17-100731 Z
• Building - Singles Family
City of Federal way Permit #:17-100731-00-SF
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003l'41,
- Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 L.,
_ „) -•..
Project Name: NASH
Project Address: 30623 28TH AVE S Parcel Number: 092104 9195
Project Description: REP-Inspection of fire damage. ***NO construction work approved under this permit***
Owner Applicant Contractor Lender
MICHAEL&ROBIN NASH MICHAEL&ROBIN NASH OWNER IS CONTRACTOR
30623 28TH AVE S 30623 28TH AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
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.)
Additional Permit Information
Occupancy#1-Construction Type Type V-B Mechanical to be Included? No
Is this an Online or O.T.C.application? No Plumbing to be Included9 No
Occupancy#1-Use Residence(1 or 2
family)
PERMIT EXPIRES Sunday, 13 August,2017
Permit Issued on Tuesday,February 14,2017
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 i -: dance with the laws, rules and regulations of the State of
gton a ' the City of Federal Way.
Owner or agent: -�"- �' Date: 2.. / ii• �O/7
RECEIVED
Ike 14 2017 PERMITiKPPLICATION
CITY OF
Federal Way CY OF FEDERAL WAY
CDS
--7
PERMIT NUMBER ) 1 0 01 ) ' _ SE TARGET DATE Z f� / 7
SITE ADDRESS SSS.J// SUITE/UNIT#
�n6a3 (:)97---71Aoc
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 09 2- 1 o f _ el 1 9 "
TYPE OF PERMIT I�BUILDING ❑'PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT A )���� -N
PROJECT DESCRIPTION � / (� /���£G ��
Detailed description of work to
be included on this permit only
NAME /,� (� /� PRIMARY PHONE
PROPERTY OWNER 4V /_ 'v S/A/ y//3 1 N `/
CM3 DESS 3 2••C/ /]) / -f U L.� - E-MAIL
�J ST TE Z
F�vc g lrUr� (5)o3 _ .
NAME O(AD PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
4/i KL p o e/N NA-5/1
APPLICANT MAILING ADDRESS ) E-MAIL
3 e7‘a, ?(5;? 47
A-1) S
CI STAT ZIP., ^/0� FAX
100
NAM E...--,-.)
C PRIMARY PHONE
PROJECT CONTACT l/ ENV/S /I/G 5--3 335- O. `D cP
(The individual to receive and MAILING ADDRESS E-MAIL p /
respond to all correspondence / '3 c2 ' >^ .> / - F14/ - Df,'v1 y0/1(4.t'
concerning this application) ' TY - STATE ZIP FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP 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 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 W•_ • to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim), which may •e m• • by any person,including the undersigned,and filed against the city,
but only where such cl• arises o• of the relian - of the 'ty, including its officers and employees, upon the accuracy of the
information supplied • the city as a p• of this appl tion.
jp,
SIGNATURE: ,-► A .-i � DATE g f / 7
PRINT NAME: tn71/4/7-5 P7//(1 A
Bulletin#100—February 22,2016 Page 1 of 2 k:\Handouts\Permit Application
• • VALUE OF MECHANICAL WORK
MECHANICAL 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.
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) LAYS)Hand s nks) 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 EXISTING PROPOSED TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area m Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—February 22,2016 Page 2 of 2 k:\Handouts\Permit Application