12-103109City of Federal Way Ouilding - Single Tantily
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Community & Econ. Dev. Services Permit #: 12 -103109 -00 -SF
era[
W 8th Ave S � t E
Federal Way, WA 98003 Ins ection Request Ph: (253) 835-2607 Fax: (253) 835-2609 °'� p q st Line: (253) 835-3050
Project Name: ANDERSEN
Project Address: 750 SW 301ST PL Parcel Number: 506880 0050
Project Description: REP - Replace drywall & insulation in basement from water and mold damage. Associated
electrical permit #12-102954-00 EL to change 0-200 AMP install sub -panel which includes
(8) circuits
Owner
A olu icant
Contractor
Lender
CHRISTOPHER ANDERSEN
CHRISTOPHER ANDERSEN
SUPERMEN UNLIMITED
CARO ANDERSEN
750 SW 301ST PL
SUPERU*952N2 (7/19/14)
750 SW 301ST PL
FEDERAL WAY WA 98023-3563
16221 119TH CT E
FEDERAL WAY WA
PUYALLUP WA 98374
98023
Census Category: 434 - Residential altladd - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Areas . ft. 0 1 0 1 0 0
Additional Permit Information
New / Additional Sq. Feet - 3rd Floor....................0
Mechanical to be Included?....................................No
New / Additional Sq. Feet - Basement...................0
Plumbing to be Included?......................................No
No Fixtures .Associated With This Permit It
PERMIT EXPIRES Tuesday, January 15, 2013
Permit Issued on Thursday, July 19, 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 bq in accordance with the laws, rules and regulations of the State of Washington
an the City of Federal Way.
Owner or agent: Date:
�L I 01?q11&
THIS CARD IS TO MAIN ON-SITE
CITY of Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 12 -103109 -00 -SF Address: 750 SW 301ST PL
Project: CHRISTOPHER ANDERSEN FEDERAL WAY, WA 98023-3563
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.
Underfloor Framing (4285)
❑
Floor Sheathing (4105)Shear
Final Electrical
Walls (4245)
Approved to sheath floor
By
Approved to install flooring
Electrical, Plumbing &Mechanical Rough -in and
Approved to install siding
By
Date
By
Date
By
Date
Roof Sheathing (4220)
Approved to install roofing
Fire/Draft Stops (4095)
Approved
Final Electrical
Prior to scheduling a Framing inspection;
Right of Way
Approved
By
Date
Electrical, Plumbing &Mechanical Rough -in and
By
Date
ByC S Date ��
FirelDraft Stop inspections must be signed -off and
approved. IBC 109.3.4
Date
Framing (4120)
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
Approved to insulate
Approved to install wallboard
Approved to install mud & tape
By �LS Date _ -4-By
�,
Date _ _ X2
By Date
0
Final - Building (4050)
Approved
By C,YIs�-��
Date
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
'A 9
Federalv�ECEIVED PERMIT
COMMUNIIYDEVELOPMENT SERVICES
APPLICATION
253-835-2607• FAX 253-835;2GQ9 O
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SITE ADDRESS CDS /
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3UITE/UNIT M
P OJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
$
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeoumer Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
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be included on this permit only
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PROPERTY OWNER
NAM
N A It o r
PRIMARY PHONE
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MAILI G ADDRESS
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ZIP
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NAME - rC �
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MAILING ADDRESS
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E-MAIL
CONTRACTOR
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ZIP
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FAX
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WA STA ONTRACTOR'S LICENSE M
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
NAME
PHONE
MAILING ADDRESS
E-MAIL
APPLICANT
CITY
7
STATE
ZIP
FAX
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
Required value oj$5,000 or more
NAME
(�
OWNER -FINANCED
MAILING ADDRESS, CITY, STATE, kIP
PHONE 72-2-7 O
(RCW 19.27.095)
I cert(& 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 cert(& 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 art oft 's appIica n.
i
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SIGNATURE: DATE —
PRINT NAME: it, I—t
Bulletin #100 —January 1, 2011 Page 1 of 3 k:Wandouts\Permit Application
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