02-103874City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
IMF
Building - Single Family Permit #:02 -103874 - 00 - SF
Inspection request line: 253.835.3450
Project Name: MORENO
Project Address: 28813 20TH P t Parcel Number: 422280 0100
Project Description: RES ADD - Construction of new 612sgft addition, including mechanical. No plumbing.
Owner
Applicant
Contractor
Lender
Belinda A & Lionel Moreno
Belinda A & Lionel Moreno
Belinda A & Lionel Moreno
US BANK '
28813 20TH PL S
28813 20TH PL S
2317 PACIFIC AVE
FEDERAL WAY WA
FEDERAL WAY WA
28813 20TH PL S
TACOMA WA 98401
98003-3834
98003-3834
FEDERAL WAY WA
Includes:
Census category: 434 - Reside #1 #2 #3 #4
Occupancy Group: R-3
Construction Type: Type V - N
Occupancy Load:
Floor Area (Sq. Ft.):
1 st Floor Proposed Sq. Feet ................................. 612 Census Category ................................................. 434 - Residential alt/add - no
Mechanical ................................................. Yes Occupancy Group#1........................................... R-3
Plumbing ................................................. No Total Building Sq. Feet ........................................ 1790
Total Proposed Sq. Feet.......................................612 Zoning Designation ............................................. RS 7.2
Plumbing Fixtures
Gas Pipe Outlets 1
Mechanical Fixtures
-e --0.e60ri' tion Quanti - Desai tion ` :. Quenu Description,?N
Ducts 1
CONDITIONS:
1. No building shall encroach onto any building setback line or easement shown or not shown.
2. Building setbacks are: 20 feet front; 5 feet side; 5 feet rear.
3. This decision shall not waive compliance with future City of Federal Way codes, policies, or standards relating
to the subject proposal.
PERMIT EXPIRES March 9, 2003, IF NO WORK IS STARTED.
Permit issued on September 10, 2002
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.
Owner or age b Date: !®
P THIS CARD ON THE FRONT OF BUING
Blf DING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE #: 253-835-3050
PERMIT #: 02 -103874 -00 -SF
OWNER'S NAME: Belinda A & Lionel Moreno
SITE ADDRESS: 28813 20TH S
FOOTINGS/SETBACKS %t�O FOUNDATION WALL -7, (P
9-
A
DRAINAGE: Line _()Connection
( ) UNDERFLOOR
ROUGH PLUMBING: DWV -Water
O ROUGH MECHANICAL
SHEATHING
SHEAR WALLS
O ELECTRICAL ROUGH -IN
( ) FIREA)RAFTSTOPS
7zl- 4c,
Is Y Gas piping
;�10,Roof ld.1111,07-A IKloor mlig—az
TW5
RIKT711- - - - - - - qjg�7-
( ) FRAMINGTIRESTOPPING.
Ditch Cover
( ) INSULATION: Floors
1-005, , —VI., m- a —Sm
Towo
WALLBOARD NAILING
SUSPENDED CEILING
AVJE J
............
O
ELECTRICAL FINAL
/--
( ) PLANNING
( ) PUBLIC WORKS
() FIRE
( ) BUILDING FINAL
Y THIN BUILD.
&I"' bN' Titl-bihiBNd-
r, 751
CON 'TION PERMIT APPLICATION
PLICATION NUMBER: -
���f��® PLICATION NUMBER:
n( PPLICATION NUM6ER:.
AIINi'ng is required information — Please print (in ink) or type**
Please note:
,
?ElectricahtfSEftj _b n Systems and Engineering permits may require a separate application.
._., nc
SITEADDRESS: So ASSESSORS TAX/PARCEL #: `i
LEGAL DPTIO O
F SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): L -I V -e
,z-
PR03ECT INFORMATION
TYPE OF PROJECT (This application): 19 BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): �.� 1 f 1 el 12� k �, h I Ru - �Of•; v1
L
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
CONTACT PERSON I
0 PEOPLE INFORMATION
NAME: DAYTIME PHONE:
(
MAILING ADDRESS (STREET AD u, r, STATE, ur).
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP):
EVENING PHONE:
CTTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUM
— — — — — — — —
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
1 /
EXISTING USE: ��< E� v. , EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: 0,Cr- Aa PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? ❑ YES �NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: KEHAVEN 11HIGHLINE 11TACOMA 11PRIVATE (WELL)
SEWER SERVICE PROVIDER: 70(
AKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL•CONSTRUCTIOLY**
or of *
NUMBER OF BEDROOMS: -ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT. •
TOTAL
BASEMENT _
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FIRST
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SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNITS)
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 INSERTS) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAINWATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINK(S) WATER CLOSET(S) MIST. )
SUMP(S)
■ "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 (Sty 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 supplie0o the city as a part of this application.
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
DATE: �I1
QOMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.2S3-661-4000 • FAX: 253-661-4129
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QOMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.2S3-661-4000 • FAX: 253-661-4129
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