12-105557 i a
1111 wilding - Single Family
communiitty&Econ.Deof Federalrv'Services Permit #: 12-105557-00-SF
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: LAURELWOOD GARDEN APARTMENTS-BLDG Q UNIT6
Project Address: 29422 21ST PL S Parcel Number: 422291 0020
Project Description: REP-Repair drywall,sheetrock,insulation and plumbing fixtures from fire damage
Owner Applicant Contractor Lender
KING COUNTY HOUSING S I R CONSTRUCTION S I R CONSTRUCTION OWNER IS LENDER
15455 65TH AVE S 14751 N KELSEY ST SUITE 105 SIRCO**0660T(3/19/14)
SEATTLE W 98188 MONROE WA 98272 14751 N KELSEY ST SUITE 105
MONROE WA 98272
Census Category: 434-Residential alt/add-no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Area(sq.ft.) 0 0 0 0
Additional Permit information'
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0
Mechanical to be Included? No Plumbing to be Included? Yes
Plumbing Fixtures
Bathtubs 1 Dishwashers 1 Sinks 2
Water Closets 1
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Monday, June 10, 2013
Permit Issued on Wednesday, December 12, 2012
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: Date: {Z (Z((Z
f
ct fiat, WV*,
THIS CARD IS TO MAIN ON-SITE
CITY of ''' i4 Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-105557-00-SF Address: 29422 21ST PL S
Project: KING COUNTY HOUSING FEDERAL WAY, WA 98003
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 SWM Precon Site Mtg(4400) 0 Initial Erosion Control(4365) 0 Plumbing Groundwork(4190)
Approved To be done prior to breaking ground Approved to cover
By Date By Date By Date
O Underfloor Framing(4285) ❑ 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) Rough Plumbing(4230) Fire/Draft Stops(4095)
Approved to install roofing Approved Approved
By Date By l,F Date /���/,3 By FOC.
Date l—/7-/3
O Interim Erosion Control(4370) Prior to scheduling a Framing inspection; Framing(4120) '
Approved Approved to insulate
Electrical,Plumbing&Mechanical Rough-in and
Fire/Draft Stop inspections must be signed off and /G
By Date approved. IBC 109.3.4 By Date /- /7
o Insulation(4150) ❑Gypsum Wallboard Nailing(4130) '0 Final Erosion Control(4375)
Approved to install wallboard Approved to install mud&tape Approved
By J/ Date( /3 By /G Date /2-f—e..5 By Date
O Final-Plumbing(4075) 0 Final-Building(4050)
Approved Approved
By Date By Date
❑ Rough Electrical Final Electrical EI Right of Way
Approved Approved Approved
By Date By Date By Date
1 _ k 055 E7--
CITY OF ': lit)ERMIT SF MF CO ME PL DE EN FP
Federal w +ECEIVED
COMMUNITY DEVELOPMENT SERVICES APPLICATION g
253-835-2607•FAX 253-8359(� y j 2012 �9"g
il .'1:!�'.fiilO FfiPYU(L"2IICO�lG�+
CITY OF FEDERAL WAY
SITE ADDRESS CDS SUITE/UNIT N
Z 4t'zz z/Sr PL S Fe Oe 444 Z-etr ,,v4• diao 33 62 ~ 6
PROJECT VALUATION ZONING ASSESSOR'S TAI/PARCEL It
$ 42Z2 ( - Q02-c
TYPE OF PERMIT lit/BUILDING 53 PLUMBING ❑ MECHANICAL
0 DEMOLITION ❑•ENGINEERING ❑ FIRE PREVJNTION
• NAME OF PROJECT$
(Tenant Name/Homeowner Last Name) G#141464 W006'. 4.4 R A C 4/S ii-P rs.
•
rt d$ro u RPS ti -r µ
PROJECT DESCRIPTION PR - FtR� CdNA/r!o.v� ST.edcrv�{4>
Detailed description of work to " t 1/,VL 4r(0.1
be included on this permit only 411/S (64y 14/01(.4
Sao,6 64h44 c. orvr4OL
_
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME S(4 C O 4/.c.S r k v c r r 0 t/ PHONE4Z7D 74 O
MAILING ADDRESS E-MAIL
CONTRACTOR 1 737 A/ if&L s y sr Svr rd (0 C
CITY STATE ZIP FAX
f aA.406 W4 fS2.r2. 4.2r• 3:5- • oras
WA STATE CONTRACTOR'S LICENSE It EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE It
$ Aco'• 066or /� _�j ./� _ PHONE
3 !1 t4
NAME CS 4 8 4 O R 3 4 A/ +ZS% S749' {9 17+
APPLICANT MAILING ADDRESS E-MAIL
if/ 7' r( N •(E[,Sy sr sore (°c c0it64A* StitCovsPit%.•crip.e.p,
CITY STATE ZIP FAX
110Nt06 14/4 fat 72. .
PROJECT CONTACT NAME PHONE
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
I certify under penalty of perjury that I am the property owner or authorized 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 authorized 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 Ci - f • " a ' 1 im including costs, expenses,and attorneys'fees incurred in
the investigation and defense of such clai I .w 14 miN
including the undersigned,and filed against the city,
but only where such claim arises out of e re:ante o t officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
DEC 1S 2012
SIGNATURE: DATE
PRINT NAME:
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\'en"nit Application
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VALUE OP MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many 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 ,_,___ OTATER TANKS(Gas) _ ;b
COMPRESSORS GAS LOG SETS * <H .WREFRIGERATION SYST`
DUCTING GAS PIPING WOODSTOVES
div �
„, .<a.' .r ° ,,a' �,. T . , x„ ., nt. �»� ,.°r�' <..�....s». .°..ar.'<'
Indicate how many of each type of fixture to be installed or relocated as part`of this project. Do not include e .- ing fixtures to remain.
I • BATHTUBS IorTub/Shower Combo) (1 LAVS(Hand sinks) J ' TOILETS / WATER PIPING
I • DISH HERS RAINWATER SYSTEMS URINALS., Of • OTHER(Describe)
DRAINS SI-L'O'NERS" ' '- ." "VACtJUM BREAKERS
DRINKING FOUNTAINS • •SINKS IKmhen/utilry) < • WATER HEATERS.(Elee el
4'•:' V' '`HOSE BIBBS. ' . . ;j` SUMPS" ,"N< ':' . WASHING Mi GHI . 's r
. ' „ : ,,.mow .
„• . .., b r E
CRITICAL AREAS ON PROPERTY? WATER PURVXYOR $ _ I SEWER PIJRVEYO n. y VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE LOT SIZE flu Square Feet) EXISTING FIRE SP' ' I ER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Ye: ❑ No ❑Yes ❑ No
:�' t^ p��N,, � 4Kv, k 5. ; ,-..,> t2.,. ..
z S �� �n?1:,�.. ss' ' � � .�.�..�h e< _ �.;��: »
AREA yr E�SeR.TPTION(in Iquare feet) EXISTING PROS=ED TOTAL - FOR OFFICE USE
-. ''fr Sze` A .. a. k �:r ,+ r z ,�., <
z- <»„�...',__i�.=a-,.w.,.... ,.,....1:,sa.«t�,.,r ,6..,.. < ?, ..�:....,�...s »,., .,k...,.br.,.wr,
FIRST FLOOD(Or Mobble Home) "" EMI .• .
c � E`4�.•�. �� s �R `� a z� � +td`" r #ffr� ,'#�� � t �i ?,s"�'^�s�„P �p�3,4 e �'¢A-, �
COVEREDcENTRY , • _, t .. . . a
GARAGE ❑ CARPORT 0
EXISTD76 PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
°
AREA DESCRIPTION , Area Occupancy Group(s) Construction #of Additional Information
in uare FeetStories
ADDITION
: _
AREA DESCRI' ON Occu anc s Construction #of
P y Grou PI 1 • ° .e Stories Additional Information
AREA ONLY
.SY....d. .a4.2F _.maa9_...L �&�<'vi^k � 5}.e
Bulletin#100—January 1,2011 Page 2 of 3 k:\-Iandouts\Permit Application