17-102465 Building - Single Family
City of Federal Way Permit #:17-102465`00-SF
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: DICKEY
Project Address: 30430 21ST AVE SW Parcel Number: 122103 9166
Project Description: ALT-Replace window with French doors,including stairs and landing.
Owner Applicant Contractor Lender
ERIC DICKEY ERIC DICKEY OWNER IS CONTRACTOR
30430 21ST AVE SW 30430 21ST AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
Census Category: 434 -Residential alt/add - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.)
Additional Permit Information
Occupancy#1-Construction Type Type V-B Mechanical to be Included No
Is this an Online or O.T.C.applications No Plumbing to be Included9 No
Occupancy#1-Use Residence(1 or 2
family)
Total Valuation:2,000.00
ASS` <: a; ..� hisP q.
CONDITIONS:
Subject to field inspection without plans. \°. 11
tAP1/4
PERMIT EXPIRES Sunday, 19 November,2017 10A
Permit Issued on Tuesday,May 23,2017
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.
/ //7Owner or agent: Date: 5G �
THIS CARD IS TO REMAIN ON-SITE
CITY
°FConstruction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 102465 00 Address: 30430 21ST AVE SW
Project: LAURA DICKEY FEDERAL WAY WA 98023-2306
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.
Prior to scheduling a Framing inspection; 1❑[
Framing(4120) ® Gypsum Wallboard Nailing(4130)
Electrical,Plumbing&Mechanical Rough-in Approved to insulate Approved to install mud&tape
and Fire/Draft Stop inspections must be signed-
off and approved. IBC 109.3.4 By�> Date /J ( - /, By Date
—1 /
8❑ Final-Building(4050)
Approved
;OLA« Date�j_ r ,_, ((�
111 Rough Electrical111Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY OF +^...� MAY 2 3 2017
PERMIT APPLICATION
Federal Way CITY OF FEDERAL WAYPERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER / _'� _ / 0 (7 - S F
TARGET DATE (((
SITE ADDRESS SUITE/UNIT#
3 cytko 21 - Y\Uc -'5LAJ Git , w\ `13D23
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 2,�0O / -- / 6 3 - 9 ( (Q 6
TYPE OF PERMIT BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT i�_ u I 1 11 n
PROJECT DESCRIPTION IJcn ►X�� 1 �ncZJfCC�C (�hC� CAN(�
Detailed description of work to ,1TA
be included on this permit only
NAME ' PRIMARY PHONE q
Z r
39c,-
c,- J26S
PROPERTY OWNER
MAILING ADDRESS E-MAIL
05 Et)c --xvt 1( f e[ ►r���.cam.
CIT STATE ZIP -�?
\-e Q C4 L.C. Li �I j 3
NAME PHONE
et-v \
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME . PRIMARY PHONE
n ec
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT 0-.0(\e-
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME �q
PROJECT FINANCING Owner- ,f7K OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 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. 7
SIGNATURE: ,/ DATE 5/2 3/ i -/
PRINT NAME: p-1- I C- VcJ1LIL
Bulletin#100-January 29,2016 Page 1 of 2 k:\I-Iandouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
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 HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Indicate how many of each type if facture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or'rub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR V E OF'EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYST ? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING •ROPOSED OTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals I I I
**NEW OMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NE ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Const action #of Additional Information
Square Feet Ty.e Stories
NEW BUILDIN
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
Square FeetType Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application