09-102536 - • 4. iilding - Single Family
I
City ity of DeFederalDevelopment
y [i 1 F:. Permit 09-102536-00-SF
Community Development Services � #:
PO.Box
Federal Way,WA 980971863-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: RIGHT AT HOME ADULT CARE
Project Address: 5331 SW 326TH ST Parcel Number: 189831 0230
Project Description: NEW-Verification of Occupancy.No construction work allowed under this permit.
Owner Applicant Contractor Lender
NELSON POMALES NELSON POMALES
5331 SW 326TH ST 5331 SW 326TH ST
FEDERAL WAY WA FEDERAL WAY WA
98023-1934 98023-1934
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
New/Additional Sq.Feet-1st Floor New!Additional Sq.Feet-2nd Flt
New/Additional Sq.Feet-3rd FIoor 0 ''New i Additional Sq.Peet-Basement 0
Basic Plan? No New/Additional Sq.Feet-Deck 0
New/Additional Sq.Feet-Garage 0 Mechanical to be Included? No
New/Additional Sq.Feet-Other 0 Plumbing to be Included? No
New/Additional Sq.Feet-Total 0 Zoning Designation RS 7.2
"' <A 'T+IoFixturesAssociated WithiThis erm
-. amu. r �
PERMIT EXPIRES Saturday, January 2, 2010
Permit Issued on Monday, July 6, 2009
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
-----an, d the City of Federal Way.
Owner or agent"_ " k C1)(-1-V \...,1 4 ,.vr._�'--, Date: 1 ' ��
l? city of Federal Way I •
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: RIGHT AT HOME ADULT CARE Permit#: 09-102536-00-SF
Address: 5331 SW 326TH ST
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq. ft.) 0 0 0 0
Owner Name: NELSON POMALES
NELSON POMALES
Owner Name:
Owner Address: 5331 SW 326TH ST
FEDERAL WAY WA
�•:0, -1934 C�
- ���/ ( U -
Building • icia 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.
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www.dtmoffederahuau.com
SITE ADDRESS
5331 W r2h S I P-c\-et-c,_I Locui w
SUITE/UNIT• ZONING ASSESSOR'S TAE/PARCEL t
� ,/�e �y,E.»�...w
NAME OF PROJECT �J, �-P �iG�1 IT r rT V�E
(Tenant or Homeowner Name) A Z>V r C ��
❑BUILDING 0 PLUMBING 0 MECHANICAL /
TYPE OF PERMIT
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
P-(k_AV cri..YN6.-I L k e
PROJECT DESCRIPTION C A4- 0
Detailed description of work to
be included on this permit only
.��.� �fA„ a,�,�r,��a �,.,,€ �. ,. ,. r�: _, ,,,,��•. �'' �,,,�.,R� x� Esc ..���a��,,rs�ae��<����,,> ,,�,�>.,P ,.F.�.,o,nxbY„�, .,,, un F .�,a�� u°�rs4
NAMEPRIMARY PRONE
PROPERTY OWNER -��e--xbr'L. ç) S(
vva.l-C . (ZS) ?3 )L - D`3 s-7
ADDRESS,CITY,STATE, E-MAIL
r33 t S L3 32.1 S l 1_er�-( \,c-)cu ryelSpy,f7f i-- ( 1. c
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT C0 1CT
NAME I r PRIMARY PHONE 1
( ) -
CONTRACTOR MAILING ADD ,CITY,STATE,ZIP FAX
( ) -
WA STATE CONTRACTOR'S LICENSE 0 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
/ /
NAME e” PRIMARY PHONE
APPLICANT )Q..-Q-I�+-OYL \7e e S— (25,S) '71.16857
MAILING ADDRESS,CITY,STATE,ZIP FAX
S CeY C? a_\-- 0.1Q ( ) -
PROJECT CONTACT NAME Si'PRIMARY PHONE
(The individual to receive and 1Q-�(C -1l\.._ Pkv � �I (2 S37 L Y S 7
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP \ FAX
,(.
concerning this application) c „e 0...,,iJ 0,,),, ,,A,1���Q ( ) -
AL
TE
,(r �.a._�ENAM PRIMARY PHONE E MAIIL
% 'eS ( )25S- 2:1'79'
PROJECT FINANCING NAME r A
C 0 OWNER FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the
best of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
!further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the (,
information supplied to the city as a part of this application.
SIGNATURE• /Q/a'aV� DATE , /0 '09
11
PRINT NAME: N e .I Cy(J,..... OY' ,tQ�
Bulletin#100—4/17/2009 Page 1 of 4 k:\Handouts\Permit Application
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Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commereia4
BOILERS FURNACES HOT WATER TANKS pee)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Aa .,9.koaa�--ten �' a � d I4 3;. �s.�
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks( TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/uhuty) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FII URE
GENERAL INf}RMA'TION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
FIRST, FLOOR(or Mobile Home)
17 . &*H S 13 I d 3 ,1. ..
EMS
ilingtg
,. _gg .t » :a .liP
COVERED ENTRY
DECK
GARAGE ❑ CARPORT 0
"II p 2 gge3 A Yk.
EXISTING PROPO5ID TOTAL
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
�,..�., �' �. .;:., a4,. � ��.. 311":'
sr �' � ... �.
AREA DESCRIPTION Area Construction #of
Occupancy Group(s) Additional Information
in Square Feet Type Stories
PIERNMOR*******30114110:45,1MBRANVIDNIESEPIRENINNOSION
iltigtHERREMINIIIINIEVE ' 'fir
ADDITION
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
3 L 3 1 '" l �3n ? 13I
m, e%� ��I�r�����,� >�� � ' v ��' A� IJII�I�1�� � �(.t� � 3�il9 I'� v 3 �.�d� i
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TENANT AREA ONLY
3A IW 3 L
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