04-104672 * •
City of Federal Way Building - Single Family Permit #: 04 - 104672 - 00 - SF
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: MICHAELS
Project Address: 29825 4TH AVE SW Parcel Number:720500 0250
Project Description: ADD-256sqft family room addition with mech work
Owner Applicant Contractor Lender
Jim Michaels &Heather A Michaels Jim Michaels Jim Michaels Jim Michaels
29825 4TH AVE SW 29825 4TH AVE SW 29825 4TH AVE SW
FEDERAL WAY WA FEDERAL WAY WA 29825 4TH AVE SW FEDERAL WAY WA
98023-3513 98023-3513 FEDERAL WAY WA 98023-3513
Includes:
Census category: 434-Reside #1 #2 #3 #4
Occupancy Group: LH___. R-3
.,..H
Construction Type: -1 Type V-N
Occupancy Load: H,
Floor Area(Sq Ft.):
1 st Floor Proposed Sq.Feet 256 Census Category 434-Residential alt/add-no
Height of Structure 11 Mechanical Yes
Occupancy Group#1 R-3 Plumbing No
Total Proposed Sq.Feet 256 Zoning Designation RS 9.6
Mechanical Fixtures
Description Quantityi, Description (Quantity Description Quantity
Ducts r 1
PERMIT EXPIRES May 21,2005.
Permit issued on November 22,2004
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and theme will be in aezerdance-Tvite laws,rules and regulations of the State of Washington and
the City of Federal Way. -/
Owner or agent: �.// /Mil/_..„9 Date: //:- <!•1-- 6P,
THIS CARD IS TO ;MAIN ON-SITE -
CITY OF - itommunitYDevelopmentInspection Ins ection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-104672-00-SF
Owner: JIM MICHAELS
Address: 29825 4TH AVE SW
FEDERAL WAY, WA 98023-3513
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) ❑ Footings/Setback(4110) 0 Foundation Wall(4115)
To be done prior to breaking ground Aproved to
place concrete Approved to place concrete
�.
By Date By —1-------"Date I Z/1/i1 By Date
❑ Drainage/Downspout(4040) ❑ Plumbing Groundwork(4190) 0 Slab/Concrete Floor(4255)
Approved to backfill Approved to cover Approved to place concrete
By Date By Date By Date
•
,❑ Underfloor Framing(4285) 0 Floor Sheathing(4105) �❑ Shear Walls (4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date By Date By 4 ' DatetAW
•
e❑ Roof Sheathing(4220) " ❑ Mechanical Rough-in (4165) 0 Gas Piping(4125)
Approved to install rootingApproved
/ Approved Approved to release test
ByDate / °`4II ByDate ByDate
�.. �-. �'
❑ Fire/Draft Stops(4095) NOTE: Prior to scheduling a Framing(4120) ❑ Framing (4120)
Approved inspection;Electrical,Plumbing&Mechanical Approved to insulate
Rough-in Dft Sop spm
I �� signed off aa approvedFire/ ra. SI Bt C 109.3.4/UBC inections 108.5.ust be4 {ij L i/I3/ s
By Date � � By t t/9 Date
❑ Insulation (4150) Idypsum Wallboard Nailing(4130) 0 Final- SWM (4375)
Approved to install wallboard Approved to install mud&tape Approved
By ! Date 011/06- By c Date \._‘q �S By Date
•
El Final-Mechanical(4065) 0❑ Final-Building (4050) • ❑Temp. Erosion Maintenance(4370)
Approved Approved Approved
By Date By G.. Date Z..7•Qs By Date
o
......_ ...-......_ 3
Federal WayECEI - q
PERMITI 7 2_
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32F5 ESDERALr"AVENUEWAY,SUATI98063971BPo ,t f• BOX 97 8
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253-835-2607•FART253 I35-2609
www w ahloffederala.ati cora
4..I r , SAL WAY
The following is required inforn2.tfian-an incomplete ap•lication will not be accepted. Please •rint legibly(in ink)or type.
• PROPERTY IINFORMATION
SITE ADDRESS c /C) S ` / T7P'L ) CA-ii SUITE/UNIT #
ASSESSOR'S TAX/PARCEL# 7 1 0 5 C 0 - Gt 4 c o LOT SIZE (sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy Legal desoipnonl
`< ' ` - I PROJECT INFORMATION
TYPE OF PERMIT BUILDING ❑ PLUMBING 0 MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu).
"rte'.,,. sp 4470 q yr iA_ C,-V11)
PROJECT NAME(Name of Business or Owner Last Name) 1 "'Y1 ill, Gi 4 e!,j'
U PEOPLE INFORMATION
PROPERTY NAME
///� j PRIMARY PHONE �7
OWNER /0-s-)0-s-) /1®/14 e_. 7 J4 e' 4' 053 ) 5),'.5 -.- C 7 g-,
MAILING ADDRESSCITY,STATE,ZIP
v29d) c— 'f _ If 'e s(-Li Fe_ /4(2=t.14 7 ct* SJR 3
CONTRACTOR COMPANY NAME APPLICANT NAME
OFFICE PHONE
C /L t 6,� ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
B L / / (
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME
` OFFICE PHONE y
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT''. NAME /� PRIMARY PHONE E-MAIL ADDRESS
i'le c_4; . -0 is ( ) -
LENDER Per RCW 19.27.095: Lender information is NAM �/
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
, , .- '',■ DETAILED BUILDING INFORMATION
EXISTING USE Re'a' 4 _.4 PROPOSED USE /kill f
CO
EXISTING ASSESSED/APPRAISED VALUE $ /7i, C ' VALUE OF PROPOSED WORK $4i! 93O c'
SPRINKLERED BUILDING? ❑ YES 0410 FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
' WATER SERVICE PROVIDER {IKLAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 'ir..LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
. . - P-OJECT FLOOR AREAS
—
AREA DESCRIPTION EXISTING SQ.FT. PRO•'•s D SQ.FT. TOTAL
BASEMENT ?
FIRST Z,! • J(o I 5 L'J
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT 72_0 -7 2_0
TOTAL exam-0w TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
HOW MANY FLOORS? exam-0w
"NEW HOMES ONLY" NUMBER OF BEDROOMS
: -. FIItTIIRES • ,,.".-_-:--_, •,:,:;:--_:_.--,7,-_-_-_,,::::::„:
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing factures to remain.
MECHANICAL <� r7 j CIO
//
Value of Mechanical Work $ g• /
EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
MR HANDLING UNITS HOODS(com<rsiaq WOODSTOVES
BBQS FANS m
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBINGDescribe
BATHTUBS(or Tub/ShouvCombo) SHOWERS WATER CLOSETS tro,k0 MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroomsulks) VACUUM BREAKERS ELECTRIC WATER HEATERS
-- - - ' ai NSCLAIMERISIGNATUREBLOCK
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 reliant of the city,inciudi and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE Wd:l DATE
(Signature) (Title)
RELATIONS TO PROJECT XOwner o Agent ❑ Contractor ❑ Architect ❑ Other
(
FOR OFFICE USE ONLY
a NEW a ADDITION a ALTERATION o REPAIR o'TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? 0 YES 0 NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
I
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Bulletin#100—March 30,2004 — Page 2 of 4 k\Handouts—Rcvised\Permit Application