04-102846 City Federal Way
Comunity Development Services ' Building - Single Family Perm : 04 — 102846 — 00 — SF
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: IVY HILL ADULT FAMILY HOME
Project Address: 30141 12TH AVE SW Parcel Number: 515320 0352
Project Description: ALT-Inserting corridor inside existing garage to create storage and pantry area and exit through
garage.NO plumbing or mechanical.
Owner Applicant Contractor Lender
Marianna Garrett TONY GARRETT TONY GARRETT NONE
30141 12TH AVE SW 30141 12TH AVE SW
FEDERAL WAY WA FEDERAL WAY WA 98023 30141 12TH AVE SW
98023-3409 FEDERAL WAY WA 98023 NONE
Includes:
Census category: 434-Reside #1 #2 #3 #4
ih-
Occupancy Group. R-3 ---+— -----
- — --.
Construction Type: � Type V-N i
Occupancy Load:
E----- ---4 --H
[-Floor Area(Sq.Ft.):
Census Category 434-Residential alt/add-no, Mechanical No
Occupancy Group#1 R-3 Plumbing No
PERMIT EXPIRES January 29,2005.
Permit issued on August 2,2004
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 in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way. r /�
Owner or agent: Date: vy 2i�
` THIS CARD IS T( iZEMAIN ON-SITE -
b 0Community� Development Inspection Record
carr o= ��.. p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-102846-00-SF
Owner: MARIANNA GARRETT
Address: 30141 12TH AVE SW
FEDERAL WAY, WA 98023-3409
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.
•
0 Temp.Erosion Control(4365) ❑ Plumbing Groundwork(4190) 0 Underfloor Framing(4285)
To be done prior to breaking ground Approved to cover Approved to sheath floor
By Date By Date By Date
rBy
Floor Sheathing(4105) �❑ Shear Walls (4245) �❑ Roof Sheathing(4220)
Approved to install flooring Approved to install siding Approved to install roofing
Date ) By Date j `By Date
��JJ Fire/Draft Stops(4095) scheduling _..•__g( ) 0 Framing(4120)
ILJ h NOTE: Prior to a Framm 4120
Approved inspection;Electrical,Plumbing&Mechanical Approved to insu;ate
Rough-in and Fire/Draft Stop inspections must be /
sis*ned-off and approved. IBC 109.3.4/UBC 108.5.4 7 ��'/
By Date By Date/
[ril Insulation (4150) ❑Gypsum WallboardNailing (4130) ❑ Final-SWM (4375)
Approved to install wallboard Approved to install mud&tape Approved
y /kiii`� Date g 27 1/ By hif Date F-31? beBy Date
0 s Final-Building(4050) ❑Temp.Erosion Maintenance(4370)
Approved Approved
By Date By Date
ao t RECEIVE c - J 6_ a c 0
Federal Way / —
COMMUNIYDEVELOPMEATSERV PERMIT �� F CO ME EL PL DE EN FP
33530 FIRST WAY w 8 63 2 2°O4APPLI CATI O N
253-6614115.FAX 2536614129 / / E
wwvi.tittpfrederdt(..W OF FEDERAL WAY ^V
BUILDI G � a
The ollowin• is re.ucrelktn oiihktion-an Inco •lete a.•lication will not be acce'ted. Please .rint le.ibi (in ink)or •-.
PROPERTY INFORMATION •
SITE ADDRESS 30141 124k l Ve' 5L9 recltat/al'/ 4. 9 'O Z3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 5 ) 5 a 2 `0 - 0 l3 LOT SIZE(sf) 16,,t,
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) c T LOT 10, illevrslne V}eta&IqW y A. G tooP)
(Attach separate page for lengthy legaldesoipnor) //
PROJECT INFORMATION
TYPE OF PERMIT V(UILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed des ption of work include on this permit only)
Fin %tSh or 5arMe IXYect To C JII/e a �►at( uV4 —ce041 /(vl 0 YeA 0,
2
basy)i e )-f +D s-014T1 1 I etf / ex"I. Q '-e- AA VQ +6 66 �ePI
Its l 5 .0r &. U1A �1 LDL 1,J! Y e. n� 5 tr'
P � � 9a � t� � f�'r��
GIa, 6l'C Cop& (°G* a e in- h , rP, f tiJrM 914 e
1� l �� P �'I j SCJ �odr�Wt�9`c
PROJECT NAME(Name of Business or Owner Last Name) L.Vy Hai_ et'
_ - PEOPLE INFORMATION
PROPERTY NAME f /��, �� �*'�7� /PRIMARY PHONE C
OWNER Y l ay-1 Dane, v vet ` I-oh I &srvt J I (253 ) 5Z�-5t15
15
MAILING 301 Yl ADDRESS/2,4410' Sw CITY, TATE, IP WA
^ '°
2-3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
OW — ( )
MAILING AD RESS CITY,STATE,ZIP CELL PHONE
( )
CItlY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
— — / / ( )
B L
CQNTRACTOR'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
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect o Tenant 0 Agent 0 Other (Describe) ( ) -
CONTACT NAME PRIMARY PHONE
E-MAIL ADDRESS
(
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000'
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ (if
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
1
x
off-
•
__.._._ ----__ ,__...______. PROJECT FLOOR AREAS ,.• ,
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING / TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTI N •TED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or elocated 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(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS . ub/ShowerCombo) SHOWERS WATER CLOSETS(Toilet) _ MISC(Describe)
DISHWAS RS SINKS DRINKING FOUNTAINS
GAS P ' OUTLETS SUMPS RAINWATER SYST
W•: ING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) 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. //�� h/a
NAME/TITLE DATE 7 Z(J v✓/
(Signature) (Title) /
RELATIONSHIP TO PROJECT 0 wner 0 Agent o Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
a NEW o ADDITION a ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? 0 YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? a YES ❑NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin tl l00—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application