12-100131• , wilding - SinglF Fa>tiily
City of Federal Way
Community & Econ. Dev. Services
Permit #: 12-100131 -00-SF
33325 8th Ave S
Federal Way, WA 98003
171LE
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253
) 835-3050
Project Name: CASEY
Project Address: 3112 SW 300TH PL Parcel Number: 416710 0330
Project Description: ADD - Construction of 40 square foot addition to single family residence.
Census Category: 434 - Residential alt/add - no change in number of units
Includes:
Owner
Applicant
Contractor
L nder
Type V - B
JOHN & KIM CASEY
JAY VOLZ
OWNER IS CONTRACTOR
40 1 0 1 0 1 0
New / Additional Sq. Feet - Other ..........................0
PO BOX 140
BERNIE BAKER ARCHITECT
Residence (1 or 2.
family)
KENT WA 98035
5571 WELFARE AVE NE
BAINBRIDGE ISLAND WA 98110
Census Category: 434 - Residential alt/add - no change in number of units
Includes:
#1 #2 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load:
0
Floor Areas . ft.
40 1 0 1 0 1 0
New/ Additional Sq. Feet - 1st Floor....................40
New / Additional Sq. Feet - 3rd Floor....................0
New / Additional Sq. Feet - Basement...................0
V - B
New / Additional Sq. Feet - Deck ..........................
0
Mechanical to be Included?....................................No
R-3
New / Additional Sq. Feet - Other ..........................0
New / Additional Sq. Feet -Notal ..........................
Residence (1 or 2.
New / Additional Sq. Feet - 2nd Floor...................0
Occupancy # I - Area (Sq. Feet) .........................:...40
Occupancy #I - Construction Type ........................Type.
V - B
New / Additional Sq. Feet - Garage .......................
0
Occupancy # I -Class .............................................
R-3
Plumbing to be Included?.......................................No
40 Occupancy #1 - Use ...............................................
Residence (1 or 2.
family)
Zoning Designation................................................RS 7.2
CONDITIONS:
Subject to field inspection with plans.
PERMIT EXPIRES Sunday, July 8, 2012
Permit Issued on Tuesday, January 10, 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: Date: l `\CAu_
THIS CARD IS TO REMAIN ON-SITE
ciry aF, '
Construction Infection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 12 -100131 -00 -SF Address: 3112 SW 300TH PL
Project: JOHN & KIM CASEY FEDERAL WAY, WA 98023-2328
Scheduled inspections may be failed if this card
possible (read left to right, top to bottom). Plea
is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
se schedule inspections as appropriate. Work must not be covered until it is approved. Check
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.
with your
SWM Precon Site Mtg (4400)
E] Initial Ejrosion Control (4365)
❑ Footings/Setback (4110)
Approved
To be done prior to breaking ground
Approved to place concrete
Approved
By
By Date
By Date
By -'. J jI, Date -2
Foundation Wall (4115)
Approved to place concrete
By -Z Date Z � lS - r�
Underfloor Framing (4285)
Approved to sheath floor
By Date
Drainage/Downspout (4040)
Approved to backfill
By Date
Floor Sheathing (4105)
Approved to install flooring
By `�� f Date 3 /Z
Slab/Concrete Floor (4255)
Approved to place concrete
By Date
Shear Walls (4245)
Approved to install siding
By ,'� f Date /Z
0 Roof Sheathing (4220)Fire/Draft
Rough Electrical
Approved
Stops (4095)
Interim Erosion Control (4370)
Approved to install roofing
Approved
By
Approved
By Date 3 /
By
Date �� ,.
By
Date
Date
Framing (4120)
Insulation (4150)
Prior to scheduling a Framing inspection;
Electrical, Plumbing & Mechanical Rough -in and
Approved to insulate
Approved to install wallboard
Fire/Draft Stop inspections must be signed -off and
By
Date
By
Date
approved. IBC 109.3.4
5,3_!
-11
E] Gypsum Wallboard Nailing (4130)
E]
Final Erosion Control (4375)
Final - Building (4050)
Approved to install mud & tape
Approved
Approved
By Date
By
Date
By
Date
EJ
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
NJ vo
4%
- -'
G
Federal Way
PERMIT ERMIT
COMMUNDEVELOPMENT SEA
2538352c607FAXra2l53a835-2609PPLICAT I
O N
wuw'jtuo(redew-u.com FVE
GZX OF
COS
121 - -Z 0 ( ) Ls /
SF VI CO ME PL DE EN FP
� l C -
SITE ADDRESS
SUITE/UNIT #
311(1- S' 300"�'�'
c , �F.��rzn,� W ^y
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
$ 4-1l to - 4-0
RS --T. 2
--�_ 1 Cm -;,- _ o -
O S 3 0
TYPE OF PERMIT
g BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
rCenant Name/Homeowner Last Name)
Ga s� `� Iz_r-
PROJECT DESCRIPTION
op
Detailed description of Mork to
0 0 Tc
be included on this permit only
PROPERTY OWNER
NAME
J 0KN \ YA IA CA S F_- V
PRIMARY PHONE
2►t53 - 6, S k " 9 G+
MAH.ING ADDRESS
VSTL1 1�_-e 214AST S -r
F_MAD.
�n.1K-caS���9C,Vco
1z_ITY
±ztyT
STATE
WA
ZRgiZ
NAME
PHONE
MAII.D�iG ADDRESS
E -MAH.
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PHONE
VOL
7�b(o- 7,-5 12f3
AIAELMqG ADDRESS
Yo1ZCJ C0rAC2'0- W -t
APPLICANT
%u u;isol
AX
PROJECT CONTACT
NAME` ,
PHONE
(The individual to receive and
Y b L_-1—
MAIIAVG ADDRESS
)k 60IF—
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE ZIP
FAX
ALTERNATE CONTACT NAME: PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
MAEL NG ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that 1 am the property owner or authorized agent of the property owner. I cert{fy 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,
construction or environmental laws.
or federal laws regulating
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 ty
apart of this application.
SIGNATURE:
DATE
/ � �
PRINT NAME: U v 'Y's `�
Bulletin #100 -January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
� • 5%-f_f_e
_ OKA. WATI`-'
LAy2f_"A`1V_A Lk(L.
$ 510( bob
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Tz c £- 1 F— ? _
sr-
❑ Yes)4 No
❑ Yes < No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
t 2 [
(�
11-44--
........................................................................................................................................................................................
FIRST FLOOR (or Mobile Home)
12 l0 1
c1 -p
\ S c `
SECOND FLOOR
10:3G
O
0Z �o
AREA DESCRIPTION
COVERED ENTRY
Occupancy Group(s)
Construction
Type
ZS
Additional Information
DECK
(old-
C
6 �2
............._... ...................... ....... ............ .... _.................................................................... ............................. ..._..
GARAGE ❑ CARPORT �(
/� /L
Q
TO'2
.......................................................................................................................................... _. _... ........ _.... _.
OTHER (describe)
PROJECT AREA ONLY
Area Totals
4-475
41 S
4+�o
............ .... ..... ........................ .... ................ ........... _.._... ....... _............... _............... _............... .....................................
"NEW HOMES ONLY""
ESTIMATED SELLING PRICE $
1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW Bunn G
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 -January 1, 2011 Page 2 of 3 k:\HandoutAPermit Application
•
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
Name
0
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-9.
OMB No. 1660-0008
Expires March 31, 2012
SECTION A - PROPERTY INFORMATION I For Inwrartce Cormm Use;
A2. 9ufldtftg StfeetAdtlrega (Ir@tdin(L, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.i Corn�mr NAIC Nr>m6er
.... _.
w►. tsullding Use (e.g., Residential, Nan -Residential, Addition, Accessory, etc.) M 1 MENTI R%. --
A5. Latilude/Longitude: Lat. V. 4 Z07 Long. _MZ _ 37443 Horizontal Datum: F] NAD 1927 X NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 7-
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) WoAlk _ sq fl a) Square footage of attached garage /JAQLJE-_ sq ft
b) No. of permanent flood openings in the crawlspam or b) No. of permanent flood openings in the attached garage
enclosures) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq In c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings? Yes No d) Engineered flood openings? [] Yes 0 No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP Community Name IL Community Number B2. County Name B3. State
L Z l IJ
B4. Mep/Panel Number
o�7�G/t7 G�
B5. SuffixB6.
FIRM Index
Date
87. FIRM Panel
Effective/RevisedDate _
B8. Flood
Zone(s)
89 Base Flood Elevations) (Zone
Abase flood depth)
01U. mkncake kne source or the case Rood tievauon (SFE) data or base flood depth entered in Item B9.
Fis Profile 'O FIRM Community Datemlined ❑ Other (Describe)
B11. Indicate elevation datum used for SFE In Item B9:ANGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
B12, is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes ANo
Designation Date [3 CBRS C] OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1
C2
Building elevations are based on: ❑ construction Drawings- ❑ Building Under Construction' �inishe
`A new Elevation Certificate will be required when construction of the building Is complete.
Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA. ARAE, AR/A1-A30, AR/AH, AR/AO.
below according to the building diagram specified in Item A7. Use the same datum as the BFE. _
Benchmark Utilized I1
Conversion/Comments
Construction
Complete items C2.a-h
rQ Check the nwasurernent used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) &.a!:> A -M feet 8 meters (Puerto Rico only)
b) Top of the next higher floor Sey
c) Bottom of the lowest horizontal structural member (V Zones only)
N/A
feet
feet
meters (Puerto Rico only)
❑ meters (Puerto Rico only)
d) Attached garage (top of slab)
_._0
feet
❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building
At*1 . ._Q
feet
❑ meters (Puerto Rico only)
(Describe type of equipment and location in Comments)
0 Lowest adjacent (flnished) grade next to building (LAG)
�r feet
❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade next to building (HAG)feet
h) Lowest adjacent grade at lowest elevation of deck or stairs, including ---- 1
meters (Puerto Rico only)
meters (Puerto Rico only)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification Is to be signed and seated by a land surveyor, engineer, or architect authorized by law to cert fy ele
information. f teddy that Nie information on dmis CePolicafe repmaents my best efforts to inhWat the data available.
I understand that any fain statement may be punishable by fine or imprisonment under 18 U.S. Code, Sectbn 1001
Check here if comments are provided on back of form
Name
Were latitude and longitude in Section Arovkted by a
licensed land surveyor? ayes No
Z53 - 43st
40016 v
T O
L LAN
FEMA Form 81-31, Mar 09 See reverse side for continuation. ReDlaces all
IMPORTANT: In titese spicas, copy the corresponding information from Section A. For Us wer.we Company U"
Building Street Addrbss (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Boat No. PONW Number
City State ZIP Code COMPSIrry NAIL Nuntbsr
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner.
Comments
Signature Date
❑ Check here If attachments
SECTION E BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete item E1 -ES. If the Certificate is intended to support a LOMA or LOMB -F request, complete Sections A, B.
and C. For items E1 -E4, use natural grade, if available. Check'Uue measurement used. In Puerto Riau only, enter ureters.
El. Provide elevation infomaetion for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top Of bottom floor (including basement, crawlspace, or enclosure) is (]feet ❑meters &above or below the HAG.
b) Top of bottom floor (including basement, crawlepace, or enclosure) Is Deet ❑meters bove or Hbelow the LAG.
E2. For Building Diagrams 8-9 with permanent flood opeNngs provided len SecllqIA Items 8 jn�lor 9 (see 8-9 of instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is . _ ❑ feet ❑ meters U above or U below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F • PROPERTY OWNER (OR OWNERS REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zane A (without a FEMA4s3ued or community -Issued SFE)
or Zone AO must sign here. The statements In Sections A, 8, end E are corroct to Me best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Gtid^� hexa if ori'- niRsri "
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A. B, C (or E),
and G of this Elevation Corticate. Complete the applicable Rem(s) and sign below. Check the measurement used in Items G8 and G9.
Gt. The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation Information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or community -issued BFE) or Zone AO.
G3, ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes,
G4. Permit Number G5. Date Permit Issued G8. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if sttachmentn
FEMA Form 81-31, Mar 09 Replaces all previous editions
Building Photographs
See Instructions for Item A6.
For Uwrance Cot y use.
Building Street Address (including Apt, Unit, Suite, and/or Bktg. No.) or P.O. Route and Box No. PWq KRZ
3 IM L.
C State ZIP Code comaar,► Ikn�der
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the
reverse.
:
�,r,77#a£,,a-rstw.x%.t'".+a..*x,m
+cr;
Building Photographs
Continuation Page
For Irowance Conww Ise:
Building Street Address (including Apt, Unit Suite, and/or Bldg. No.) or P.O. Route and Box No. Poky Nang
L
City State ZIP Code Nj"w
rury-AM, WA 100V3 1
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."
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