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07-100991
A * - A v a 6 06 1—, City of Federal WaBuilding - Single Family Permit • 07-100991-00-SF mmeZervces • P.O.Box 9718 Federal Way,WA 98063-9718 n Ph:(253)835-2607 Fax.(253)835-2609411:,, ,,f,', Inspection Request Line: (253)835-3050 Project Name: MARCHX HOUSE iL7 Project Address: 34915 4TH AVE S Parcel Number: 202104 9015 Project Description: REP-Structural and siesmic improvements to the main "I" beam in the basement of home. r Owner Applicant Contractor Lender CITY OF FEDERAL WAY CITY OF FEDERAL WAY ASAP CONSTRUCTION INC CITY OF FEDERAL WAY CITY OF FEDERAL WAY ASAPCI*000BM(12/22/2008) PO BOX 9718 PO BOX 9718 PO BOX 1351 FEDERAL WAY WA 98063-9718 FEDERAL WAY WA 98063-9718 PUYALLUP WA 98371 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: Floor Area(sq. ft.) 0 0 0 0 - Additional Permit information New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement. 0 Occupancy#1 -Construction Type Type V-B Mechanical to be Included? No Occupancy#1 -Class R-3 Plumbing to be Included? No Occupancy#1 -Use Residence(1 or 2 Zoning Designation SE family) - No Fixtures Associated With This Permit I! PERMIT EXPIRES Friday, February 27, 2009 Permit Issued on Tuesday, February 27, 2007 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 c. . __._-.--� and the City of Federal Way. Owner or agent" T /„...,/ �"-- : . Date: 7 Z 7 -‘27 . . . A • THIS CARD IS TWEMAIN ON-SITE ' , . ' , CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 r PERMIT#: 07-100991-00-SF Owner: CITY OF FEDERAL WAY Address: 34915 4TH AVE S FEDERAL WAY, WA 98003-7011 This card is part of your required inspection documents. 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. 0 Temp.Erosion Control(4365) 0 Underfloor Framing(4285) ❑ Floor Sheathing(4105) To be done prior to breaking ground Approved to sheath floor Approved to install flooring By Date By Date By Date ❑ Shear Walls(4245) 0 Roof Sheathing(4220) 0 Fire/Draft Stops (4095) Approved to install siding Approved to install roofing Approved By Date By Date By Date • NOTE: Prior to scheduling a Framing(4120) ❑ Framing(4120) ❑ Insulation (4150) inspection;Electrical,Plumbing&Mechanical Ap roved to insulate Approved to install wallboard Rough-in and Fire/Draft Stop inspections must be signed-off and approved. IBC 109.3.4/UBC 108.5.4 By �' Date 44.z7-07 By Date ❑Gypsum Wallboard Nailing(4130) ❑ Final- SWM(4375) ❑ Final-Building(4050) Approved to install mud&tape Approved Approved By Date By Date By G cJ Date 4/ Q7 ['Temp.Erosion Maintenance(4370) Approved By Date • -- 4 • "4i,";:;fr,• ,'f,.',' ,,,, , '.,.•,,...';„El elfii•''''' , ' ,',''7 -I.M ".-1,.•-;'.,k'C-'r. 'p'7,-:kr-' •X-wg. (ofi ,g,,,,kr' ',.,,ozV-"eII-.-.rt.f''',...f..,',1„‘,'•.•,••.4v,0,.,44.0,..'+..:.;i. .144,,.:'',.-1:4,i;;it'kAi7,,'*','',,.•'"e;,,,.t,‘,,:'',;-!-Y?4;.:W',c '' ' \s LitArs-' ' '' - -ADA; '....4` .' 1 '.”•iA '' '''"CRIJO- ' ;. 4,t,k•'.4.: r.,.., ,s,t, , fri. 14 , 4, ... „,,,,'•,- , ,„.2.,,,,,,,,t - .4.,*„.. • ,r-:,,,,,,,,,,,,,,„,, , '''..;;Z' ''',* ..:A. 4iittri. 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E g11111111 < - 4 E E EE ‹ ' ,E E E E E •, E ,E E E ' E Z _ 4 4 , E E m , , . , 4 E 4 x4 4 4 4 4 4 4 4 E , - -E . 4 E E , E E E E E E E -4.. Z E , 5X 71 M 04/24107 TUE 13:52 FAX 253 681 4739 Fed Way Park Mnt 4j002 • SITE OBSERVATION Engineering, plc MEMO Structural consulting&design 1411 Fourth Ave,Suite 76o Seat*,Washington 96181 *****DRAFT TO: Mr. Jason Gerwin,The City of Federal Way FROM: Michael Leonard, P.E. PROJECT: Marchx House Evaluation SUBJECT: Site Observations DATE: April 19, 2007 • Introduction The City of Federal Way requested that MLA provide structural observations and report of existing conditions at the Marchx house, located at 34915 4th Ave South in Federal Way, Washington. The purpose was to identify structural requirements for improving life-safety conditions, provide documents for constructing repairs where required, and briefly evaluate the seismic resistance of the house. Our scope did not include performing a detailed seismic analysis or formal evaluation of the house. On November 2,2006, MLA Engineering made site observations at the Marchx house. We were on site approximately 80 minutes,during which time we took photos and made notes regarding the existing conditions. Following the observations, we reported our findings and recommendations orally and,with the approval of the City of Federal Way, prepared sketches for improving structural deficiencies that would be considered above average life safety risks, relative to the age and type of construction of the house, The fist draft of the structural improvement documents was issued via PDF email on January 2, 2007 and followed up with an updated hard copy that was mailed on January 15, 2007. The City of Federal Way used these documents to solicit bids for construction of the work,which was executed and substantially completed in March 2007. This memo/report summarizes our observations,evaluation, and recommendations for repair of the existing house. Photographs of the existing conditions are included in Appendix A, the documents that we issued to the City of Federal Way are included in Appendix B,and photographs of the completed repairs can be found in Appendix C. • Marchx House Elevation—looking northwest 04/24/07 TUE 13:53 FAX 253 661 4739 Fed Wa3- Park Mnt Z003 • • Site Obeevetion Memo&Evaluation Marchi House,City of Federal Way Page 2of3 Existing framing The house is one-story wood-framed construction over a cast-in-place concrete daylight basement. Although foundations are concealed by soil at the exterior and concrete slab at the interior, it is likely that the walls bear on continuous concrete footings that were cast against native soil. The superstructure appears to be conventional 2x"stick"framing with wall sawn studs at the walls with sawn joists at the floors and roof. Plywood sheathing could be observed at the roof and floor. The walls were concealed by finishes; it is likely that they are also sheathed with plywood. The perimeter of the house is supported by casti-in-place concrete walls.A steel wide-flange beam, running in the north-south longitudinal direction, provides an interior line of supports for the • main floor joists. The steel beam bears on the exterior wall at its north support and two wood posts at its interior support. Connectors are not present where the wood post supports the column or where the post bears on the concrete plinth. A cast-in-place concrete stair landinglplatform located at the west exit of the main floor is supported from a steel column that has corroded. The column appears to be lacking fasteners where its base plate bears on the concrete wall . • Findings& Recommendations Structures built prior to the adoption of the 1997 Uniform Building Code will generally fail to meet all requirements of the 2003 International Building Code, currently adopted by the State of Washington. Light wood-framed construction of the type noted in this house,however, will likely remain standing following moderate seismic events in the 6.0—7.0 Richter-sale magnitude, provided that shear walls comprise at least 30% of the wall area and that the roof and floors are well-connected to the walls and posts. The shear wall length at the Marchs house appears to be ample., we noted during our walk-through observations that several elements can be upgraded, at a relatively low cost, to improve the seismic resistance of the house. Recommended improvements include: 1) connecting the wood sill plate to the concrete foundation wall 2) adding connection hardware at the top and bottom of wood posts in the basement 3) repairing the large vertical crack in the basement wall at the northwest corner • 4) replacing the steel post and its connection to the concrete wall located at the exterior landing Our investigation of the superstructure was limited due to wallboard finishes that conceal the framing. Walls are likely plywood sheathed 2x4 sawn studs. We reviewed photos of the attic framing and note that it is not connected with metal plate hardware as is typically used in current construction, but it likely is nailed according to standards of the 1960s. Considering the light weight, low-pitch,continuous roof geometry,the existing roof framing does not appear to present an undue safety risk to it occupants. Potential uplift forces under extreme wind conditions are more likely a safety threat than seismic motion, but no more so than comparable houses of the same age and construction. Other items that should be maintained, but do not present immediate life-safety concerns include: 1) Check for dry rot-wood that is in contact with concrete does not appear to be pressure treated 04/24/07 TUE 13:53 FAX 253 661 4739 Fed Way Park Mnt 2004 . • • Site Obsevation Memo&Evaluation Marghz Nouse,City of Federal Way Page 3 of 3 2) Prune shrubs and bushes to allow air flow around the exterior of the house and reduce the risk of pests attacking the structure 3) Maintain gutters, downspots and direct surface water away from the perimeter of the house Construction and post-construction review MLA Engineering was in contact with the contractor and The City of Federal Way throughout the construction period. We did not make site observations during or after construction, but responded to questions, made minor modifications to the design where existing conditions required it,and reviewed the photographs of the completed construction. At the time this memo was written, construction of Items#1,#2 and#3 as noted above had been completed. We understand that fastening the sill plate to the basement wall is not possible to achieve without great difficulty along portions of the wall where posts, beams,and ductwork interferences occur. A plan is included in Appendix C that identifies where sill plate cups could not be installed. We find the condition acceptable, but recommend that clips should be added if the duct is removed at a future date. Item#4 is a lower-priority item, but its repair would increase the likelihood that the west exit would remain functional following an earthquake. Understanding that inspection of work was provided during construction, it appears from reviewing the photographs that the construction of repair items#1 through#3 was completed satisfactorily and that the life-safety improvement have been achieved as intended by the structural design. END OF MEMO REPORT i A F I LE Structural Notes & Sketches for Improvements to the Marchx House 34915 4th Ave South Located in Federal Way, Washington APPROVED Prepared for The City of Federal Way BY 5(4‘(--- 2 - 2t. • o7 &Si & is ro DrN 4., o' `''"N�` , / .� • c;�o /(4 .2167 January 2, 200' -J PERMIT:07-100991-00 SF • ADDRESS.34915 4TH AVE S PROJECT: REP-STRUCTURALOWNER. MARCHX HOUSE IMPROVEMENT MLA Engineering; DATE: 2/23/07 1411 Fourth Ave, Suite 760-- Seattle, Washington 981 Q'ts �,r i 206-264-2727 fi/tet II g 206-264-4835 Fax RECEIVED FEB 2 3 2007 CITY OF FEDERAL WAY BUILDING DEPT. • • GENERAL NOTES PROJECT LOCATION: 34915 4T"AVE SOUTH, FEDERAL WAY, WASHINGTON WORK DESCRIPTION THE WORK SHOWN IN THE ATTACHED SKETCHES PROVIDES IMPROVEMENTS TO THE STABILITY OF THE STEEL FLOOR BEAM AND VARIOUS POST CONNECTIONS THAT ARE LOCATED IN THE BASEMENT OF THE EXISTING HOUSE. CRITERIA CODE REQUIREMENTS: DESIGN AND CONSTRUCTION SHALL CONFORM TO THE REQUIREMENTS OF THE 2003 INTERNATIONAL BUILDING CODE. THE PUBLICATIONS LISTED BELOW ARE THE GOVERNING CODES AND STANDARDS REFERENCED BY THE BUILDING CODE. IN CASE OF CONFLICTING REQUIREMENTS, THE BUILDING CODE SHALL GOVERN. APPLICABLE CODES AND STANDARDS: IBC: 2003 INTERNATIONAL BUILDING CODE NDS: NATIONAL DESIGN SPECIFICATION FOR WOOD CONSTRUCTION, 2001. DESIGN LOADS IN ADDITION TO THE DEAD LOADS, THE FOLLOWING LOADS WERE USED FOR DESIGN: LIVE LOAD 40 PSF FLOOR JOBSITE SAFETY THE CONTRACTOR/BUILDER SHALL BE RESPONSIBLE FOR CONSTRUCTION SITE SAFETY AND THE METHODS, TECHNIQUES, SEQUENCES AND PROCEDURES REQUIRED TO PERFORM THE WORK. EXISTING CONDITIONS FIELD-VERIFY EXISTING DIMENSIONS AND FRAMING PRIOR TO FABRICATION AND CONSTRUCTION. CONCRETE ANCHORS EXPANSION BOLTS INSTALLED INTO CONCRETE SHALL BE HILTI KWIK BOLT II OR APPROVED EQUIVALENT. INSTALLATION SHALL BE IN STRICT ACCORDANCE WITH ICBG REPORT ER 4627. ADHESIVE ANCHORS INSTALLED INTO EXISTING CONCRETE SHALL BE A36 STEEL ROD AND SHALL BE EPDXY GROUTED WITH HILTI HY-150 EPDXY ADHESIVE OR APPROVED 1 1 i EQUIVALENT UNLESS OTHERWISE NOTED. INSTALLATION SHALL BE IN STRICT ACCORDANCE WITH ICC REPORT ER 5193. STEEL REFERENCE STANDARDS: AISC AMERICAN INSTITUTE OF STEEL CONSTRUCTION, SPECIFICATIONS FOR STRUCTURAL STEEL BUILDINGS-ASD AND PLASTIC DESIGN, AISC 335-89s1 OR LRFD SPECIFICATION FOR STRUCTURAL STEEL BUILDINGS, AISC LRFD-99. AWS AMERICAN WELDING SOCIETY, STRUCTURAL WELDING CODE—STEEL, AWS D1.1-2000 AND STRUCTURAL WELDING CODE—SHEET STEEL, AWS D1.3-1988. MATERIALS: ANGLES, PLATES AND MISC STEEL: ASTM A36 Fy = 36,000 PSI THREADED WELD STUDS: ASTM A108 Fy = 50,000 PSI BOLTS: ASTM A307 BOLTS SHALL BE PROVIDED WITH LOCK WASHERS UNDER NUTS OR SELF-LOCKING NUTS. BOLT HOLES SHALL BE STANDARD SIZE UNLESS NOTED OTHERWISE. WELDING SHALL BE IN CONFORMANCE WITH AISC AND AWS STANDARDS AND SHALL BE PERFORMED BY AWS/WABO CERTIFIED WELDERS, WHO ARE QUALIFIED FOR THE WELD TYPE THEY PERFORM, USING E70XX ELECTRODES. ONLY PREQUALIFIED WELDS (AS DEFINED BY AWS) SHALL BE USED. WELDS SHOWN ON THE DRAWINGS ARE THE MINIMUM SIZE. INCREASE WELD SIZE TO AWS MINIMUM SIZES BASED ON PLATE THICKNESS. MINIMUM WELDING SHALL BE 3/16 INCH. SHOP DRAWINGS SHALL SHOW ALL WELDING WITH AWS A2.4 SYMBOLS. WOOD SAWN LUMBER SHALL BE KILN-DRIED OR MC-15, GRADED AND MARKED IN CONFORMANCE WITH WCLIB STANDARD GRADING RULES FOR WEST COAST LUMBER NO. 17, LATEST EDITION. FURNISH TO THE FOLLOWING MINIMUM STANDARDS: WALL STUDS AND PLATES DF-LARCH NO.2 Fb=900 PSI POSTS AND TIMBERS DF-LARCH NO. 1 FcF = 1200 PSI b= 1000 PSI BLOCKING & MISC. HEM-FIR STANDARD GRADE WOOD FRAMING DETAILS NOT SHOWN OTHERWISE SHALL BE CONSTRUCTED TO THE MINIMUM STANDARDS OF THE IBC. MINIMUM NAILING SHALL CONFORM TO IBC TABLE 2304.9.1. ALL NAILS SHALL BE COMMON UNLESS NOTED OTHERWISE. PROVIDE WASHERS UNDER THE HEADS AND NUTS OF ALL BOLTS AND LAG SCREWS BEARING ON WOOD. TABLE I COMMON NAIL SIZE TABLE SIZE DIAM LENGTH 2 • • • 6d 0.113 2" 8d 0.131 2-1/2" 10d 0.148 3" 12d 0.148 3-1/4" 16d 0.161 3-1/2" 20d 0.192 4" THE TABLE LISTS THE NAILS USED TO ENGINEER THE WOOD FRAMING FOR THE PROJECT. ALL NAILS USED SHALL COMPLY WITH THE DIAMETERS AND LENGTHS NOTED. SPECIAL NAILS WILL BE NOTED IN THE CONSTRUCTION DOCUMENTS. ANCHOR BOLTS AND WOOD CONNECTION BOLTS SHALL CONFORM TO ASTM A307. BOLTSSHALLOLES SHALL BE STANDARD SIZE UNLESS NOTEDOR BE PROVIDED WITH LOCK WASHERS UNDER NUTS OTHERWISE.SELF-LOCKING NUUTSS.. BOLT HO PROTECT WOOD FROMS WEATHER SUCH THAT NOT EMCOISTUREEED °/CONTENT AT THE TIME GYPSUM WALLBOARD WOOD IN DIRECT CONTACT WITH CONCRETE OR EXPOSED TO WEATHER/EXTERIOR CONDITIONSSHALL BE WITHPROVIDE TWO LAYERS OF ASPHALT IMPREGNATED BUILDING PAPER BETWEEN UNTREATED LEDGERS, BLOCKING, ETC., AND CONCRETE. WOOD CONNECTORS CALLED OUT BY LETTERS AND NUMBERS SHALL BE "STRONG-TIE" BY SIMPSON COMPANY, AS SPECIFIED IN THEIR CATALOG NO. C-2006, (OR LATEST EDITION). EQUIVALENT DEVICES BY OTHER MANUFACTURERS MAY BE SUBSTITUTED, PROVIDED THEY HAVE ICBG APPROVAL FOR EQUAL OR GREATER LOAD CAPACITIES. PROVIDE NUMBER AND SIZE OF FASTENERS AS SPECIFIED BY MANUFACTURER. HOT DIP GALVANIONNECTORS ZE OR PROVIDE CONR�NG TO THE MANUFACTURER'S RECOMMENDATIONS. FINISH ON ALL CONNECTORS. WOOD FRAMING DETAILS NOT SHOWN OTHERWISE SHALL BE CONSTRUCTED TO THE MINIMUM STANDARDS OF THE 2003 INTERNATIONAL BUILDING CODE. MINIMUM NAILING, UNLESS OTHERWISE NOTED, SHALL CONFORM TO IBC TABLE 2304.9.1. UNLESS NOTED OTHERWISE,WASHERS UNDER THE HEADS AND NUTS OF ALL BOLTS AND LAG N PROVIDEIZED. HOT-DIPPEDAILS SHALL BE COMMON. NAILS SHALL BE SCREWS BEARING • ON WOOD. BOLTS ASTM A307—PROVIDE NUTS AND WASHERS, HOT-DIP GALVANZE LAG SCREWS ASTM A307—PROVIDE WASHERS, HOT-DIP GALVANIZE FLOORS/CEILING: PROVIDE DOUBLE JOISTS UNDER ALL PARALLEL PARTITIONS THAT EXTEND OVER MORE THAN HALF THE JOIST LENGTH AND AROUND ALL OPENINGS IN FLOORS OR ROOFS. PROVIDE BRIDGING AT 8'-O"OC AND SOLID BLOCKING AT ALL BEARING POINTS. TOENAIL JOISTS TO TOP PLATES OF BEARING WALLS WITH TWO 16d NAILS. ATTACH TIMBER JOISTS TO NOTES ABOVE. 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Please print legibly(in ink)or, type. ,,f(q ,/ IN PROPERTY INFORMATION SITE ADDRESS ..34 J/5 A `f' - AVE-isJV SOI/ ?i SUITE/UNIT# ASSESSOR'S TAX/PARCEL# 2- C) 2 - 1 o '4 - - O / Sr- LOT SIZE NO LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) r 1,(1Q-(;A40034- • (Attach separate page far lengthy legal description) • ■ PROJECT INFORMATION TYPE OF PERMIT UILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only) --arg-k:—L12•olL t. ,56i3t-4 ie.- i ivit'R-od&r(Er✓,S 1� 7• - MA/n/ I ,3&4-1 rnl THC 6ASEi-fe&' of Nor-(F_. PROJECT NAME(Name of Business or Owner Last Name) vvl tifc.ii k as u.s.-e___ • IN PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER Lr of FF_b -A i-- WA (.)51 ) g35' - 6J4.� MAILING ADD S • CITY,STATE,ZIP E-MAIL ADDRESS 33,)-5 6' Ate- S• FEb L poky,WA CONTRACTOR CO PANY NAME APPLICANT NAME OFFICE PHONE ASA r evrJ5-re-4 -ri c rJ PAV L AlCITY,STATE,ZIP '} ( ) - . M., 0. &"-S1351 Pu /irit.U/ �� J 03 / I CELL PHONE - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DTE 1rFAX NUMBER 207-0 6r — \'b -\`3 0 L 2-- 31 -b -7 ( ) COPY of earl sequin.' CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS whtt Me application - APPLICANT COMPANY NAME APPLICANT NAME• OFFICE PHONE 11.t-cis+ a FE)NE_f_A(_ vJA j ...4A50..) .6/6 ( 15 )8 3 5 - F>6 b� MAILIN DDRESS CITY,STATE,ZIP - CELL PHONE 33 33S 8T-= AVC S FEDEeIAL lA1j (.)_s3) „Li,( - 3`14-1 RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect 0 Tenant 0 Agent 0 Other ( ) - PROJECT NAME- PRIMARY PHONE I E-MAIL ADDRESS CONTACT o,ASo .) 6e clU p6-3 ) 35 - 6969-- aSun•kE cnl&Ct/efiareiA�WI LENDER NAME Per RCW 19,27.095: `"cal Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - MI DETAILED BUILDING INFORMATION EXISTING USE :.5 Fg---- PROPOSED USE SFe • EXISTING ASSESSED/APPRAISED VALUE $ • . _ VALUE OF PROPOSED WORK $ f V l pt;24— SPRINKLERED BUILDING? o YES y FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ?Q_IO WATER SERVICE PROVIDER o LAKEHAVEN o HIGHLINE 0 TACOMA RIVATE(WELL) ' \ SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE RIVATE(SEPTIC) AREA DESCRIPT EXISTING PROPOSED TOTAL • SQ.FT: SQ.FT. $Q.FT. BASEMENT FIRST • SECOND THIRD • ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR 0 UNCOVERED?) • GARAGE 0 CARPORT ❑ • lOOSTMO PROPOSED TOTAL • AL LASTINO Sr TOTAL PROPOSED SF TOTAL SF NUMBER OF FLOORS "NEW HOMES ONLY** NUMBER — EMMA :` LINO PRIG - -- - • FIXTURES • Indicate number of each type of facture to be it tailed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ (A CPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPO• TIVE COOLERS G • PIPE OUTLETS WOODSTOVES BBQS FANS t• S WATER HEATERS MISC(Describe) BOILERS FIREPLACE SERI'S HOODS(commerci4Q COMPRESSORS FURNACES RANGES DvJ 3, GAS LOG SETS REFRIG.SYSTEMS • PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(Bathrooms URINALS MISC(Describe) DISHWASHERS • RAINWATER T VACUUM BREAKERS • DRINKING FOUNTAINS SHOWERS WATER CLOSETS rrona) ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUM SIGNATURE I certify under•penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further,that I am authorised by the owner of the above premises to perform the work for which the permit application is made. 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 flied against the City of Federal Way,but only where such claim arises out of the reliance of the city,includi its officers and employees,upon the accuracy of the information supplied to the city as a part of this application4 (SIaLur NAME/TITLEDATE e) ( de)RELATIONSHIOJECT ❑ Owner Agent 0 Contractor ❑ Architect 0 Other • o NEW o ADDITION o ALTERATION o REPAIR TENANT IMPROVEMENT • • BUILDING SHELL ONLY? o YES 0-NO BASIC PLAN? o YES c4.O ZONING DESIGNATION 5 t CHANGE OF USE? o YES dFNO • NEW ADDRESS REQUIRED? o YES "CNO UP/SEPA/SU? o YES QFNO PLATTED LOT? o YES INTO DEMO PERMIT REQUIRED? o YES XNO • • Bulletin#100—January 1,2007 Page 2 of 4 k i-landouts\Permit Application