05-100080 0 I
City of Federal ay Building - Single Family Permit #: 05 - 100080 - 00 - SF
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection request line: (253) 835-3050
Ph::(2525 (2533)835-7000 Fax:(253)835-2609 r
Project Name: LISITSYN,M
Project Address: 32907 7TH CT SW Parcel Number: 182104 9065
Project Description: ADD-Construct 24 square foot deck.
Owner Applicant Contractor Lender
Mikhail N Lisitsyn Mikhail N Lisitsyn Mikhail N Lisitsyn NONE
28134 29TH AVE S 28134 29TH AVE S
FEDERAL WAY WA FEDERAL WAY WA 28134 29TH AVE S
98003-3387 98003-3387 FEDERAL WAY WA NONE
Includes:
Census category: 434-Reside #3 #2 #3 #4
Occupancy Group: R-3
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.):
Census Category 434-Residential alt/add-no, Deck Proposed Sq.Feet 24
Mechanical No Occupancy Group#1 R-3
Plumbing No Total Proposed Sq.Feet 24
PERMIT EXPIRES July 9,2005.
Permit issued on January 10,2005
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 it`accordae with the laws,rules and regulations of the State of Washington and
the City of Federal Way. /
Owner or agent: '� �P r ;' Date: ` `7 ,.... 0.5
/
THIS CARD IS TOOEMAIN ON-SITE
CITY OF - �`- ommuntY Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100080-00-SF
Owner: MIKHAIL N LISITSYN
Address: 32907 7TH CT SW
FEDERAL WAY, WA 98023
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 Footings/Setback(4110) 0 Foundation Wall(4115)
To be done prior to breaking ground Approved to place concrete Approved to place concrete
By Date By Date By Date
O Drainage/Downspout(4040) 0 Plumbing Groundwork(4190) 0 Slab/Concrete Floor(4255)
Approved to backfill Approved to cover Approved to place concrete
By Date By Date By Date
O Underfloor Framing(4285) 0 Floor Sheathing(4105) 0 Shear Walls(4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date By Date By Date
❑ Roof Sheathing(4220) 0 Fire/Draft Stops(4095) NOTE: Prior to scheduling a Framing(4120)
Approved to install roofing Approved 1 inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be •
By Date By Date signed-off and approved. IBC 109.3.4/UBC 108.5.4
[2 Framing(4120) 0 Insulation (4150) 0 Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By abzd1/4-i_i Date ' -_ ac-t) S l By Date By Date
•❑ Final- SWM(4375) I 0 Final-Building(4050) ❑Temp.Erosion Maintenance(4370)
Approved I Approved Approved
` By Date J By ✓- Date 7/,3/10r0 By Date
Federal Way PERMIT
COMMUNITY DEVELOPMENT SERVICES '.N 0 7 ZUL SF F CO ME EL PL DE EN FP
33325 8"AVENUE SOUTH•PO BOX 9718 p PLICATION T° --f--o a . --
FEDERAL WAY,WA 98063-9718 ''°
253-835-2607.FAX 253-835-2609 OF FEDER 1
www.eit,iof[ederahttatt.rom BUILDING DEPT..
The following is required information-an in ;mplete ap lication will not be accepted. Please print legibly(in ink)or type.
1I,PROPERTY INFORMATION
SITE ADDRESS )). 0 01 J`,k/ Fu) W/� (--i0:,13
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE (sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) LO I
(Attach separate page for lengthy legal desenp ion)
t
t -t . ...,4.17 i':,'
--- in:.PROJECT INFORMATION- '_;
l
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
43,.( tc.L, 1L"� a
PROJECT NAME(Name of Business or Owner Last Nzme) "VC.{/Y jL.-(I `l k_4_a/
.()
,;-,, ,`. - , :. , - i1 PEOPLE INFORMATION
PROPERTY NAME 9 'l PRIMARYCPHONE
OWNER �/f--'�q1( Li "ii ().+J /)� 7 -s7.69..6J'. _
MA D ESS Sit CITY ..rte I N'0.1.2„, `^r 9f0:-)
0:—) _
CONTRACTOR COMPANY NAME /�V i APPLICANT NAME OFFICE PHONE
10W/11 ( ) -
,,�
' (( 1O"
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
/'� � CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
(`•w' -^
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
/
l ) -
RELATIONSHIP TO PROJECT . FAX NUMBER
❑ Architect ❑ Tenant 0 Agent CI Other(Describe) ( ) -
CONTACT NAME •
L PRIMARY PHS E E-MAIL ADDRESS
0(e-el. 1--1 ')‘r
-t '� 7>c7;'l (? ) 70` - 9,9 J to
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
�
--'f•'-',','`,":';'4., .n/ DETAILED BUILDING INFORMATION . _ p
EXISTING USE ., F`r� I PROPOSED USE l l 5 F/`
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 13 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES t<NO
WATER SERVICE PROVIDER 51 LAKEHAVEN ❑ HIGHLINE 0 TACOMA CI PRIVATE(WELL)
SEWER SERVICE PROVIDER Q LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS '
•AREA DESCRIPTION EXISTING SQ.FT. PR• ./SED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) err2 Li I
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXIST. TOTAL PROPOSED TOTAL EXISTING ASD PROPOSED
"NEW HOMES ONLY"" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $___
.,FIXTURES -
Indicate number of each type of fixture to be insta -d or relocated as part of this project. Do not include existing fixtures to remain.
' MECHANICAL `
Value of Mechanical Work
AIR HANDLING UNITS EVAP••• - •• ERS •S LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(comm«<iai) W OODSTOV ES
BOILERS FIREPLAC -"' • -- MISC(Describe)
COMPRESSORS .- `•CES GAS WATER - -:S
DUCTS / GAS PIPE OUTLETS
PLUMBING
BA - /BS(o ub/Shower combo) SHOWERS WATER CLOSETS(rode! MISC(Describe)
•ISHWAS RS SINKS DRINKING FOUNTAINS
GAS PI' OUTLETS SUMPS RAINWATER SYST
WA `ING MACHINES URINALS HOSE BIBBS
0 VS(Bathroom Si,sks) VACUUM BREAKERS ELECTRIC WATER HEATERS
I
,{ f- .1 :DISCLAIMER/SIGNATUREBLOCB - '":
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. j_47/NAME/TITLE /......64S7\---' DATE J5
p (Signa[ (Title)
I RELATIONSHIP TO PROJECT
Owner 0 Agent ❑ Contractor 0 Architect 0 Other
S
i
( FOR OFFICE USE ONLY:.
o NEW a ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
t BUILDING SHELL ONLY? o YES a NO BASIC PLAN? o YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
t NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES ❑NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
,
Bulletin#100 March 30,2004 — Page 2 of 4 k\Handouts—Rcvised\Permit Application