16-100200 •
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City of Federal Way
Community&Econ.Dev.Services Permit #: 16-100200-00-SF
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: LELOUP
Project Address: 32009 21ST AVE SW Parcel Number: 132103 9036
Project Description: REP-Inspection only of fire damage. ***No construction work included on this
permit.***
Owner Applicant Contractor Lender
JOHN A LELOUP JOHN A LELOUP
33211 30TH AVE SW 33211 30TH AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
Census Category: 434 -Residential alt/add-no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.) 0 0 0 0
Additional Permit Information
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement. 0
Calculated Structure Valuation 0.00 Occupancy#1-Construction Type. Type V-B
Mechanical to be Included9 Yes Occupancy#1-Class R-3
Plumbing to be Included? Yes Occupancy#1 -Use Residence(1 or 2
family)
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Tuesday, July 12, 2016
Permit Issued on Thursday, January 14, 2016
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.
,9Owner or agent: �i� C.tr Date:
�,r of PERMITIPPLICATION
Federal Way JAN 14 2016
// / CIT/Y OF FEDERAL WAY
PERMIT NUMBER ! / 9 _ 0 C n �", _
!/!! l(/ (� (� TARGET DATE C----s.--'--......."----\ -}
SITE ADDRESS SUITE/UNIT#
.3 2.0 0c A-l s i9 Vii. . S', w,
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT UILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
- ` r.
PROJECT DESCRIPTION r-
Detailed description of work to `
be included on this permit only J IA
104.-01-Un---
, 01- '^
NAMEPRIMARYPRIMARY PHONE G ''
t U! L�� L0 N e ,lO1 ~ 7-5j - r 2-8`'.5
PROPERTY OWNER
MAILING ADDRESS E-MAIL
3 3 p....1 ( 3-d rte` ,-4.vlL S. w •
CITY STATE ZIP
Ft 445 i 't 1_ (,d y t 4- S��-1...) 7-3
NAME
7-0H
ii h€t'uIQPHONE,4 — .3 -5 ties
MAILING ADDRESS E-MAIL
CONTRACTOR 33 2-11 3 d T`y 4 Vr£ S. `'r✓..
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
TistAl 41z..coulep 2-o6 -- 2-.53-- STzY-s
APPLICANT MAILING ADDRESS E-MAIL
33 7--(l 30' 1-`' 4-vii„ S, w-
CITY STATE ZIP FAX
)-7S,1€tzAt1_ 64/Ay c'.4 9o�3
NAME PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME .. ..
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.29.095)
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 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: DATE 0/ /1 ,1 /
PRINT NAM
Bulletin#100—January 4,2016 Page I of 3 k:\Handouts\Permit Application
S •
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offacture 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(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many 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/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? 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
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK.
GARAGE ❑ CARPORT ❑
OTHER(describe)
Area Totals W EXISTING PROPOSED TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
Area in Construction #of Additional Information
AREA DESCRIPTION Square Feet Occupancy Group(s) Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 4,2016 Page 2 of 3 k:\Handouts\Permit Application