14-105142 ITr
• wilding - Single Family
City of Federal Way
Community&Econ.Dev.Services Permit #: 14-105142-00-SF
33325 8th Ave S
Federal way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 FILEIAC 4
Project Name: CHA-WATER DAMAGE
Project Address: 214 SW 368TH ST Parcel Number: 570780 0220
Project Description: Inspection of water damage to walls,floors and ceiling caused by burst pipe in vacant
home.
Owr Applicant Contractor Lendet `
giant
PETER M CHA YOUNG KIM
214 SW 368TH ST NW ARCHITECTURE
FEDERAL WAY WA 13031 NE 10TH ST
98023 BELLEVUE WA 98005
Census Category: 434-Residential alt/add-no change in number of units
Includes: #1 #2 #3 #4
- Occupancy Class:
Construction Type:
Occupancy Load ,
Floor Area(sq.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 ' ermit II
DITIONS:
NO CONSTRUCTION APPROVED THIS PERMIT-INSPECTION ONLY.
PERMIT EXPIRES Wednesday, April 1, 2015
Permit Issued on Friday, October 3, 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.
Owner o ager /f U�i 7A_-____ Date: CO-- 3 1.=:
w ;
• •
-4.0C1 DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8`h Avenue South
CITY OF ���r PO Box 9718
Fed e ra I I'1ay' Federal Way WA 98063-9718
253-835-2607;Fax 253-835-2609
www.cityoffederalway.com
INCIDENT DAMAGE CHECKLIST
Case# 14 - 105142- 0o - SF
Owner's Name: PETeac. Phone: 14
Date of Incident: N l lor Date of Inspection: 1 0 b ( I
Site Address: 2t`" SW 3(06T� S's'
Nature of Incident/Scope of Damage: IN STC'`- D14 14^t4I-A 6/ Ft-.nab I r4 4 Dim ^I o
t A l rI G. -rD 1 Do Set..-0 Ft L,
(If the value of the damage is greater than 75 percent of the assessed value of the structure, a site plan is required.)
BuiVing Posted:
g No OCCUPANCY Cl DANGEROUS BUILDING El OTHER El NOT POSTED
Perfits Require
Ly BUILDING PLUMBING L7 MECHANICAL L7 ELECTRICAL ❑DEMOLITION
Plans Required: El Yes "No Plans to Show:
Engineering` Required: O Yes El No Specifically: Ft ta.) INS?Iz12-C1,641-‘r0T 1a-I12-C1,641-‘r0P dilotll3-e-D fr i,w � ..44-pn11G/��- ,lC �"�ULO S�/�L tkt�1 4.T-
.
G42-rrei-A AS TO SIA4 I-1 Iviert-T H- .o..'C lT10 .-/S r Ira ri
Demolition Complete: El Yes El No IN/A 2"Inspection Required: El Yes 134o
Permit Application Information Provided to Applicant:
El Demolition Permit Application El Building Permit Application
El Submittal Checklist 0 Electrical Permit Application
O Other
,i✓� (253) 835- '1-4 l-3
Inspector Phone Number
**APPLICANT: PLEASE BRING THIS FORM TO THE CITY WHEN APPLYING FOR PERMITS**
4 1' I .°�decEivED
•
CRY OF PERMIT APPLICATION
Federal Way OCT 0 3 2014 M�0
CITY OF FEDERAL WAY
/ CDS�
PERMIT NUMBER / V_ L O S I �j _ SF
TARGET DATE
SITE ADDRESS SUITE/UNIT#
14 '$ ) be)." 57
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 4esidenfto 5x0_ 0 - D `22o
TYPE OF PERMIT u BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT GH A 1.-10(A .-
1 tik e
.10lv" e of wat- da1&0L
PROJECT DESCRIPTION
Detailed description of work to ()JAI- ---R, -1)1-ivl A'Co e 64 e 0 K. jC Zr-) F, °c
be included on this permit onlg may. 6125 13 et-01^, , ALL p24 w(A-1.L, -XT, WA-L.1_ f NI S U t a4i(O0,
NAME PRIMARY PHONE
PROPERTY OWNER V" H £ C H A
MAILING ADDRESS „ E-MAIL
2-IA Sid 6 2D+If STATE
ZIP
cr. ' /� r
CITY e. P-P-A-L V6,54-`1 - 9 e QZ�
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
1-6 4)
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
14 Kilt, 0 ,M 2063 6'q646 la6yv
APPLICANT MAILING ADDRESS E-MAIL II�,
I001 WE 1O S7' my kci8o050y6,,It6Or(4tvi
CITY STATE ZIP
Beg cry Ne_ w,_ Rpo05
1 5a,rme as NAME PRIMARY PHONE
PROJECT CONTACT °Ve _
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME S7 O UB f�e,r- ,..
PROJECT FINANCING �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 appli ation.
e....—____, r
SIGNATURE: 1604 ? 7 DATE p ct - 3 -2-°14
PRINT NAME: N(0 q 1\16) 1 I j'✓`
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application