDERFLOOR(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) ❑ELECTRICAL ROUGH-IN(4225)
Approved to install siding Approved to install roofing Approved
I
By Date By Date 1 By Date
❑PLUMBING ROUGH-IN(4230) 1 ❑MECHANICAL ROUGH-IN(4165) ❑GAS PIPING ROUGH-IN(4125) f
Approved Approved Approved to release test
By Date By Date By Date
❑FIRE STOPPING(4095) NOTE: ❑FRAMING(4120)
Approved Approved to insulate
Prior to framing inspection,all rough-in&
firestopping sign-offs must be approved.
By Date IBC 109.3.4/UBC 108.5.4 �y Date
❑INSULATION(4150) j ❑GYP.WALLBOARD NAILING(4130) ['SUSPENDED CEILING GRID(4265)
Approved to install wallboard Approved to mud&tape Approved to drop tile
By Date By Date By Date
❑FINAL-FIRE(4060) ❑FINAL-PLANNING(4070) ❑FINAL-PUBLIC WORKS(4080)
Approved Approved Approved
By Date jy Date _ By Date
❑FINAL-S.W.M(4375) ❑FINAL-ELECTRICAL(4090) ❑FINAL-BUILDING(4050)
Approved Approved Approved
By Date By Date By Date
•
cYo, 4. - / (Dolot ?
Federal way RECE►VEOPE RM IT \
COMMUM7Y DEVELOPMENT SERVICES
SF FCO ME EL PL DE EN FP\A—%
33530 FIRST WAY SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718
253-665 FAX 253 6 4129 �,� 2APPLICATION °
uww.ci hlo(federal wa qt ro m
The ollowin. is re.uGgYi g:rEif e A. 1 ih'o •late a.•lication will not be acce.ted. Please •rint le•ibl (in ink)or .-.
} PROPERTY INFORMATION
j �j Py
SITE ADDRESS 10 2. 32`1- ' 4- 'F o� ciL W q6 O3 3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# ( I) (2 ( a - _ 0 LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description(
•
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit()nig)
-Dkvide
4i 1 C*U nH �tC{it and a 3 and `-ccke ifra
(rs- q-e dcy3v oAk ractAKI. a window.
PROJECT NAME(Name of Business or Owner Last Name) tel, 1a,�� 2J
PEOPLE INFORMATION
PROPERTY NAME �/y i� PRIMARY PHONE
OWNER L`5 C bS1( rural (.2-52-55
MAILING ADDR5S,S CITY,STATE,ZIP _ -
CONTRACTOR COMPANY NAME ///�/f4 APPLICANT NAME OFFICE PHONE
if 40MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- B L / / ( ) -
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHS.
E-MAIL ADDRESS
LENDER Per RCW 19.27.095: Lsy formation is NAME
required if value exceeds$5,000
MAILING •SS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION .
EXISTING USE PROPOSED USE !�
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ /) 00 V
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL _
BASEMENT
FIRST
—
SECOND __..---
THIRD
=.-"THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
—DECK(COVERED?)
GARAGE/CARPORT
—
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLE• . GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercia) WOODSTOVES
BOILERS FIREPLA 'SERTS RANGES MISC(Describe)
COMPRESSORS FU'• • ES GAS WATER HEATERS
DUCTS AS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub ower Combo) SHOWERS WATER CLOSETS Iroiieq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS'
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) 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 application is made. I further agree to hold
harmless the City of Feder•tWay as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim), which may be m••e by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance'\h, city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
5.-",/al.,(._-0 (I
NAME/TITLE '4DATE DATE
;,Ala (Title)
RELATIONSHIP TO PROJEC l •wner ❑ Agent ❑ Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
a NEW o ADDITION ❑ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? a YES o NO
,.r-
Bulletin#100 March 30,2004 Page 2 of 4 \I landouts–Revised\Permit Application