08-102804 r f t
City of Federal Way Bull( - Single FamilyPerm#: 08-102804-00-SF
Community Development Services g g
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: CIESLAK
Project Address: 32428 11TH AVE SW Parcel Number: 926493 0310
Project Description: Re-roof,remove shake roof, re-sheet and re-roof with comp.
Owner Applicant Contractor Lender
JAMES CIESLAK HORIZON CONTRACTORS INC HORIZON CONTRACTORS INC
32428 11TH AVE SW 32705 5TH AVE SW HORIZCI11OKR (05/14/09)
FEDERAL WAY WA FEDERAL WAY WA 98023 32705 5TH AVE SW
98023-4910 FEDERAL WAY WA 98023
Census Category: 555 -Non-structural roofing permits
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 Included9 No Plumbing to be Included? No
No Fixtures Associated With This Permit !!
PERMIT EXPIRES Sunday, December 7, 2008
Permit Issued on Tuesday, June 10, 2008
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
aip the City of Federal Way.
Owner or agent: j L. \ Date:
Fl Mktab G 11 a9
- THIS CARD IS TO EMAIN ON-SITE
CITY OF Itommunity DevelopnWnt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-102804-00-SF
Owner: JAMES CIESLAK
Address: 32428 11TH AVE SW
FEDERAL WAY, WA 98023-4910
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 SWM Precon Site Mtg(4400) ❑ Initial Erosion Control (4365) ❑ Underfloor Framing(4285)
Approved To be done prior to breaking ground Approved to sheath floor
By Date By Date By Date
— [] Floor Sheathing(4105) ❑ Shear Walls (4245) ❑ Roof Sheathing(4220)
Approved to install flooring Approved to install siding Approved to install roofing0//4".
By Date By Date By Date
Fire/Draft Stops(4095) ❑ Interim Erosion Control (4370) NOTE Prior to sched lMinFraming a Framing(4120)
Approved Approved inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be
By Date By Datesigned-offand approved. IBC 109.3.4/UBC 108 5.4
❑ Framing (4120) ❑ Insulation (4150) ❑Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date By Date By Date
❑ Final Erosion Control(4375) ❑ Final-Building (4050)
Approved Approved •
By Date By Date
•
For inspector reference only
O Rough Electrical ❑ FINAL-Electrical
Approved Approved
By Date By Date
6
FederalCEIVEC — —
'ERMIT `SIJ MF CO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325
FEDERAL 8rU AVENUEWAYSOUWATH98063-97.PO BOX
18,-�9718I 1 o 2°°8 A P P L I CATION
TO / /253-835-2607•FAX 253-835-2609wu,w.ciltioilederalwai.com -
("�TY ( = FEDERAL WAY
The folloIliCng is require• ; • •tion-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS . 04 !14C-* ,1 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# _ f?Ve ,,_- LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of works inc luded on this permit onhi)
f:-C-1��►-C_. `_jly t; :., --- I ,,s,6-IA. eXC./c(( g i je---)
PROJECT NAME(Name of Business or Owner Last Name) � t` l S f rt U—
N PEOPLE INFORMATION
PROPERTY NAME�' ' PRIMARY PHONE
OWNER 3-7/0/0 Li c l COC, ( ) -
MAILING ADDRESS� CITY,STATE,ZIP E-MAIL ADDRESS
` 1.- I s.0i i--- Lac.., L
/
CONTRACTOR COMPANYNAM! l APPLICANT NAME OFFICE PHONE
144-i' ''11 C4 n ok.cb4.1 i• (
MAILINGADDMSS CITYOT E,ZIP CELL PHONE
V 61 6 K ,-y 4'00 (. c- ) -2 3.'k -z NIF 1
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE _ FAX NUMBER
i6 — /6 ( � `.. -7 6 ° ( 2_ b ( )
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
ted ei 7---c: 1 I I Q c-(..
APPLICANT COMPANIO‘NAME APPLICANT NAME OFFICE PHONE
(3-V\ ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant 0 Agent 0 Other ( ) -
PROJECT NAME -" PRIMARY PHONE E-MAIL ADDRESS
CONTACT ' 01,\_ • C: J'Z" ( ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ c.( -,t❑-
i
SPRINKLERED BUILDING? 0 YES 0 NO F OPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVE ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
- in PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT ❑
NUMBER OF FLOORS EXISTTNO PROPOSED - TOTAL. TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
U 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$ (A COPY OF'BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commerda4
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(orTtb/Shower Combo) LAVS(Bathroom sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roaey
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 cert4fy 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 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, 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.
SIGNATURE: ;
j DATE
Property Owner and/or Authorized Agent
•
a NEW a ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES o NO 4 UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO
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Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application