12-10145044 J
.• City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003�.�.�?
Ph: (253) 835-2607 Fax: (253) 835-2609 i
Project Name: WHEELER
Project Address: 2612 SW 323RD ST
(Wilding - Single Family
Permit #: 12 -101450 -00 -SF
Inspection Request Line: (253) 835,3050
Parcel Number: 873180 0440
Project Description: REP - Inspection of fire damage. **NO construction work approved under this permit**
Owner
ARRIIcan
Contractor
Lender
STEVEN WHEELER
EVERGREEN RESTORATION
2612 S 323RD ST
13716 CANYON RD E SUITE C
FEDERAL WAY WA 98023
PUYALLUP WA 98373
Census Category: 434 - Residential altladd - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load-
Floor
oadFloor Areas . ft. 0 0 0 0
Additional Permit Information
New / Additional Sq. Feet - 3rd Floor....................0 New / Additional Sq. Feet - Basement .................. 0
Mechanical to be Included?...................................No Plumbing to be Included? ...................................... No
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Saturday, September 29, 2012
Permit Issued on Monday, April 2, 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: �ZAA7-0 o.
J;(*4AWD 4/4/IZ
013TH Kj11T„ '
www. A oaI hkin# jiA e.,oA#
INCIDENT #: 12-03580 LOCATION: 2612 SW 323rd ST, Federal Way, WA 98023
DATE/TIME FIRE OCCURRED: 3/16/12 @ 2117 1ST UNIT ARRIVAL TIME: E63 @ 2122
OCCUPANT: Steven Wheeler HOME PHONE: 253-874-5624 WORK PHONE:
OWNER: Same HOME PHONE: WORK PHONE:
OWNER'S ADDRESS: same as location
OCCUPANT INSURANCE COMPANY: N/A
OWNER INSURANCE COMPANY: N/A
INJURIES:0 DEATHS:0
CASE #: N/A ❑ KING COUNTY ❑ FEDERAL WAY POLICE ❑ DES MOINES POLICE
INVESTIGATOR NOTIFICATION TIME: 2218 ARRIVAL TIME: 2330
INCIDENT COMMANDER: Chaney
OK TO RELEASE?: Yes ® No ❑
1. INVESTIGATOR'S CONCLUSION:
In view of the below stated facts and observations, it is the opinion of the undersigned that this fire is undetermined
however natural cause has not been ruled out as the cause of this fire..
2. DISPOSITION:
This case is open.
3. DESCRIPTION OF PREMISES:
This fire occurred in a two story single family residence of woodframe construction located in a subdivision.
4. WEATHER CONDITIONS:
The weather conditions at the time of this incident were rain and the temperature was approximately 43 degrees F
with a 10 mph south wind.
5. EXTERIOR EXAMINATION:
Exterior examination disclosed fire damage to the deck and exterior wall at the northwest corner of the back of the
house. The fire extended up to an upper level deck. The deck was approximately 24" above the ground. Looking
under the deck,There was some sawn wood on the ground that sustained fire damage from the top of the wood.
There was a plastic storage container similar to the container that burned in the fire against the exterior wall under the
kitchen window..
6. INTERIOR EXAMINATION:
Interior examination disclosed light smoke damage and heat damage in the family room and kitchen area where the
exterior window broke and allowed product of combustion into the house..
7. AREA/POINT OF FIRE ORIGIN:
The area/point of fire origin was determined to have been on the deck under the family room window where there had
beed a plastic storage container that contained fertilizer and yard maintenance supplies. .
8. ADDITIONAL INFORMATION:
3 16 17 1st AVENUE SOUTH • FEDERAL WAY, WASHINGTON 98003.5201
Seattle: 253/946-7248 fax: 253/529.7206
An Equal Opportunity Employer
The`'Gccupants were alerted to the0e when they heard someone pounding ont front door. As they went to
investigate they heard glass breaking in the back of the house. Thinking it was a burglary the occupants son chased
the person down the street with his gun. They then discovered the fire on the back deck. According to the occupant
the contents of the storage bin had lawn fertilizer, lawn seed, propane bottles and chemicals..
9. CASUALTIES:
0.
Investigator: Chris Ingham
Signature:
Case #_�'�
A
•
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 81h Avenue South
PO Box 9718
Federal Way WA 98063-9718
253-835-2607; Fax 253-835-2609
www.cityoffederalway.com
INCIDENT DAMAGE CHECKLIST
Owner's Name:Phone:
Date of Incident: Date of Inspection: 4 -4
Site Address: � (2 1 k Y2,3 " 'I r'
Nature of Incident/Scope of Damage: FAT094,; 4- FLjZ-C
(If the value of the damage is greater than 75 percent of the assessed value of the structure, a site plan is required.)
Building Posted:
❑ NO OCCUPANCY ❑ DANGEROUS BUILDING ❑ OTHER KNOT POSTED
Permits Required: X
,�UILDING ❑ PLUMBING MECHANICAL ELECTRICAL ❑ DEMOLITION
Plans Required: AYes ❑ No Plans to Show: FL, s 1-�i►�� z ,l ,✓C %/�
' ZZ�r& z 2
Engineering Required: ❑ Yes )No Specifically:
Demolition Complete: )(Yes ❑ No ❑ N/A 2"d Inspection Required: ❑ Yes ❑ No
Permit Application Information Provided to Applicant:
❑ Demolition Permit Application ❑ Building Permit Application
❑ Submittal Checklist ❑ Electrical Permit Application
❑ Other _
ll
�4r�-y �r1�11G�-- (253)835-
Inspector
253)835-Inspector Phone Number
"APPLICANT: PLEASE BRING THIS FORM TO THE CITY WHEN APPLYING FOR PERMITS"
Federal way Cie
RMIT
COMMUNITY DEVELOPMENT SER C SG_p L I C A T I O N
253-835-2607• FAX 253-835-266
R�nwviu,rityott�e4_Mlwau. mm ,
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�F CO ME PL DE EN FP
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SITE ADDRESS �
fv �OS
SUITE/UNIT M
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL M
TYPE OF PERMIT
�BUIIMING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
W
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
ST v
MAILING ADDRESS
E.MRAIL
CITY STATE ZIP
NAME
PHONE
MAILING ADD
E-MAIL
CONTRACTOR
C
STATE
FAX -
WASTATE CONTRACTOR'S LICENSE S
EXPIRATIO
RAL WAY BUSINESS LICENSE X
NAME /+
iL
PHONE
APPLICANT
LING ADDRESS
FAL
C
uY
STATE
ZIP
FAX
PROJECT CONTACT
(The individual to receive and
NAME
Awy C fee t?
PHONE
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
RC4e
STATE
Wh
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
Required value of $5,000 or more
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 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 of this application.
SIGNATURE: DATE
PRINT NAME: G
Bulletin #100 —January 1, 2011 Page] of 3 k:\Handouts\Permit Application