09-103744 { ilding - Single Family
City of Federalevelopm Way
ntS Permit #: 09-103744-00-SF
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph (253)835-2607 Fax (253)835-2609
Project Name: A NEW HAVEN AFH IILtAts
'�_
Project Address: 3641 SW 317TH CT Parcel Number: 873198 0990
Project Description: NEW-Verification of Occupancy for Adult Family Home. ***No construction work
allowed under this permit.***
Owner Applicant Contractor Lender
VERNETTA A BAILEY-HECKMAN WINNIE L ELLAZAR
3641 SW 317TH CT 2631 SW 320TH PL
FEDERAL WAY WA 98023-2133 FEDERAL WAY WA 98023
Census Category: 434 - Residential alt/add - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Ply Area(sq.ft.) 0 0 0 - 0
New/Additional Sq,Feet-1st Floor...:..... 0 New/Additional Sq.Feet-2nd Fluor....... ...... .0
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0
Basic Plan? No New/Additional Sq.Feet-Deck 0
New/Additional Sq.Feet-Garage 0 Mechanical to be Included? No
New/Additional Sq.Feet-Other 0 Plumbing to be Included? No
New/Additional Sq.Feet-Total 0 Zoning Designation RS 7.2
57, fi aZ No Fixtures Ass. -t-feitNllitilThis Permit f f
PERMIT EXPIRES Saturday, March 27, 2010
Permit Issued on Monday, September 28, 2009
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.
Owner or agent: G "�` X � �--- Date: ?/�g/i 9
F 4A1, i0 /5/1;s9
City of Federal Way
Y Y
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: A NEW HAVEN AFH II Permit #: 09-103744-00-SF
Address: 3641 SW 317TH CT
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq. ft.) 0 0 0 0
Owner Name: VERNETTA A BAILEY-HECKMAN
VERNETTA A BAILEY-HECKMAN
Owner Name:
Owner Address: 3641 SW 317TH CT
FEDERAL WAY WA 98023-2133
= 0 �'
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible(within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.SO, Ai
l'
z ' . 11
7,0/9Z. 0 9 - 10 •3
� OPERMIT FCOMEELPL
Federal Way DE EN FP
C0MMUMTYDEVELOPMENT 253-83SERVICES APPLICATION / /
253-835-2607•FAX 253-835-2609
www.dttpfTeder Iwap.cum
...E .. . -. ..., . a •
SITS ADDRESS
344/ 5v 3/?
SUITE/UNIT. ZONING g- �TAX/PARCEL II � � g` _ 0 7 ?D
3•
r.
NAME OF PROJECT f�� _ �y � j
(Tenant or Homeowner Name) W I Il.(1L I L L, e (,,( z; L A NW 4' -/V Al I
BUILDING 0 PLUMBING 0 MECHANICAL
TYPE OF PERMIT
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
U 04 ar#L * T i 0 /1") r
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
„'�«e� �
NAME PRIMARY PHONE
VP-PROPERTY OWNER ISE 4 f Jt 1 ' • 1 ,r ■ J A (?04 ) 2 - '3
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
150 3/ 7 n-t-,;" 144. 9s-0 2-3
OWNER IS ALSO: o CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
NAME PRIMARY PHONE
CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP
WA STATE CONTRACTOR'S LICENSE 8 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
NAME _---- PRIMARY PHONE
APPLICANT W ,U&r L. L .2.53 ID - 1 c
fir:\1�1'c �.•-�:+:�. , - , Ar - ��, -4 O.2,,,'f FAX
1 w Pt.4 ;jet ,y - )_1 "
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and A) - • C L(/4 794.2 2c3 /-
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP
concerning this application) W 1 `• L� -
ALTERNATE CONTACT NAME: PRIMARY PHONE 7i E-MAIL
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
I certify wider penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the
best of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,atpenses,and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied�rto the city as a part of this application.� L/
SIGNATURE: "�/vt/� e U' �Z 1 � DATE !q/"'Q-/
PRINT NAME: VI Il(N1 70f el.
Bulletin#100-4/17/2009 Page 1 of 4 k:\Handouts\Permit Application
. 7
laif •iii ii,
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number 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(can)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Ifilia$bra. ^t m'F _ tt r a , 4ah;..
E ., is # ;„< u
t
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not inclu.- existing fixtures to remain.
:BATHTUBS(or Tub/Shower Combo) LAVS(Handsinka( TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BRE• '-S
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEAT''S(Electric)
HOSE BIBBS SUMPS WASHING „ACHINES _ TOTAL FIXTURES+
GEN L 1iO lY A
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(Ia Square Feet) EXISTING-s-: SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
: ,fill .A ::. ,�. ,., . 12i€ s s4.,, 1, ..e.. •.. ::.. mss;; MeS: 6:�? 'n,
AREA DESCRIPTION(in square feet) D*c ' i ING 'ROPOSED TOTAL FOR OFFICE USE
BttE1GENT '
3t I �
FIRST FLOOR(or Mobile Home)
COVERED ENTRY
I1ECI
GARAGE 0 CARPORT 0
i.. gyp, p,fingatagq.':1-Pnit.gte NOREIRNIME glingtigget Mdeilifietaila
EXISTISO PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRIC $ #OF BEDROOMS
a dr _r ' r ��ry� a , .i iii n <
i
f'fir''/::,1
iitna �. ,M>.A . r °i. . Clm �. .'11- ,9.Nr tets,iift. a,. rj> 6,,,,,,if
AREA DESCRIPTIO ' Area Construction #of
Occupancy
Group(s) Additionala o 0ain Square Feet
l,' "Btzt G' f EI
._''�'• fi�diY F, �,I a3»Y.. ,.,, rf ,,..,,.,,
ADDITI,,N
rials n sir
r- ,^y,� .a.«� S � "Z'f'-S , ,, 1 4 1 0, ® S :.` n�,.� '' ,.�3 1
�u,��e rte._...,• � ,�.. ..
AREA D -CRIPTION Area Construction #of
Occupancy Group(s) Additional Information
in Square FeetType Stories
TCIT`AL B a DI I3 1 iig 1,1 8
� �
NANT AREA ONLY
Bulletin#100—4/17/2009 Page 2 of 4 k:\Handouts\Permit Application