04-103700 •
City of Federal Way Building - Single Family Permit #:04 - 103700 - 00 - SF
Community Development Services
33530 Ist Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: CARTER
Project Address: 29644 9TH PL S Parcel Number:515160 0335
Project Description: Reroof; shake to comp
Owner Applicant Contractor Lender
Robert R Carter &Mary C Carter ADKINS ROOFING INC ADKINS ROOFING INC NONE
•
ADKINS ROOFING INC ADKINR1031D6 2/06
PO BOX 1217 ADKINS ROOFING INC
AUBURN WA 98071 PO BOX 1217 NONE
Includes:
Census category: 555-Non-st #1 --]� #2 #3 #4
Occupancy Group: R-3
Construction Type: Type V-N 1L
Occupancy Load:FI
Floor Area(Sq.Ft.): -
Census Category 555-Non-structural roofing p Mechanical No
Occupancy Group#1 R-3 Plumbing No
PERMIT EXPIRES March 14,2005.
Permit issued on September 15,2004
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: Ati'A (j KL) Date: 13
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416:IL
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THIS CARD IS TO MAIN ON-SITE
CITY aF ''S'4"""'4'" ,,704" Pommunit Development Inspection Rcor
d
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103700-00-SF
Owner: ROBERT R CARTER
Address: 29644 9TH PL S
FEDERAL WAY, WA 98003-3754
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.
O Temp.Erosion Control (4365) ❑ Plumbing Groundwork(4190) 0 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) 0 Shear Walls (4245) 0 Roof Sheathing(4220)
Approved to install flooring Approved to install siding Approved to install roofing
By Date By Date By Date
El Fire/Draft Stops (4095) NOTE: Prior to scheduling a Framing(4120) ', ❑ Framing(4120)
Approved inspection;Electrical,Plumbing&Mechanical Approved to insulate
Rough-in and Fire/Draft Stop inspections must be
By Date signed-offgand approved. IBC 109.3.4/UBC 108.5.4
By Date
❑ Insulation (4150) 0 Gypsum Wallboard Nailing (4130) ❑ Final- SWM (4375)
Approved to install wallboard Approved to install mud&tape Approved
By Date By Date By Date
❑ Final-Building (4050) ❑Temp. Erosion Maintenance(4370)
Approved Approved
By Date By Date
cmr
of (�
Federal Way IECEIV 0 t -
COMMUM7YDEVELOPMENT SERVICES - 0 Z 7 0-0
PERMIT SF MF CO ME EL PL DE EN FP
33530 FIRSTFEDERAL WAYWAYSOUWA •98063-PO BOX9718 9718 i.) 1 -APPLICATION TD
TH
253-6614115.FAX 2536614129 / /
www.dttpfjederdwaU.-om OF FEDERAL WA'i
The ollowin• is re.uired in ormation-an Inco .fete a..iication will not be acce.ted. Please .Tint le.ibl (in ink)or .•.
/y / PROPERTY INFORMATION ICI.
SITE ADDRESS 0-9'6°7 fr(� S SUITE/UNIT# , `all
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desoipton)
PROJECT INFORMATION
TYPE OF PERMIT Ai.BUILDING 0 PLUMBING ❑ MECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIO nide detailed description o work included on this permit only)
„,q‘q (.J2..0 O n
PROJECT NAME(Name of Business or Owner Last Name) SAa 6'('S U Q i• , OR-)77/e/2.
PEOPLE INFORMATION •
PROPERTY NAMEPRIMARY PHONE
OWNER C ' 4 ?r ( ) -
MAILING DDRESS CITY,STATE,ZIP
004 Pl. S. , Lk ,1.
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
r _
,tuns ROrO-Z r ci ,. -A7.,---.1 AcLi 2- (a�)5'.39 33c/s
+M/�/AAIII N`O ADDRESSy'' 3 , ' CITY,STATE,ZIP ti/A-- CELL PHONE
Vifi
CITY OF FEDERAL AY BUSINESS LICENSE NUMBER 6� EXPIRATION DATE FAX NUMBER
/ / ( )
- B L
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE
aK_-ail ik LG 3 1 0 La, =a. / / C,6:
APPLICANT COMPANY NAME APPLICANT NAME
OFFICE PHONE
t IL r uc ;(‘
UADDRESS CI; � L/. _ h 2,-, lG" (953) S3 t -33Q3
MA NG STATE,ZIP CELL PHONE
• 6 /a-77 146(4 . 7 AA 9dt)'7/ ( )REeo.
IONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
t a, C.',LK.)rL.C, ( )q39 - 3 3 i S--
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION •
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ (0122
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS .
` AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
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 of fixture 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 COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commecdai) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/SnowerCombo) SHOWERS WATER CLOSETS(roue) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(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 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 /t
14.'711- :1 DATEv
(Signature% om
C9///,/ -14:-.
(Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent 7t ontractor o Architect 0 Other
FOR OFFICE USE ONLY
a NEW o ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES a NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application