05-105378 •
IID
City of Federal Way Building - Commercial Permit #: 05 - 105378 - 00 - CO
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: FEDERAL WAY HIGH PORTABLE CLASSROOM
Project Address: 30611 16TH AVE S Parcel Number:082104 9001
Project Description: REM-Construct interior partition walls to create dressing area and secure stoarge.
Owner Applicant Contractor Lender
FEDERAL WAY SCHOOL DISTRIC" FEDERAL WAY SCHOOL DISTRIC" FEDERAL WAY SCHOOL DISTRIC NONE
31405 18TH AVE S31405 18TH AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 31405 18TH AVE S
FEDERAL WAY WA 98003 NONE
Includes:
Census category: 437-Comm #1 #2 #3 #4
LOccupancy Group:
Construction Type:
Occupancy Load.
Floor Area(Sq Ft.):
Census Category 437-Commercial alt/add Mechanical No
Number of Stories 1 Permit for Building Shell Only No
Plumbing No
PERMIT EXPIRES April 17,2006.
Permit issued on October 19,2005
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 in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way. 1
Owner or agent: . *C' Date: 7 o4 .
SUBJECT TO FIELD INSPECTION.
` THIS CARD IS TOMAIN ON-SITE ,
CITY OF ommunity P Inspection ment Ins ection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105378-00-CO
Owner: ROD LELAND
Address: 30611 16TH AVE S
FEDERAL WAY, WA 98003
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.
❑ Footings/Setback(4110) 0 Foundation Wall(4115) 0 Drainage/Downspout(4040)
Approved to place concrete Approved to place concrete Approved to backfill
By Date By Date By Date
ElRe-steel(4215) 0 Plumbing Groundwork(4190) ❑ Slab/Concrete Floor (4255)
Approved to place concrete or grout 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 Date
❑ Roof Sheathing(4220) 0 Fire/Draft Stops (4095) NOTE: Prior to scheduling a Framing(4120) 1.
Approved to install roofing Approved inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 109.3.4/UBC 108.5• .
By Date By Date
0 Framing(4120) ❑ Insulation(4150) 0 Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date L�/Z Star— By Date By Date `Q/ /or—
•EI Suspended Ceiling Grid (4265) ❑ Final-Fire Department(4060) ❑ Final-Planning(4070)
Approved to drop tile Approved Approved
By Date By Date By Date
0 Final-Public Works (4080) 0 Final-Building(4050)
Approved Approved
By Date By `%f� ....--./ Date /10)/�
0CI OF 101111111% CIli
Federal Way r /�'�? (..C1F 1 05 Q S ,3
COMMUNTyDEVELOPMENT'SERVI �F��'� PER
IT SF MF CO E EL PL DE EN FP
33325 8rN AVENUE SOUTH•PO BOX 9718
FEDERAL 07.FAX
98063-260 APPLICATION °Agivii---
253-835-2607•FAX 253-835-2609 �1 ` (� (�
WW.cituo((ederalway.com :-i t� 1 I V Z4 :...
The ollowin. is re.wired ;f••I. an incom•lete a.•lication will not be acce•ted. Please •rint le.ibl (in in or •e.
' ■ PROPERTY INFORMATION
SITE ADDRESS 3 0& I ( / W — ' S
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 0 2 eA I q— d 0 i
r LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate pogefar lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT a . ILDING ❑ PLUMBING ❑ MECHANICAL
0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
t /
PROJECT NAME(Name of Business or Owner Last Name) FW 0 S —'IO T C
a PEOPLE INFORMATION
PROPERTY NAME
OWNER PRIMARY PHONE
MAILINGDDRESS /<�`9/ ,e,..,/?z re `�'4y�/ /z:Ci �ZS ) `/�f� 5 3S
CITY,STATE,ZIP /
CONTRACTOR COMPANY NAME APPLICANT NAME J
_ OFFICE PHONE
1 5 CITY,STATE,ZI � 1 c5 ) y`J 5 �J
P �
MAILING ADDRESS
CELL PHONE
, c ', 6 `_ .. 5?cc ST /-.5.----- _ i.,/..• /-.
K/ 1 /Yin (,2-53) c-4 i 1506
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
MAIL[ D t- Li 4-, -A Vim- ( ) -
CITY,STATE,ZIP - CELL PHONE
RELATIONSHIP TO PROJECT )
0 Architect 0 Tenant ❑Agent 0 Other(Describe) FAX NUMBER
( )
CONTACT I NAME
c
PRIMARY PHONE I E-MAIL ADDRESS
5// / /'
( r%/ It >: ) %�.t/ ,�' ?tr� TIS
ff/ &IL(.✓L�5..f7
LENDER r NAME �� 017
:1;1'5';
MAILING ADDRESS CITY,STATE,ZIP
• " ■ DETAILED BUILDING INFORMATION
EXISTING USE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ to e,
VALUE OF PROPOSED WORK $ c 0C,C,
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
' . PROJECT FLOOR AREAS
•AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH •
•
ADDITIONAL FLOORS(DESCRIBE)
•
DECK(COVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL TOT O ISO• F. ��TOTAL PROPOSED SP m r 'j TOTAL Er .�
NUMBER OF FLOORS .
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
•
. . . FIXTURES.
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commarciaq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shower combo( SHOWERS WATER CLOSETS pile) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Ba broom s nks( 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 __ `P.
I 2� GI �*J � L DATE /c .//t
_ . . . e) (Title)
RELATIONSHIP TO PROJECT dOwner 0 Agent 0 Contractor 0 Architect 0 Other
O kapI'ON
b as , tIO MEN P � �ti� �� ( •
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application