05-103924 1 r r
! •
City of Federal ay Building - Single Family Permi #: 05 - 103924 - 00 - SF
Communi Develo ment Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 FaX (253)835-2609 Inspectio I request line: (253) 835-3050
Project Name: FISK
Project Address: 33208 6TH AVE SW Parce Number:729801 0170
Project Description: Remove Shake Roof,Lay New Sheathing,Apply Asphalt Roofing.
Owner Applicant Contractor Lender
Marcia L Johnson DARRELL FISK FAST ROOFING NONE
33208 6TH AVE SW 33208 6TH AVE SW
FEDERAL WAY WA FEDERAL WAY,WA 9530 AURORA AVE N SUITE 105
98023-6179 98023 SEATTLE WA 98103 NONE
Includes:
Census category: 555-Non-st #1 - #2 #3 #4
—it_
Occupancy Group: 4 R-3 1
Construction Type: Type V-B IrL
r--
Occupancy Load:. 1L______H -i
I Floor Area( Ft.):
Census Category........:. .... ...........................555-Non-structural roofing pi Mechanical ! No ;„
Occupancy#1-Class. „R 3 r - MOND No r.
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 10)and must col ply with FWCC,Chapter 22,
Article XIV"Critical Areas" and fill out a Hazardous Materials Inventory Statement,if.pplicable.
PERMIT EXPIRES February 1,2006.
Permit issued on August 5,2005
I hereby certify that the above information is correct and that the construction on the above d;scribed property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the St:to of Washington and
the City of Federal Way. t
f
Owner or agent: Date: 0r*1 o
a.ff ‘ -\14, i1,k1
I
DATE INSPECTOR AREA AND TYPE OF INSPECTION
9/0� � Foams SfreL %' 6 J47-/ f//4 o/e
• THIS CARD IS TO F41114AIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-103924-00-SF
Owner: MARCIA L JOHNSON
Address: 33208 6TH AVE SW
FEDERAL WAY, WA 98023-6179
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) 0 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 e,,n- b ,
O Fire/Draft Stops(4095) } NOTE: Prior to scheduling a Framing(4120) ❑ Framing(4120)
Approved inspection;Electrical,Plumbing&Mechanical i Approved to insulate
Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 109.3.4/UBC 108.5.4
ByB Date
Date �� �.. y
❑ Insulation (4150) ❑Gypsum Wallboard Nailing(4130) 0 Final-SWM(4375)
Approved to install wallboard Approved to install mud&tape Approved
By Date By Date By Date
O Final-Building(4050) ['Temp.Erosion Maintenance(4370)
Approved Approved
By Date By Date
A • • ElvED .1934°
g' _5_ - 1_ La /c2_ 4
Federal Way
COMMURI7YDEVELOPMENTSERVICES PER i 5 c .R 0F CO ME EL PL DE EN FP
333258m AVENUE SOU'17!•,b BOX 9718 A P P LI� F ��wAY \
FEDERAL WAY,WA 98063-9718 ,
IIIIIINNallimilimmis
253-835.2607•FAX 253-835-2609
w3526 yoffFAX 25 ay.com
IL IG DEPT. IIIIIIIIIIIIIIIIMIIIIIIIM
The ollowi • is re• 1red in orn ation-an inc,u,•late • ••lication will not be acce•ted. Please •rint le•ibl in in or
• la PROPERTY INFORMATION
SITE ADDRESS 330 6-_ ,cbe `S SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Ahad,separate page for lengthy legal deuription)
gl PROJECT INFORMATION
TYPE OF PERMIT BUILDING 0 PLUMBING 0 MECHANICAL -
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJ, DESCRIPTION • . milli)
d= ailed description ppf work includedion this permimilli)
l;ei 0c) / '-- :. /t /0 chi:,. / /�` ®`, , , .. //®1 s -6
PROJECT NAME(Name of Business or Owner Last Name)
FI PEOPLE INFORMATION
•PROPERTY NAM PRIMARY PHONE
OWNER V
a vye if- /S.l (>253)�3g - .%?19
MAILINGDRESS CITY,STATE,ZIP
3 30 8 6'—,Aka ,se- ) T�� .orte.) u2,1 9(0,23
'CONTRACTOR COMPANY NAME APPUCANT NAME OFFICE PHONE
FCtaSZ. )0_,n. -,,y1 & /�' l/ryr'e (?t1 )5-)__a2... -, '�q
MAILING ADDRESSCITY,STATE,ZIP CELL PHONE
) g.-11
CITY OF FEDERAL WAY B SI ESS CENSE NUMBER EXPIRATION DATE
FAX NUMBER
_ plicoL- 1015IDJ - / / ( )Sad - X66 ( .
?� B� L
CO CTOR'S REGISTRATION NUMBER(copy of card required with etch application) EXPIRATION DATE
1 06
APPLICANT COMPANY NAME APP CANT NAME
�� OFFICE
PHONE Off]
MAILING F.4&DRESS r,A'V 6111,1„-C ff iV V Ci 444, �1//er ( Com ) -/4-! !
CITY,STATE,ZIP CELL PHONE
(3530 24UOlLA ,✓i r✓ 1rIc SCA r(c-,L A 9 /O) ( 06 ) ,86 - 8, 1cp
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect ❑Tenant ❑Agent q-Other(Describe) C C -�AC..n)IL ( ) 5Q2 2 - 2f6G l
CONTACTS 'PRIMARY PHONE ., L ,D.ESS
.I_. Y 0 /- ; '- _ . _. . i "e041
LENDER ..- .w", r� i;`df -. .i�y . y NAME
MAILING ADDRESS CITY,STA E,ZIP
• ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? p YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES o NO
WATER SERVICE PROVIDER 0 LAKEHAVEN o HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN 0 HIGHLINE . o PRIVATE(SEPTIC)
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSEDTOT
SQ.FT. SQ.FT. J SQ. •
BASEMENT
FI•w`1
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DES =E)
DECK(COVERED?)
GARAGE 0 CARPORT 0
EXISTING !R• •'6D TOTAL `�.yiY..:..�a..:,..?.aa.J .7 .» a• t4 ie A1.Sri ..
NUMBER OF FLOORS +t r
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTI ED SELLING PRICE $
FIX'►TIRES
Indicate number of each type of fixture to be installed or r- .cated as ,art of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
•
AIR HANDLING UNITS APORATIVE COOLERS GAS LO• REFRIG.SYSTEMS
BBQS FANS HOODS(comm WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES OAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS b/Shower Combo) SHOWERS WATER CLOSETS(toaet) MISC scribe)
DISHW ` ERS SINKS DRINKING FOUNTAINS
GAS ' PE OUTLETS SUMPS RAINWATER SYST
RING MACHINES URINALS HOSE BIBBS
LAVS(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 f U` C DATE
(Slg re) (Title)
RELATIONSHIP TO PROJECT ❑ Own ❑ Agent ❑ Contractor ❑ Architect 0 Other
krt))— ;11.1.110('00)4 ,`41,J0);v',t4p(0;I x 4D3v,te,A •,;)9)0, pe
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application