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03-100214 .8. • City'of Federal Way Building - Commercial Permit #:03 - 100214 - 01 - CO Community Development Services 33530 1st Way S Federal Way,WA 98003-6210 Ph:253.561.4000 Fax 253.661.4129 Inspection request line: 253.835.3050 Project Name: CHURCH OF BLESSING Project Address: 1430 S 330TH ST Parcel Number: 172104 9045 Project Description: See project description on attached document. Owner Applicant Contractor Lender CHURCH OF BLESSING DAVID THORSTAD CHURCH OF BLESSING US BANK*OSCAR GONZALEZ* 31037 44TH AVE S 406 S 289TH PL 858 2ND ST S AUBURN WA FEDERAL WAY WA 98003 CHURCH OF BLESSING RENTON WA 98055 98001-2610 1430 S 330TH ST Includes: Census category: 437-Comm I #1 ____I L #2 #3 � #4 r-- 1 Occupancy Group: A-3 B Construction Type IIIB IIIB 1a _ a _a _u. —Occupancy Load: ---T354 9 r � ���� u Floor Area(Sq Ft.): 7705 864 1st Floor Proposed Sq.Feet 21775 Building Pre-con.Meeting Re *d 'i' Census Category 437-Commercial alt/add Fire Sprinklers Yes Mechanical No Number of Stories 1 Permit for Building Shell Only No Permit for Foundation Only No Plumbing No Special Inspection Required No Total Proposed Sq.Feet 21815 Will Certificate of Occupancy be Issued? Yes Sensitive Areas? No Zoning Designation BC CONDITIONS: 1.See Conditions of Approval in Document File.No occupancy can be granted until conditions of approval are met. 2.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the subject proposal. PERMIT EXPIRES January 5,2005. Permit issued on July 9,2004 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 i\dance w 4 e laws,rules and regulations of the State of Washington and the City of Federal Way. U (..14.6. Date: / Owner or agent: / •,. • City of Federal Way Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 109 of the Uniform 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: CHURCH OF BLESSING Permit number: 03 - 100214-01 Address: 1430 S 330TH #1 #2 #3 #4 � p y Type: A-3 IIIB_ IIIB Occu anc Group: B , Construction T e: Occupancy Load: 354 9 if � — Floor Area(Sq.Ft.): 7705 864 Owner CHURCH OF BLESSING Name: 31037 44TH AVE S Address: AUBURN WA 98001-2610 �N1s. n40.444, c ao 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 severely 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. • Church of Blessing Project Description 03-100214-01-CO TI-PHASE I of project to establish church use in eastern first floor portion of existing building to include 8,569 square feet of sanctuary, office and restrooms; use of 68 stall existing parking lot along with site improvements. Construction of exterior fire department lane is required. NO PLUMBING OR MECHANICAL ON THIS PERMIT. APPLICATION REVISED TO ADD THE FOLLOWING: • 2nd floor framing and concrete pouring over 1st floor bathrooms and hallways • Construction of exterior phase II canopy ■ Construction of a ramp to provide access to the stage ■ Construction of a classroom and storage room in conjunction with the ramp construction (originally part of Phase II now part of Phase I) ■ Complete change of the south facade of the building to stucco and brick,with parapets, cornices, new doors and rounded windows. BASED ON THE REQUESTED REVISIONS,THE TOTAL SQUARE FOOTAGE IS 9,598 SQUARE FEET FOR PHASE I. I THIS CARD IS TO REMAIN ON-SITE CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 03-100214-01-CO Owner: Address: 1430 S 330TH ST FEDERAL WAY, WA 98003-6302 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 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 I�� Date 7/74/a 7 ❑ Re-steel (4215) ❑ Plumbing Groundwork(4190) 0 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) 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) ❑ Fire/Draft Stops (4095) NOTE: Prior to scheduling a Framing(4120) Approved to install roofing Approved 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 ❑ Framing(4120) 0 Insulation (4150) 0 Gypsum Wallboard Nailing(4130) Approved to insulate Oti Approved to install wallboard A-ppr�oveedd to install mud&tape By, Date MABy Date By i v Date /166 � ❑ Suspended Ceiling Grid (4265) �❑ Final-Fire Department (4060) Er Final-Planning (4070) Approved to drop tile Approved Approved By Date By Date By (PI3 Date 3b/C) -- ❑ Final-Public Works(4080) ❑ Final-Building(4050) Approved Approved By Date B Date/4./V . ' INSPECTION LOG DATE INSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION P5A1) lit''jt7 F-Dat I t g 5 -F a r Calt4ibio I A ro 0 i ail, f Of C011411)111 1 il ,04-7. lii, (i.r eq Wi---7)FiS ft // -) 604661War k for 6,fit rd W' ye rfi4ifi ItIStaltati'ai* /E 1 beetoN rt 'fool " Roai igArac il' ---ie 7 -, Grodild /I/Vr -- rOir egri"-C r00111 '' ) i,,, - //1 - i ti/i7%; * >4I 6 ro4a1 if/ark- 1(.0K- 11/29/0 1 11,-- >z m/hi j pot 'ins 0 n poo 1 )1 , IZ_Akb3 A .1— O /< -For wit // (over" ,'1 ____a 5 5t-ing2 a_a_ 11 n )9' eice-t 5af6--/-, , 1247/9 91- ' .-., 111501a1-1i711 a 5S Cni 4.. aid i 1 1.4,A).- 1/-*i't --O'' ---- ) ____,/.. 9-, wile I I if) i,5,:cr,-/ili, ,,)-:, 4 1()I -g -.2 "-: oi-/c......."----- 4.-- --F0,A cr 4.4. 4,--ill< , ft._..k.e.„...._ ..,..,.----.s 0,....„ zi7A7-6ril 477:--/ >4:. roo ,:.i; ' {2 A --fir Ji:_ii _ 1,,i,t+I iv' ('';- --5 51 17-1/ 1 <A:'.,. '' / i -I /- ,- :/ ( I' ri,-, 4-1 1 f.ef. :i't . .isi( - j .../ ,!, Tr. i.-1.1/.;/ /. / ) i;:i-' , (, 1 "-- / , /7l; Ir rilafso 7 f)," ri:ffr r ,, 7,(2;,./,); 1 .y.if /,-. .;,;ti, ,, ?,u. , iic ,./ - ./- . , - i'y /,; i ; / t/ :i- .',.71:..- --... /i/ 1 1 _,__, i ,i7; ' ;:',. , 1 , 7 j 1/1' 74 , 0.1% &r.,V 5.44 7*, l 'Xilfil 1 ,---./ F y ,._.\ ts/2y1wiTt, L-X7r iL14.,.: -/ / 1-Z C 4 —1 ------ I 'l .% City of Federal Way Building - omni rcial er111 it #:03 - 1002 Y4 - 00 - CO Community Development Services I 33530 1st Way S Federal Way,WA 98003-6210 Inspection request line: 253.835.3050 Ph:'253.661.4000 Fax:253.661.4129 Project Name: CHURCH OF BLESSING Project Address: 1430 S 330TH ST Parcel Number: 172104 9045 Project Description: TI-PHASE I of project for a tenant improvement to locate church in eastern portion of existing building to include 8569 SF of sanctuary,office and restroo:.,c and use of 68 stall existing parking lot along with site improvements.Construction of exterior fire department lane is required.No plumbing or mech on this permit. Owner Applicant Contractor Lender CHURCH OF BLESSING DAVID THORSTAD CHURCH OF BLESSING NONE CHURCH OF BLESSING 406 S 289TH ST 1430 S 330TH ST FEDERAL WAY WA 98003 CHURCH OF BLESSING FEDERAL WAY WA 98003 1430 S 330TH ST NONE Includes: Census category: 437-Comme #1 #2 #3 #4 Occupancy Group: A-3 -- B I Construction Type: IIIB IIIB Occupancy Load: 354 — 9 Floor Area(Sq.Ft.): 7705 864 1st Floor Proposed Sq.Feet 21775 Building Pre-con.Meeting Required Yes Census Category 437-Commercial alt/add Fire Sprinklers Yes No On 5C Grp•+'@ fGrAlt Number of Stories 1 Mechanical �,.__ P Permit for Building Shell Only No Permit for Foundation Only No y� dO Special Inspection Required No Plumbing .�7i. �1 Total Proposed Sq.Feet 21815 Will Certificate of Occupancy be Issued? Yes Zoning Designation BC Sensitive Areas? No CONDITIONS: See Conditions of Approval in Document File.No occupancy can be granted until conditions of approval are met.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the subject proposal. PERMIT EXPIRES February 1,2004. Permit issued on August 5,2003 1 hereby certify that the above information is correct an at the construction on the above described property and the occupancy and the use will be in accordance . 't laws,rules and regulations of the State of Washington and the City of Federal Way. / - Owner or agent: Chfi7et' dir Date: ,e/5-3 mip City of Federal Way Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 109 of the Uniform 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: CHURCH OF BLESSING Permit number: 03 - 100214-00 Address: 1430 S 330TH #1 #2 #3 #4 Occupancy Group: A-3 B Construction Type: IIIB IIIB Occupancy Load: 354 9 Floor Area(Sq.Ft.): 7705 864 Owner CHURCH OF BLESSING Name: CHURCH OF BLESSING Address: 1430 S 330TH ST FEDERAL WAY WA 98003 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 severely affect the health and safety of the general public. Although the City has made a: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. INSPECTION LOG DATEINSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION 4Wa% F O I S f,or C o, t ' i n p,01 a 111 or COI Ohl A$ 1 pi 0;4 1 ) a red 'MO in *-- I Cxrotind work for Atter orJ V-erg J Iii sJ 4fir;n11 914 r bec* II arpoi ' room ,Q 1443 pt- )4 &ro1n / War k f0 r 'Vars.( Moil 10fr X09-L;;� ..{ -fir fang- & c�% ' I0 7� In-i GVou� �.9rk 140 kl4C All r, 1� M-163 .G J.P,�r rdr���� do faa , It/14,01 07 .- -71 2 k 712I //An (01`rr /% 01.3:,667.1h /i dill ,o4 ii c/ GrpF 5efillr 12 z A ✓ �� /I)SL1/fid/f f c t riemb J I i n /7—/ /01c1 Pi:y-717411 /4 ,0_9-6-'074 hjj..v I'll, 61 1 3 Z zj/--C] 3c7c..„) - -c,,.� w;. I ct.-� �r 7� g�rc)o,vi t l t/./irAL-7z '` /14 y 01%4t2 fly( iti T'or /�r ( rA' {i POST THIS CARD ON THE FRONT OF BUILDING cry/'ar- Federal Way BUILDING DIVISION INSPECTION RECORD INSPECTION REQUEST PHONE#: 253-835-3050 PERMIT #: 03-100214-00-CO OWNER'S NAME: CHURCH OF BLESSING SITE ADDRESS: 1430 S 330TH /ic/ ' �Ih O FOOTINGS/SETBACKS 11/1-1/0 /"'Y () FOUNDATION WALL DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED x, Y" a illi () DRAINAGE: Line 71 7-41/6 /f°V�� O Connection DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED ,;:,-:` r' or ( ) UNDERFLOOR FRAMING ( ) ROUGH PLUMBING: DWV Water piping ( ) ROUGH MECHANICAL Gas piping ( ) SHEATHING Roof Floor O SHEAR WALLS O ELECTRICAL ROUGH-IN Ditch Cover ( ) FIRE/DRAFTSTOPS �. .....A: .,,,,H . 0,_T ,,. .. �; ..,kg, PRIOR TO FRAMING INSPECTION ( ) FRAMING/FIRESTOPPING /0 2.10 /f f I OR SHEETRO KING ( ) INSULATION: Floors Walls Attic ",,ifil 'ro s 411W40 OV E MUOIO.. 1�. ,,,D ry', ��,','i .. y.,.i r 1, s..,..,.. ...... `r-.<, '• -.xsa () WALLBOARD NAILING () SUSPENDED CEILING i,, g A .. ,EM'PROVED PRIOR TO TAPING ORIINSTALLING CEILING TILE 4, „x ,.. ,. () ELECTRICAL FINAL ( ) PLANNING FINAL () PUBLIC WORKS FINAL () FIRE FINAL THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL O BUILDING FINAL DO NOT OCCUPY THIS BUILDING UNTIL BUILDING _�::. GFW. ...:�: S APPROVED &mITY Building Division 33530 First Way South / P.O.Box 9718 7 Federal Way 98063-9718 Phone 253-661-4115 Fax 253-661-4129 INSPECTION NOTICE ADDRESS: to tt3 , 7 n I1 ft #: i rut w/ Q4 / p rov-ei i�s i orLf 2 (t)ciLl A v-f .1 rd i ' s tint' i 11; vi47 bwMa pp r2k-( / tof ssyte4° fla r (>>Vev uly sir k )fl 44)i,41° 51-(41,-r/�` ati �S fh-to ref/151'W h r JeX11 `apprIV"/2 IF YOU HAVE ANY QUESTIONS CALL (253) 661 LD Call for reinspection before cover WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE-INSPECTION. SEE BACK OF CARD FOR DETAILS. DATE INSPECTOR DO NOT REMOVE THIS NOTICE Page of 10-Digit Permit Number: IVR InspSion Line On this sheet is a complete list of inspections available on our automated Inspection Line with the four-digit code assigned to it by the permit tracking system. The listed inspection code must be used to schedule/cancel/reschedule/obtain inspection results. Call 253-835-3050 to schedule/cancel/reschedule/obtain inspection results and to leave a message for the inspector. Inspections scheduled on the system prior to 6:00 a.m. can be inspected the same day. The system will require the following information to successfully schedule/cancel/re-schedule/obtain inspection results: • 10-Digit Permit Number• Inspection Code • Date of Inspection •AM/PM Preference (NOT GUARANTEED) •Phone Number Please Note: Sites without addresses clearly posted will not be inspected — re-inspection fees may be assessed. ***YOUR INSPECTION IS NOT SCHEDULED IF YOU DID NOT RECEIVE A CONFIRMATION NUMBER*** We recommend that you note your confirmation number for use when communicating with our office about any inspection problems you may experience BUILDING INSPECTIONS ELECTRICAL INSPECTIONS ATTACHMENT 4010 ALARM PANEL 4005 BLOCKING/TIE DOWNS 4015 CEILING COVER 4020 DRAFTSTOPS 4035 DITCH COVER 4030 DRAINAGE/DOWNSPOUT/FOOTING 4040 FEEDERS/SUB-PANELS 4045 FINAL-BUILDING 4050 FINAL-ELECTRICAL 4090 FINAL-FIRE DEPT 4060 POOL BONDING 4295 FINAL-PLANNING 4070 ROUGH ELECTRICAL 4225 FINAL-PUBLIC WORKS 4080 SERVICE 4235 FINAL SWM 4375 SERVICE-MANUFACTURED/MOBILE HOME 4240 FIRE STOPPING 4095 TEMPORARY POLE 4270 FLOOR FRAMING 4100 TEMPORARY POWER 4275 FLOOR SHEATHING 4105 WALL COVER 4300 FOOTING/SETBACKS 4110 FINAL INSPECTION 4090 FOUNDATION WALL 4115 FRAMING 4120 GYPSUM WALLBOARD NAILING 4130 PLUMBING INSPECTIONS INSPECTION CONSULTATION 4145 FINAL-PLUMBING 4075 INSULATION 4150 PLUMBING GROUNDWORK 4190 MECHANICAL UNIT SCREENING 4170 RAINLEADER 4210 MISCELLANEOUS INSPECTION 4175 ROUGH PLUMBING 4230 OTHER CONCRETE FLOORS 4180 RE-STEEL 4215 ROOF SHEATHING 4220 VIOLATION INSPECTION CODES SHEAR WALLS 4245 COLLECTION COMPLIANCE INSPECTION 8020 SKIRTING/FINAL 4250 NOTICE&ORDER COMPLIANCE VERIFICATION 8040 SLAB ON-GRADE 4255 VIOLATION COMPLIANCE VERIFICATION 8085 SUSPENDED CEILING GRID 4265 TEMP EROSION/SEDI CNTRL MAINT 4370 TEMP EROSION/SEDIMENT CONTROL 4365 SIGN INSPECTIONS UNDER-FLOOR 4285 ATTACHMENT 4010 UNDER-SLAB GROUNDWORK 4295 FINAL-SIGN 4085 FOOTINGS/SETBACK 4110 TRENCH COVER/ROUGH ELECTRICAL 4280 MECHANICAL INSPECTIONS FINAL-MECHANICAL 4065 GAS PIPING 4125 MANUFACTURED HOMES MECHANICAL ROUGH-IN 4165 BLOCKING/TIE DOWNS 4015 SKIRTING/FINAL 4250 T ,��� RECEIVE,_ CONST UC.I ION PERMIT APPLICATIC �[-7� 1— • PPLICATIIUMBER: _ _ - I QO L I - I0 `>`> JAN 0 6 2003 PPLICATION NUMBER: CITY 'IOF FEDERAL WAY _PPLICATION NUMBER: - - **The folioµf WItP zPc filiiormation-Please print(in ink) or type** Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. i a '.. 1 r: L /4 fi >-.: lE' PROPEitill/NPORMK'RON ..'� A:. ,.; ::fit SITE ADDRESS: I''Z) 'f, ��1�=,;>-111 E ASSESSOR'S TAX/PARCEL #: L 7_ 2.+ •i- I i -1 ),21- LEGAL _'LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATT CH SEPARATE DESCRIPTION IF LENGTHY): .";747:1-Rr '-, - s� 031.0 ,k16 t a. iNNAirV.t 411W7EetiNFORMA'RON f. rr`'..v. �7!p ik'I:Y,+f i ASS-+:17: :% t¢ 1.VS li TYPE OF PROJECT(This application): a BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SY!STEM- PROJECT DESCRIPTION (Provide detailed description): 4.._ $ 7 1 � .41 }114j — 2."1 -�,F-J 1"21I-k.7 t'.- 1l- --`2�7 d7r � 'r" .)L ,1 7 PROJECT NAME: i -f 1..)P-' �-- G.0 t--1.- -/4/1)-.111 s�-.6;• s n..• rs.;•i-t� �� 4 1• i ^ ���t�R t�'ey�l'r; '+ qtr „SSS. <.''�•,s;�, ''.r�, •744`t�}e,t.: ,� 4n* i ittl. :/+ 07`03" o ,' G 1.` EOPLEtNFORMI linin POS:111.1-. • _ ..�:.,' IA,- �' `'� .s �YstTi.;j.,� n+•,..i,' y 3,z.�:CA��: a3"f�r�. 14�� v.v;�: r� •" .� __-4474__-.•,_� .-'--- -- - PROPERTY OWNER: NAME: 1' I DAYTIME PHONE: "-JY .k -"i'�;"4711--14 Jli ) MAILING,ADDRESS(S1 RI I AD RLSS;CI\Y,SI AI L,ZIP): r J Ilt72 MJF / � t 4 / fri'Vr...?-4-_—_ Ali N� CONTRACTOR: NAME: 1 DAYTIME PHONE: MAILING ADD ESS(SIRE ADDRESS;CITY,STATE,ZIP): EVENING PHONE: , y ( ) - CITY OF FEDE L WAY BUSINESS LICENSE NUMBER: FAX NUMBER: - - ( ) -- CONTRACTOR'S REGISTRATION NUMBER: -- EXPIRATION DATE• : / / NAME: DAYTIME PITON-: APPLICANT: �,{If{L // I10 _ AL)lir 417 '~ %1 (VI �G PII DNE 1 ___/ MAI NG ADDRESS(STRt[I'ADDR S;CI1!(,Si ATE ZIP): t RE ONSHIP TO PROJECT'. I FAX NUMBER: �r ARCHITECT LI TENANT ❑ OTHER( DESCRIBE)__ ( )171 - --- _"--- - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: U PROPERTY OWNER lel APPLICANT ❑ CONTRACTOR ___ iii , t'.e-i'nF>ii,r'. dIi,rP. s ?..:. !• ..:vrt,. . ',:,•it'::,. 4 1 . ' . 1I t \ c ,FORMATION a ; . !, -,� ;., :rr.f fit. �" k n EXISTING USE: f-UL,=J EXISTING BUILDING ASSESSED/APPRAISED VALUATION $''{ .�. 1 — PROPOSED USE: ,41+- it "iPROPOSED VALUATION FOR IMPROVEMENTS: $ j7 SPRINKLERED BUILDING? El YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRRED:❑ YES a WATER SERVICE PROVIDER: WI LAKEHAVEN El HIGHl_INE ❑ TACOMA El PRIVATE(WELL) SEWER SERVICE PROVIDER: Q LAKEHAVEN LI HIGH LINE LI PRIVATE(SEPI IC) A _ - - - ' ' - £ALLUIl:,tRt.' t NUMBER OF BEDROOMS: • ESTIMATED SELLING raid. 3-- .; f :TI" -,v ..! %'.• '.. P4., . ,I .. PRO3ECTFL00ttAREAS. • . • 1.:..';.. FLOOR EXISTING SQ.I I. PROPOSED SQ.FT. TOTAL -- BASEMENT -- FIRST 61"7.Loei ••••4 721 SECOND + THIRD — - -- FOURTH r) ctc OTHER FLOORS(DESCRIBE) - 2,i L4 517 I1 DECK GARAGE HOW MANY FLOORS? TOTAL: 1 - "r , 1 g4 ' + � 4 . E41% 'ti ..k +C ` . N. n % =ya, x .Z 1;sis~e "' `yte. { 'w{ .. ;�i`,e- „ifoxl rdicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) — EVAPORATIVE COOLERS) _ GAS LOG(S) REFRIG.SYSTEM(S) -- BBQ(S) FAN(S) _ 110013(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) '" COMPRESSOR(S) DUCT(S) FURNACE(S) GAS PIPE OUTLE T(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS PLUMBING ___ BATHTUB(S) _ __ LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWERS) WASH MACHINE OUTLET GAS PIPE OUTLET(S) S.NK(S) 7 WAFER CLOSET(S) ___ MISC.( _.-_.) { i.� INTERCEPTOR(S) SUMP(S)P(w/ M y a : %.* 414Pri vi xr, s'u y"'�s t�'a,}as t ct,1 r+`^�d'1�' !r°oN$Y MM 1•CC. liZ ii 4}1.!CL`RV�S'!�i, `Y",'; *%'? 7: ..'�'!,�"ry:6_t i ,. ,,�,. ti s SIGNATURE 8 '�': . 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(induding 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 Fedcral Way, but only where such claim arises ol.l 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. l / rte 1 NAME/TITLE: 1 �L�+'a.----' L . 4r1 -Ph- 1. __ DATE: YIP/ j •_ - U PROPERTY OWNER APPLIC NT L CO RACIOR FOR OFFICE USE ONLY: - ❑.NLW: ❑,ADDITION ` I] ALTERATION : •.-❑-REPAIrZ!. ❑ TENANT'IMPROVEMENI CENSUS CODE: LOT SIZE: . ZONING DESIGNATION : .BUILDING SH..LI.ONLY? ❑ YES .. ❑ NO.=. ' -I COMP PLAN DESIGNATION - :BASYCPLAN? '❑YES •"❑ NO • SECTION . TOWNSHIP RANGE . ';;NEW.ADDRESS,PEQUIRED? ❑ YES•, ,❑ NO , PLATTED LOT? ❑ YE=S ' '❑ NO CHANGE OF USE? ❑'YES' .:'❑ NO • ` r COMMUNITY DEVELOPMENT SERVICES•33530 FIRS' WAY 50(501•P.O.BOX 9718•FCDCR/V-WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 L . ... 1 — �,_.,. �. ( .r.✓. b - r-• Yh5",'• i.'. i �e t: eY4.,..y£'•npu i.� ' _ - �y'Q i .r w e.. ^: .. '----..._.____—___-.__"_._. _. _. __...___..__,,.__.__ _ _._-i..�.__._.._------"-"--- ,. _•_ _._____ ._. .. ..,n,,,�v.ATa. .A _rt,..; �>y,., .'cr±, ye=.;•�k:.�i. t w,».,-:-„-• - , i }, Jr{i i t r IwIr s P F • _ 11 '..�! 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