01-103778City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name:
Project Address:
NELSON
Buring - Single Family Perlr,04:O1 -103778.- 00 - SF
g Y
I
33628 27TH PL SW
Inspection request line: 253.835.3050
Parcel Number: 255700 0060 J
Project Description: RE -ROOF - Remove existing shake roofing and resheet with OSB and isntall compostion roofing for
existing residence, subject to field inspection.
Owner
Applicant
Contractor
Lender
Carl R & Teena R Nelson
WALSH & SONS
WALSH & SONS
NONE
33628 27TH PL SW
30614 324TH AVE SE
WASLSHS*991NA 8/1!02
FEDERAL WAY WA
BLACK DIAMOND WA 98010
30614 324TH AVE SE
98023-7711
BLACK DIAMOND WA 98010
NONE
Includes:
Census category: 555 - Non-st #1 #2 #3 #4
Occupancy Group: R-3
Construction Type: Type V - N
Occupancy Load:
Floor Area (Sq. Ft.):
Census Category ................................................. 555 - Non-structural roofing p Mechanical................................................. No
Occupancy Group#1...........................................R-3 Plumbing ................................................. No
Zoning Designation ............................................. RS 7.2
PERMIT EXPIRES March 25, 2002, IF NO WORK IS STARTED.
Permit issued on September 26, 2001
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 W
Owner or agent Date:
11
AM
ov
cr;a Z CONSTRUOON PERMIT APPLICATION
VV FiY � PPLtATION NUMBER:
APPLICATION NUMBER: - -
PLTCATiO(y=NUMBER:
AL WAY
**TTIi�1®NI"uired information —Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
ROPERTY INFORMATION
SITE ADDRESS: -3 3 tom? j5 n2 2px .�,(� ASSESSOR'S TAX/PARCEL #: y i J9 U 6 Q
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION_ -
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): PROJECT --
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
PEOPLE INFORMATION ;'..' 77777
,
NAME: DAYTIME PHONE:
, /
MAILING ADDRESS (STREET ADDRESS; CITY, STATE,, ZIP): y
1 J 4"Z P a2 �y c s , /.2
NAME:
DAYTIME PHONE:
wz) w
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
2
( ) -�
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
— —)
— — — — — — — —
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(cVy ofcard mTWreco A b .5 ff 5 2 9 L A( A
141
DAYTIME PHONE:
MAILING ADDRESS (STREET ; CITY, STATE, ZIP): EVENING PHONE:
3-041-1
• u� o i ) -
RELATIONSHIP TO PROJECT:�'f v, NUM
11❑
ARCHITECT TENANT 11 OTHER(
DESCRIBE)• • �(�/ d� -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
EXISTING USE:
PROPOSED USE:
Z, -DETAILED BUILDING INFORMATION', -
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED VALUATION FOR IMPROVEMENTS:�iGy, &.0v—
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 11 LAKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PROJECT FLOOR AREAS -
FLOOR
EXISTING SQ. FT.
PROPOSED . FT.
TOTAL
BASEMENT
!ONINGDESIGNATIPI:_>-.: - -= ` .`= -° =r = BUI[ QIN SHEDNCX?❑YES== =:. ❑ NO
C.,,OMPI�IE�SIGN
=TU3AllVSHIP
_ _ ❑'SfES_`�❑:440`-;.�,� -
FIRST
{_ - - -.. ,---
= = _'NEW IDDRESS tEQ(/IREO? ; , -_ ; .❑ YES _.NQ -A '-
7? - ,;,❑ YDS `. ❑ ,NO
CtiANGEF 11SE? µ - ❑ :YES ❑ iV0 :_
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC.
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
71TSCI_ATMFR/SiCNATURE BLC
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
MISC. (
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 o4 of the reliance of the city, including Its officers and employees, upon the accuracy
of the information sgpglied to the city as a part of thiWppljcation.
DATE: C/_!2 12 Z
❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
>"R"QFFICE=USE'ONLY:r;
20 11ODITION' 1 - '; 'N � REPAiR fNANI MPROVEMENT `Y_.'°=:=:
=NEV��_- _ ❑AtARATIO_
_CENSUS_CODE:=s=== r°_<:=:-:: :-
-. __ _ -LOT EZ
!ONINGDESIGNATIPI:_>-.: - -= ` .`= -° =r = BUI[ QIN SHEDNCX?❑YES== =:. ❑ NO
C.,,OMPI�IE�SIGN
=TU3AllVSHIP
_ _ ❑'SfES_`�❑:440`-;.�,� -
ECTION-:_t_,;°:; RANGE
{_ - - -.. ,---
= = _'NEW IDDRESS tEQ(/IREO? ; , -_ ; .❑ YES _.NQ -A '-
7? - ,;,❑ YDS `. ❑ ,NO
CtiANGEF 11SE? µ - ❑ :YES ❑ iV0 :_
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.253-661-4000 • FAX: 253-661-4129