09-101459 Building - Single Family
City of Federal Way
Community Development Services Permit #: 09-101459-00-SF
P.O.Box 9718 F ILE
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: HAITHCOX
Project Address: 4621 SW 327TH PL Parcel Number: 189820 0110
Project Description: Re-roof,tear off existing roof and re-sheet and in I ew composition roofing.
Owner Annli• . ont a t.r Lender
PAMELA HAITHCOX BRUC 'S ROI LC R O11`. G LLC
4621 S 327TH PL 27 5 SE + RL964L 6/29/1P
FEDERAL WAY WA 98023- 8 U CLAW, 98022 15 ' '401 T
E MCLAW , - 98022
n s Category: 555 - o structural ofi g rmit
Includes: • 3 #4
Occupancy Class: •
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0 0 0 0
New/Additional Sq.Feet-3rd Floor........: .........0 New/Additional Sq.Feet-Basement........ .........0
Mechanical to be Included? " No Plumbing to be Included? No
ire • iat • T rit
PERMIT EXPIRES Saturday, October 17, 2009
Permit Issued on Monday, April 20, 2009
M
I hereby certify that the above information is correct and that the construction on the above described .ropertyand
the occupancy and th= use will be in accordance with the laws, rules and regulations of the State o ashin•ton
and the City of Federal Way.
/ p i.. _
Owner or agent: A t-
•
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-101459-00-SF
Owner: PAMELA HAITHCOX
Address: 4621 SW 327TH PL
FEDERAL WAY, WA 98023-1928
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.
0 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
•
- 0 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 � --et 'o7
❑ Fire/Draft Stops(4095) ❑ Interim Erosion Control(4370) NOTE: Prior to scheduling a Framing(4120)
Approved Approved inspection;Electrical,Plumbing&Mechanical
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 % '
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 Date
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
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COMMUNTIYDEVEIAPMENT SERVICES
33325AVENUESOUTH PO9718
FEDERAL WAY,WA 96063-9718 A P R L 0 APPLICATION
253-835-2
607*FAx 253-835-2609
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The fou°wii u( ti tin Wiltiolete application will not be accepted. Please print legibly an ink)or type.
/ IIIc! PROPERTY INFORMATION
SITE ADDRESS �b Z i I �� 3 Z 7 Pi / SUITE/uNlT#
ASSESSOR'S TAX/PARCEL it / / D 2- 0 - C} / / O LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
r .*
• PROJECT LNFORMATION
TYPE OF PERMIT 4SBUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRrION(Provide detailed description of work included on this permit onli)
4-c�r—,)kfi- L,k re,vP r re-,57ti 'i s`-1-t G l new C G.,p- :S. zz. S4 - 'e
PROJECT NAME(Name of Business or Owner Last Name) /4/` f IC Cc.K
• PEOPLE INFORMATION
PROPERTY NAME ./.1 PRIMARY PHONE
f <"-
OWNER €.!' t t&I -i C C'x (2 ) 30 a -.�/,5—c.)
ADDRESS COY,STATE,ZIP E-MAIL ADDRESS
TZ i 5 . Z? pt /2 w Li4 qt'Z?
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
OrLIceS i2oo. .'%5 -jre-1,� Se-‹f6.R... (3(0 ) g2S - /3s-k)
mr AADDRESS CITY,STATE,ZIP CELL PHONE
aS S e V()I n t -hC('c..— L'f/ 7c Z2. ( )
COY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
( )
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
Hal-“CER 4 y 6 VC I C—?,Q/c)
APPLICANT COMPANY NAME APPIUCANF NAME OFFICE PHONE
( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect ❑Tenant 0 Agent 0 Other ( )
PROJECT NAME L PRIMARY PHONE E-MAIL ADDRESS
CONTACT I P(✓1 1 X"4J/,,-2.. (Z v C' ) 3Y j` - Cr / G
LENDER NAME Per RCW 19.27.095:
Lender information is required 4fproject value exceeds$5,000
MAILING ADDRESS CnY.STATE,ZIP PHONE
( )
• DEI3ILED BUILDING INFORMATION
EXISTING USE PROPOSED USE /
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 2 2-I/
SPIII:PIKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT ❑
NUMBER OF FLOORS s� rROeoero TO2AL /VIAL n�osr TOTAL ThwOmDw rorwcsP
'*NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offudure to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Mow,of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNTIE EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SI.ib REFRIG.SYSTEMS
PLUMBING
BATHTUBS(orTbb/Shower Combo) LAVS wino.. URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETb moo
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 casts,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 „ --- 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 '-application. �[
SIGNATURE: i - DATE i—2,c>—0 q
Property Owner and/or Authorized Agent
FOR OFFICE USE ONLY
o NEW o ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF'USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES a NO
Bulletin#100—January 1,2009 Page 2 of 4 k'illandouts\Permit Application