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12-10268216 i' t W 46ilding - Single Family City of Federal Way Permit #: 12 -102682 -00 -SF Community &Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 t Line: 25 Request ues Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection q 3) 835-3050 Project Name: ROSHOLM Project Address: 29641 23RD AVE SW Parcel Number: 012103 9088 Project Description: ADD - Construct 220 square foot dormer, 89 square foot stairwell and 84 square foot deck to existing detached garage and carport. Plumbing included Owner Ag licant Contracto Lender JOHN ROSHOLM TERRY JENSEN CONSTRUCTION TERRY JENSEN CONSTRUCTION OWNER IS LENDER ANTHONETTE M ROSHOLM CORP CORP 2964123RD AVE SW PO BOX 1326 TERRYJC0160Z (5/28/13) FEDERAL WAY WA 98023-2343 ISSAQUAH WA 98027-0053 PO BOX 1326 ISSAQUAH WA 98027-0053 Census Category: 433 - Residential altladd - increase in number of units Includes: #1 #2 #3 #4 Occupancy Class: U Construction Type: Occupancy Load Floor Areas . ft. 0 0 1 0 0 Additional Pennit Information New / Additional Sq. Feet -1 st Floor .................... 0 New / Additional Sq. Feet - 3rd Floor....................0 BasicPlan?........................................................... No New / Additional Sq. Feet - Garage.......................0 Occupancy # 1 - Class.............................................0 Plumbing to be Included? ....................................... es Zoning Designation...............................................RS 15.0 New / Additional Sq. Feet - 2nd Floor...................220 New / Additional Sq. Feet - Basement...................0 New / Additional Sq. Feet - Deck .......................... 84 Mechanical to be Included?....................................Yes New / Additional Sq. Feet - Other .......................... 89 New / Additional Sq. Feet - Total .......................... 393 Plumbing Fixtures Lavatories ....................................... 1 Showers............................. 1 Water Closets................................. 1 CONDITIONS: Plans reviewed as not living spacdplans reviewed`�``Q��\T��►)ot a bedroom '' A 1 1 PERMIT EXPIRES Monday, January 7, 2013 Permit Issued on Wednesday, July 11, 2012 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 agent: 4 4 Date: ` %Z-- THIS CARD IS TO MAINON-SITE ` �� # Construction In ectlon Record Federal Way INSPECTION REQ TS: (253) 835x3050 PERMIT #: 12 -102682 -00 -SF Address: 29641 23RD AVE SW Project: JOHN ROSHOLM FEDERAL WAY, WA 98023-2343 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. SWM Precon Site Mtg (4400) Initial Erosion Control (4365) E] Footings Setback (4110) Approved By To be done prior to breaking ground Approved to place concrete By Date By Date By Date Foundation Wall (4115) Drainage/Downspout (4040) E] Plumbing Groundwork (4190) Approved to place concrete By Approved to backfill Approved to cover By Date By Date By Date 0 11 Slab/Concrete Floor (4255) Underfloor Framing (4285) Floor Sheathing (4105) Approved to place concrete Approved to sheath floor Approved to install flooring By Date By Date By Date Shear Walls (4245) Roof Sheathing (4220) 0 Rough Plumbing (4230) Approved to install siding Approved to install roofing Approved By Date By Date By Date ❑ Gas Piping (4125) Mechanical Rough -in (4165) ❑ Fire/Draft Stops (4095) Approved Approved to release test Approved By Date By Date By Date or to scheduling a Framing inspecti]nd Interim Erosion Control (4370) Framing (4120) Approved eccal, Plumbing & Mechanical Rough [Fire/Diraft Approved to insulate Date Stop inspections must be signedBy Date approved. IBC 1093.4BY Gypsum Wallboard Nailing (4130) Insulation (4150) Final Erosion Control (4375) Approved to install wallboard Approved to install mud & tape Approved By Date By Date By Date 0 Final - Mechanical (4065) Final - Plumbing (4075) Final - Building (4050) Approved Approved Approved By Date By Date By Date 1 _ 21.1 2j, Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date VA� � c,roF Federal waRECEIVE �'ERMIT COMMUNITY DEVELOPMENT SERVICES p p L I C A T I O N 253-835-2607• FAX 253-835-2609 IINILL'. (]LVOIIP.dP, i'�Ifl.'Rtj. CONI JUN 13 2012 tz---1aZ�L Sz 2— <S &F CO ME PL DE EN FP /(2- �Oj SITE ADDRESS CDS .2 6a I a Ave. SUITE/UNIT # PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL # S tb(50 ^l/ © ( � -L - _a 0- TYPE OF PERMIT !R BUILDING ".PLUMBINGEANIAL 7"11FIR:1PRECENTION ❑ DEMOLITION ❑ ENGINEERING NAME OF PROJECT (Tenant Name/Homeowner Last Name) pS ©L r''` PROJECT DESCRIPTION d� Detailed description of work to v L v be included on this permit only PROPERTY OWNER NAME /"T A., PRIMARY PHONE 97 I.5 155 MAILING ADDRESS SwtP4Se#j E-MAIL co P CITYoZ czcfL, m,4 r—� STATE w ZIP g61 NAME - 4--f Cd K c7i<--.2SSS7So PHONE O MAILING ADDRESS (�© /�Q IY1C J9 12.7 E-MAIL CONTRACTOR Su 2 r 'K ZIE,` o+. 4� 7EXPIRATION FAX W STATE CONTRACTOR'S LICENSE # VRRYj: otGa� DATE S ? .9013 FEDERAL WAY BUSINESS LICENSE # NAME kt- NS -a+r PHONE APPLICANT MAILING ADDRESS ItMAIL CITY STATE ZIP FAX PROJECT CONTACT (The individual to receive and NAME t l2 t; •T tCNS�i� PHONE MAILING ADDRESS E-MAIL respond to all correspondence concerning this application) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E -MAD, PROJECT FINANCING Required value of $5,000 or more NAME N a iv�. � OWNER -FINANCED ///�--'�� 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 authorised 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 apart of this application. SIGNATURE: DATE .J4 tit. 13 — ! 2 A f PRINT NAME: Bulletin #100 — January 1, 2011 Pagel of 3 k:\Handouts\Permit Application 4 VALUE OF MECRAWCAL WORK $ k/co bid or estimate must be provided) Indicate how many of each type off Inst tfjteldied as part of this project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREP I SERTS HOODS (Commercial) BOILERS F ACES HOT WATER TANKS p-) i COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES Indicate how many of each type ofAr ure to be installed or relocated as part of this project. Do not include existing factures to remain. BATHTUBS (-Tub/shower Combo) LAVS (H.dsinka) 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 Is&. Bulletin #100— January], 2011 Page 2 of 3 k:\Handouts\Permit Application FILE Apt! 0 rl In- '2. 23' cp TOP OF SEIB*41'45-E 5' 6. 2' FF cr GARAGE UTILITY T3 rr! L M J POLE I CA co 5 -7 OECK 40 x O�E STORY FRAME GRAVEL 1, Ape x fyi, DRIVEWAY nN AND PARKING L )q� fJERGRM 23 6' TER POWE� FENO:F- :�E RR T E RE7 wALL =24 ca 186. o RECEIVED A 13 202 CITY OF FEDERAL WAY CDS