12-10495211
b • wilding - Singlet Fa>fiily
City of Federal Way LL
Permit #: 12 -104952 -00 -SF
Community &Econ. Dev. Services .� �
33325 8th Ave S Federal Way, WA 98003Ins ection Re uest Line: 253 83Ph: (253) 835-2607 Fax: (253) 835-2609 p q ( ) 5-3050
Project Name: PARKLANE ADULT FAMILY HOME
Project Address: 34628 14TH PL SW Parcel Number: 666490 0480
Project Description: REM - Remodel interior to create additional resident bedroom and relocate existing entry
door. No plumbing or mechanical.
Census Category: 434 - Residential altladd - no change in number of units
Includes:
Owner
Applican
Contractor
Lender
Type V - B
JIMIvIIE N STONE
JEVB41E N STONE
OWNER IS CONTRACTOR
OWNER IS LENDER
3462814TH PL SW
3462814TH PL SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Census Category: 434 - Residential altladd - no change in number of units
Includes:
#1 #2 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load
Floor Areas . ft.
0 0 0 1 0
Additional Permit Information
New / Additional Sq. Feet - 3rd Floor....................0 New / Additional Sq. Feet - Basement .................. 0
Occupancy#1- Construction Type ........................Type V - B Mechanical to be Included? ................................... No
Occupancy #1- Class.............................................R-3 Plumbing to be Included? ...................................... No
Occupancy #1 - Use ............................................... Residence (1 or 2 Zoning Designation...............................................RS 7.2
family)
No fixtures Associated With This Permit 11
PERMIT EXPIRES Monday, April 29, 2013
Permit Issued on Wednesday, October 31, 2012
1 hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us will be in accordance 'th the laws, rules and regulations of the State of Washington
C' of Federal Way.
Owner or agent Date:..%�.—
�:)NArLL�.sD Z14I f Ib
CITY OF
Federal Way
PERMIT #:
12 -104952 -00 -SF
THIS CARD IS TO 7&125543)
ON-SITE
Construction In n Record
INSPECTION REQUE 835-3050
Address: 34628 14TH PL SW
Project: JIMMIE N STONE FEDERAL WAY, WA 98023-7038
Scheduled inspections may be failed if this card is not on-site. AO 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
By Date [By Datev/
SWM Precon Site Mtg (4400)
❑
Initial Erosion Control (4365)Underfloor
Walls (4245)
Framing (4285)
Approved to insulate
Approved
Approved to install wallboard
To be done prior to breaking ground
Approved to install siding
Approved to sheath floor
By
Date
By
Date
By
Date
By Date [By Datev/
Floor Sheathing (4105)Shear
Insulation (4150)
Walls (4245)
E] Roof Sheathing (4220)
Approved to insulate
Approved to install flooring
Approved to install wallboard
Approved to install mud & tape
Approved to install siding
Approved to install roofing
By
Date
By Date
By
Date
By Date
Final Erosion Control (4375)Final
I
- Building (4050)
fo
Approved
Fire/Draft Stops 409
p (
�
Interim Erosion Control 4370
( )
Prior to scheduling a Framing inspection;
Approved
Approved
Electrical, Plumbing & Mechanical Rough -in and
By
Date
By
Date
FirclDraft Stop inspections must be signed -off and
approved. IBC 109.3.4
By Date [By Datev/
Framing (4120)
Insulation (4150)
Gypsum Wallboard Nailing (4130)
Approved to insulate
Right of Way
Approved
Approved to install wallboard
Approved to install mud & tape
By
Date A d -VA—
By a
Date ,� , � Z
By Date
Date
Final Erosion Control (4375)Final
I
- Building (4050)
fo
Approved
Approved
By Date [By Datev/
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal
COMMUNITY DEVELOPMENT SERVII
253-835.2607• FAX 253-835-2609
mu.w rstuwi'�deraluau.com
s
APPLICATION
i
- --� 05'aZ'j
�F CO ME PL DE EN FP
Tr
ee� -
SITE ADDRESS
SUITE/UNIT If
/� Cos
P1, w
PROJECT VALUATION
000
ZONING
ASSESSOR'S TAR/PARCEL @
6� b 1 C-)
TYPE OF PERMIT
KBUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
® n Qi
�
PROJECT DESCRIPTION
Detailed description of work to
�(�` e ��r Ba a �� y
� d nn to w Of It ! A omni d ma ke iivtis.
area, n 4y Id Ledro,-s fl, & ckPi- 40 o r. >F
be included on this permit only
m t - a ► e- Mqr -qs
PROPERTY OWNER
NAME
4 " #n t'.e At. Stone
PRIMARY HONE
-9012—
8®1ZMAILING
MAILINGADDRESS
I Vg PL St.)
E-MAIL
-' Z 7�vPieJ -MS&C
CITY F �?i'r•► l �w
W STATE
ZIP U
NAME C)PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE 9
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE 0
NAME
PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
respond to all correspondence
o wne r,
MAILING ADDRESS
E -MAH.
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
(i OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
1 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 o this application.
-!r-
SIGNATURE: 61, DATE 0 �oIZ Y-12—
PRINT NAME: A( 9'-f-Vl4
PRINT
Bulletin #100 -January 1, 2011 Pagel of 3 k:\Handouts\Permit Application
5
-1,0
IWI
61
VALUE OFMECXANiCAL ORX $ a copy of or estimate must be provided) R r
Indicate how many of each type o re to be installed or relocated art of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER IREPLACE INSERTS HOODS (commercial)
BOILERS FU CES HOT WATER TANKS (Gas)
COMPRESSORS GAS LO REFRIGERATION SYST
DUCTING GAS PIPI WOODSTOVES
Indicate how many of each type of fixture to be installed or relocated as part o l t�ect. Do not include existing fixtures to remain.
BATHTUBS (or Tub/Shaver Combo) LAVS (Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAIN SINKS (xitchm/umRy) WATER HEATERS (electric)
HOSE BIBBS SUMPS WASHING MACHINES i
Bulletin #100— January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application