14-100567. City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: SHERLES
Project Address: 29830 23RD AVE SW
w
#uilding'- Single' yaniify
Permit #: 14-100567-00-S
Inspection Request Line: (253) 835-3050
Parcel Number: 012103 9152
Project Description: NEW - Construct 5,894 square foot 2 -story single family residence with a 68 square foot
covered entry, 96 square foot deck and 889 square foot attached garage. Includes plumbing
& mechanical.
***4 Bedrooms; $800,000 estimated selling price.***
Owner
Applicant
Contractor
Lender
GREG SHERLES
DANIEL CARASELLA
PEDERSONS CLASSIC HOMES
New / Additional Sq. Feet - Garage .......................889
2515 S•283RD PL
PO BOX 547
INC
New / Additional Sq. Feet - Other ..........................
FEDERAL WAY WA 98003
SUMNER WA 98390
PEDERCH973D4 (8/31/15)
Residence (1 or 2
family)
27148 12TH AVE S
DES MOINES WA 98198
Census Category: 101 - New Single Family House
Includes:
41 #2 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load
New / Additional Sq. Feet - Garage .......................889
Floor Areas . ft.
5,894 0 0 0
Additional Permit Information
New / Additional Sq. Feet - 1 st Floor .................... 3032
New / Additional Sq. Feet - 3rd Floor....................0
Occupancy # 1 - Area (Sq. Feet).............................5894
New / Additional Sq. Feet - Basement...................0
BasicPlan?...........................................................
Occupancy #I - Construction Type ........................Type
V - B
New / Additional Sq. Feet - Garage .......................889
Mechanical to be Included?....................................Yes
Plumbing Work Valuation?....................................10000
Occupancy #1 -Class .............................................R-3
New / Additional Sq. Feet - Other ..........................
68
New / Additional Sq. Feet - Total ..........................
6947
Zoning Designation................................................RS 15.0
Ducting..........................................
Furnaces .........................................
Hot Water Tanks ............................
Bathtubs........................................
Lavatories .....................................
Water Closets ................................
New / Additional Sq. Feet - 2nd Floor...................2862
Occupancy # 1 - Area (Sq. Feet).............................5894
BasicPlan?...........................................................
No
New / Additional Sq. Feet - Deck ..........................
96
Mechanical to be Included?....................................Yes
Occupancy #1 -Class .............................................R-3
Plumbing to be Included?.......................................Yes
Occupancy # 1 - Use ...............................................
Residence (1 or 2
family)
Mechanicali re "*
i9
1 Fans.... .................... 8 Fireplace Inserts............................. 2
1 C ................................... 1 Gas Pipe Outlets............................. 6
1
Plumbing Fixtures
3 Dishwashers ................................... 1 Laundry Washer Outlets................ 2
9 Showers .......................................... 1 Sinks............................................... 3
6 Hose Bibbs..................................... 2
CONDITIONS:
1. An approved automatic fire sprinkler system is required. No framing inspection until the sprinkler system
is. installed and approved.
2. Replacement tree plantings (15 tree units) as shown on the approved site plan shall be installed prior to
issuance of certificate of occupancy. Please contact Associate Planner, Becky Chapin, at 253-835-2641 or
' becky.chapinncityoffederalway m to schedule an inspection. '
3.'Prior to Building Permit sign, a street light shall be hung on one of Oxisting utility poles at the '
intersection of SW 304th St and 23rd Ave SW.
PERMIT EXPIRES Tuesday, October 28, 2014
Permit Issued on Thursday, May 1, 2014
I hereby certify that the above i
the occupancy and the use wi
Owner or agent:
is correct and that the construction on the above described property and
Ogme with the laws, rules and regulations of the State of Washington
,and the City of Federal Way.
Date.
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: SHERLES
Address: 29830 23RD AVE SW
Permit #: 14 -100567 -00 -SF
Includes:
#1 92 #3 44
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load
Floor Area (sq. ft.)
5,894 0 0 0
Owner Name: GREG SHERLES
GREG SHERLES
Owner Name:
Owner Address: 2515 S 283RD PL
FEDERAL WAY WA 98003
Building Official
Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner / occupant or to any otherperson that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which itis situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
r ' •City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: SHERLES
Project Address: 29830 23RD AVE SW
Guilding = Single ]Koxiij
c
Permit #: 14 -100567 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 012103 9152
Project Description: NEW - Construct 5,894 square foot 2 -story single family residence with a 68 square foot
covered entry, 96 square foot deck and 889 square foot attached garage. Includes plumbing
& mechanical.
***4 Bedrooms; $800,000 estimated selling price.***
Owner
Applicant
Contractor
Lender
GREG SHERLES
DANIEL CARASELLA
PEDERSONS CLASSIC HOMES
V - B
2515 S 283RD PL
PO BOX 547
INC
FEDERAL WAY WA 98003
SUMNER WA 98390
PEDERCH973D4 (8/31/15)
6947
family)
27148 12TH AVE S
DES MOINES WA 98198
Census Category: 101 - New Single Family House
Includes:
#1 #2 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load
V - B
Floor Areas . ft.
5,894 0 0 0
Additional Permit Information
New / Additional Sq. Feet - 1 st Floor ....................
3032
New / Additional Sq. Feet - 3rd Floor....................0
New / Additional Sq. Feet - Basement...................0
No
Occupancy 41 - Construction Type ........................Type
V - B
New / Additional Sq. Feet - Garage .......................889
Plumbing Work Valuation?....................................10000
New / Additional Sq. Feet - Other ..........................
68
New / Additional Sq. Feet - Total ..........................
6947
Zoning Designation................................................RS 15.0
Ducting........................................... 1
Furnaces ......................................... 1
Hot Water Tanks ............................ 1
New / Additional Sq. Feet - 2nd Floor...................2862
Occupancy # I - Area (Sq. Feet).............................5894
Basic Plan?...........................................................
No
New / Additional Sq. Feet - Deck ..........................
96
Mechanical to be Included?....................................Yes
Occupancy #1 - Class .............................................R-3
Plumbing to be Included?.......................................Yes
Occupancy # 1 - Use ...............................................
Residence (1 or 2
family)
Mechanical Fixtures.,; .
Fans ................................................ 7 Fireplace Inserts............................. 2
Gas Piping ...................................... 1 Gas Pipe Outlets............................. 4
Plumbing Fixtures
Bathtubs ......................................... 3 Dishwashers................................... 1 Laundry Washer Outlets................ 2
Lavatories....................................... 9 Showers.......................................... 1 Sinks............................................... 3
Water Closets ................................. 6 Hose Bibbs..................................... 2
CONDITIONS:
1. An approved automatic fire sprinkler system is required. No framing inspection until the sprinkler system
is installed and approved.
2. Replacement tree plantings (15 tree units) as shown on the approved site plan shall be installed prior to
issuance of certificate of occupancy. Please contact Associate Planner, Becky Chapin, at 253-835-2641 or
'beeky.chapin.*cityoffederalway ^ m to schedule an inspection. ,
3.'Prior to Building Permit sign, a street light sklill be %ung on one of Oxisting utility poles at the
intersection of SW 304th St and 23rd Ave SW.
PERMIT EXPIRES Tuesday, October 28, 2014
Permit Issued on Thursday, May 1, 2014
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. c�
Owner or agent:% - Date:
r
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: SHERLES
Address: 29830 23RD AVE SW
Permit #: 14 -100567 -00 -SF
Includes:
#1 #2 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load:
Floor Area (sq. ft.) 1
5,894 0 0 0
Owner Name: GREG SHERLES
GREG SHERLES
Owner Name:
Owner Address: 2515 S 283RD PL
FEDERAL WAY WA 98003
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner / occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which itis situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
.
&i1ding' - St»gle' Faini ijy.
City orFederal Way
Community & Econ. Dev. ServicesPermit #: 14-100567-00-SF
33325 8th Ave S,
"ILE
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: SHERLES
Project Address: 29830 23RD AVE SW Parcel Number: 012103 9152
Project Description: NEW - Construct 5,894 square foot 2-story single family residence with a 68 square foot
covered entry, 96 square foot deck and 889 square foot attached garage. Includes plumbing
& mechanical.
***4 Bedrooms; $800,000 estimated selling price.***
Census Category: 101 - New Single Family House
Includes:
Owner
Applicant
Contractor
Lender
Type V - B
GREG SHERLES
DANIEL CARASELLA
DI CARA CONSTRUCTION
5,894 0 0 0
Occupancy # 1 - Class.............................................R-3
2515 S 283RD PL
PO BOX 547
DICARCC8906R (9/19/15)
Occupancy # 1 -Use ...............................................
Residence (1 or 2
FEDERAL WAY WA 98003
SUMNER WA 98390
PO BOX 547
SUMNER WA 98390
Census Category: 101 - New Single Family House
Includes:
#1 #2 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load
96
Floor Areas . ft.
5,894 0 0 0
Additional Permit Information
New / Additional Sq. Feet - 1 st Floor .................... 3032
New / Additional Sq. Feet - 3rd Floor....................0
New / Additional Sq. Feet - Basement...................0
Occupancy # 1 - Construction Type .......................Type V - B
New / Additional Sq. Feet - Garage .......................889
Plumbing Work Valuation?....................................10000
New / Additional Sq. Feet - Other .......................... 68
New / Additional Sq. Feet - Total .......................... 6947
Zoning Designation................................................RS 15.0
Ducting...........................................
Furnaces .........................................
Hot Water Tanks ............................
Bathtubs.........................................
Lavatories .......................................
Water Closets .................................
1
1
1
3
9
6
New / Additional Sq. Feet - 2nd Floor...................2862
Occupancy # 1 - Area (Sq. Feet).............................5894
BasicPlan?...........................................................
No
New / Additional Sq. Feet - Deck ..........................
96
Mechanical to be Included?....................................Yes
Occupancy # 1 - Class.............................................R-3
Plumbing to be Included?.......................................Yes
Occupancy # 1 -Use ...............................................
Residence (1 or 2
family)
Mechanical Fixtures
Fans ................................................ 7 Fireplace Inserts............................. 2
Gas Piping ...................................... 1 Gas Pipe Outlets............................. 4
Plumbing Fixtures
Dishwashers ................................... 1 Laundry Washer Outlets................ 2
Showers.......................................... 1 Sinks............................................... 3
Hose Bibbs..................................... 2
CONDITIONS:
1. An approved automatic fire sprinkler system is required. No framing inspection until the sprinkler system
is installed and approved.
2. Replacement tree plantings (15 tree units) as shown on the approved site plan shall be installed prior to
issuance of certificate of occupancy. Please contact Associate Planner, Becky Chapin, at 253-835-2641 or
becky.chapin@cityoffederalway.com to schedule an inspection.
3. Prior to Building -Permit sign, a street light shall'be hung on one of >existing utility poles at
n&-r�
isection of SW 304th St an d Ave SW.
PERMIT EXPIRES Tuesday, October 28, 2014
Permit Issued on Thursday, May 1, 2014
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 b in accordance with the laws, rules and regulations of the State of Washington
and the City of, ederal Way.
Owner or agent:Date:
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: SHERLES
Address: 29830 23RD AVE SW
Permit #: 14 -100567 -00 -SF
Includes:
41 42 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load:
Floor Area (sq. ft.)
5,894 0 0 0
Owner Name: GREG SHERLES
GREG SHERLES
Owner Name:
Owner Address: 2515 S 283RD PL
FEDERAL WAY WA 98003
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most seventy affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner / occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which itis situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
• HIS CARD IS TO EMAIN ON-SITE
Construction I ection Record
Federal Way INSPECTION REQU TS: (253) 835-3050
PERMIT #: 14 -100567 -00 -SF Address: 29830 23RD AVE SW
Project: GREG SHERLES FEDERAL WAY, WA
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)
❑ Footings/Setback (4110)
Approved
To be done prior to breaking ground
Approved to place concrete
By Date
By Date
By Date _ '1
❑
Foundation Wall (4115)
eduling a Framing inspection;
Prior:Stop
❑
Drainage/Downspout (4040)
Approved
Electricabing & Mechanical Rough -in and
Plumbing Groundwork (4190)
Approved to insulate
Approved to place concrete
Date
Fire/Drafinspections must be signed -off andBy
pproved. IBC 109.3.4
Approved to backfill
Date
Date
Approved to cover
By
t
Date
By
Date
By
Date
'E]
Final Erosion Control (4375)
E:]
Approved to install mud & tape
E]
By
f
Slab/Concrete Floor (4255)
Underfloor Framing (4285)
Floor Sheathing (4105)
1:1Final
Approved to place concrete
Approved to sheath floor
- Plumbing (4075)
❑
E]
Approved to install flooring
By
Date
Approved
By C� ;, _ }- Date
Approved
By
Date (' 3a .
By Date
By
DateS—
Shear Walls (4245)
Approved to install siding
p 44E-ri AL_
By Date
Mechanical Rough -in (4165)
Approveq Sit- C;V"T(,,`r
By Date
Roof Sheathing (4220)
Approved to install roofing
By* A/ Date
zllfe
zl__�L
Gas Piping (4125)
p Approved to release test
By 1 K .L. Date I , ';^ .. ls'
Rough Plumbing (4230)
Approved
By A -t— Date ( ► . l
E] Fire/Draft Stops (4095)
Approved
Byt Ai Date U _ }. 1 j'�
❑
Interim Erosion Control (4370)
eduling a Framing inspection;
Prior:Stop
❑
Framing (4120)
Approved
Electricabing & Mechanical Rough -in and
By
Approved to insulate
Date
Fire/Drafinspections must be signed -off andBy
pproved. IBC 109.3.4
By
Date
Date
Insulation (4150)
'
Gypsum Wallboard Nailing (4130)
'E]
Final Erosion Control (4375)
Approved to tall wallboard
Approved to install mud & tape
Approved
By
f
By Date 9 _2_ _
By
Date
1:1Final
Final - Mechanical (4065)
- Plumbing (4075)
❑
E]
Final - Building (4050)
Approved
Approved
Approved
By
Date
By Date
By
DateS—
Rough Electrical
Approved
QFinal
Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
WE
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Is
Stoney Point ngineering I
April 17, 2015
Mr. Ted Pederson
Subject: Stair and Holdown Issues
Sherles Residence,
Parcel #0121039152
Federal Way, WA
Mr. Pederson,
In accordance with you request I have reviewed both the existing stair framing vs. the provided
typical stair detail and the existing holdown issues in the Garage/Den shearwall.
In evaluating the existing stair framing and the typical detail provided by Mascord, several
pictures supplied by the contractor were reviewed. It was concluded from these pictures that the
existing stair framing is an acceptable alternative to the detail provided.
The misplaced holdowns in the Garage/Den and Laundry/Bedroom #2 were reviewed for
capacity as placed. With the plywood on Laundry/Bedroom #2 shearwall placed on the opposite
face of the wall as indicated on the plans, the shearwall should be made continuous to the
exterior corner of the Bedroom. The remaining portion of this wall may be edge nailed w/ a
minimum of 8d at 6" o.c. The existing holdowns and their locations in this wall are acceptable
placed. The lower floor shearwall at the Gargage/Den is acceptable as nailed. The location of the
holdown near the Garage man door into the residence is also acceptable as placed, however, the
holdown will need to be secured to a minimum of 4.5" of DF material. This may be
accomplished by face nailing a 2x4 to the existing 4x6 w/ (2) 16d nails at 6" o.c. In addition to
face nailing the 2x, the wall sheathing should be nailed to the 2x w/ 8d at 3" o.c. All of the other
holdowns and posts in this wall are acceptable as placed.
If you have any further concerns or questions about the above please don't hesitate to call me
personally at (425) 644-9500.
Sincerely,
CAR( B
Dwayne C Barnes, PEWAS 9,L
President CaCOp • �' N �✓
Stoney Point Engineering
enclosures (2) 0 40779 Q�
orsTe�
CONAL �rG
12033 SE 40' Lane Bellevue, WA 98006 Phone: 425-644-9500
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GrV or „!!
Federal Way
RECEMM
--B (62014
CITY OF FEDERAL WAY
CDS
PERMIAAPPLICATION
' �nO
PERMIT NUMBER / �.� 0 d 5-b 7 - S F
TARGET DATE
SITE ADDRESS
o2' 4���(��f� Ste'
SUITE/UNIT A
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL M
p _) 3 '{
c
les /J , o
� � S� � 3- -
TYPE OF PERMIT
�Z BUILDINGPLUMBING MECHANICAL 1:1 DEMOLITION 1-1ENGINEERING 11 FIRE PREVENTION
NAME OF PROJECT
5 V1 6 ' �' _S I r'l C
PROJECT DESCRIPTION
Detailed description of work to
+
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
G , r
J'53 ._ A,',t, I— 2 7
MAILING AD15RESS _ j
'Z'9 l S �C pL
E-MAIL
t- �r n W I G
CITY
�-L.l-'p,� �•
STATE
LV• SJ'
ZIP
C�
4 1�100--_;
NAME
..t 1 \ S
PHONE
/� 7
oZ 5 7 7- ./-A ( _7 3 i
MAII.ING ADDRESS
P, O E q S
E -MAD.
j`s Go
CONTRACTOR
CITY
5 U w\ V1
STATE
ZIP
FAX
2 s-3- -?.�,G - It -7 06
WA STATE CONTRACTOR'S LICENSE N
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE f
NAME
PRIMARY PHONE
3 :3 3 r
MAILING ADbRESS
F-0 G
EMAIL
GwrM-5-1L c CO✓lt,\-S/r .I
APPLICANT
CITY
S -" .'x o
STATE
ZIP
C/
FAX
-'573 7cz h
NAME
PRIMARY PHONE
PROJECT CONTACT
r.)
5L 53 -,'1A /- 3'
MAILING ADDRESS
F? 0,
EMAIL
('C`�' Ca
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5, 000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 its officers and employees, upon the accuracy of the
7cijudIng
information supplied to the city as apart of this application.
SIGNATURE: DATE ( Q
PRINT NAME: l//�� �-a. r s i_l o�
Bulletin #100 - January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application
nit -
L+
..► -
GENERAL INFORMATION
T_
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
TOTAL
a ' 1a.,u C bk
$ 15, 0
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FI SUPPRESSION SYSTEM?
N (A;LI{
$ o W a .�
Indicate how many of each type of
fixture
to be installed or relocated as Cart of this project. Do not include exihingfixtures 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
L DUCTING
—�
GAS PIPING
WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
TOTAL
a ' 1a.,u C bk
$ 15, 0
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FI SUPPRESSION SYSTEM?
N (A;LI{
$ 15
Indicate how many o each type offucture
Yes ❑ No
to be installed or relocated as part o this project. Do not include existikq flxtures to remain.
` BATHTUBS (or Tnb/Sh—Combo)
__CL_
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
6 g'
DECK
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
�3
SINKS (Kitchen/utiity)
WATER HEATERS (Electric)
—sem
HOSE BIBBS
GARAGE ,pf CARPORT ❑
SUMPS
WASHING MACHINES
Lj_ TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
PROPOSED
TOTAL
a ' 1a.,u C bk
$ 15, 0
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FI SUPPRESSION SYSTEM?
N (A;LI{
806
'Yes X No
Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
JI
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BAS NT
FIRST FLOOR (or Mobile Home)
3 01 2,
O ?�
SECOND FLOOR
COVERED ENTRY
6 g'
DECK
a
GARAGE ,pf CARPORT ❑
OTHER (describe)
Area Totals
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exoeossc
*ANEW sows-OAMY**
ESTIMATED SELLING PRICE $�f0, 00 0
# OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet a Stories
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TEN ROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in SqupeVeet Type Stories
TOTAL BUILDING
TENANT AREA O
PROJECT AREA ONLY;T 7
Bulletin # 100 —January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application
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