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12-100111 City of Federal Way Ekuilding - Single Family Community&Econ.Dev.Services Permit #: 12-100111-00-S F 33325 8th Ave S Federal Way,WA 98003 Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050 Project Name: GRISWOLD Project Address: 28226 15TH AVE S Parcel Number: 025130 0050 Project Description: REP-Inspection of fire damage. **NO construction work approved under this permit** • wn r Applicant Contractor Lender JAMIE GRISWOLD KENCADE CONSTRUCTION INC KENCADE CONSTRUCTION INC 28226 15TH AVE S 8502 RIVERSIDE DR E KENCACI093NN(8/6/13) FEDERAL WAY WA 98003-6182 SUMNER WA 98390 8502 RIVERSIDE DR E SUMNER WA 98390 Census Category: 999 - Unknown Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load: Floor Area(sq.ft.) 0 0 0 0 _ s ,,. ,, ..a .3' �. ,. ..,tip_, ��,,,.,ir• � 4. ,•. .. .` .mow v,,a.. ':. New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0 Mechanical to be Included? No Plumbing to be Included? No PERMIT EXPIRES Saturday, July 7, 2012 Permit Issued on Monday, January 9, 2012 I hereby certify that the -:,ve info ation • correct and that the construction on the above described property and the occupancy and t - u - will 'e in accorda .- with the laws, rules and regulations of the State of Washington and t e City of Federal Way. Owner or agent s � �� _ , c�►T Date: / — F114,4100 /ZAtql& A M • • DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 86 Avenue South CITY OFPO Box 9718 Fede ra I VtiayFederal Way WA 98063-9718 253 835-2607;Fax 253-835-2609 www.cityoffederalway.com INCIDENT DAMAGE CHECKLIST Case# /2 ' /0/// de) Owner's Name: --7;417/ve" Phone: Date of Incident: Date of Inspection: /"24' JL Site Address: 7.4 ZZ L frv2- • 5 Nature of Incident/Scope of Damage: p/, into EVl[M ,0 _ Peyr-rd (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: 5(NO OCCUPANCY ❑ DANGEROUS BUILDING ❑OTHER XNOT POSTED Permits Required: `5iUILDING XPLUMBING MECHANICAL XELECTRICAL ❑DEMOLITION Plans Required: ❑ Yes RNo Plans to Show: ©k_ 7 —Wcl/G'" S'T�l •— /Uo f it'S Engineering Required: • Yes ❑No Specifically: /D1 H 1/F/tr-07 ?-i, l L UIir ft t TILvsS /z - -- S-7 re Demolition Complete: El Yes ,(No ❑ N/A god Inspection Required: El Yes XNo Permit Application Information Provided to Applicant: ❑Demolition Permit Application ❑Building Permit Application ❑ Submittal Checklist ❑ Electrical Permit Application ❑Other A (253) 835- /'Z3 Ins ector Phone Number **APPLICANT: PLEASE BRING THIS FORM TO THE CITY WHEN APPLYING FOR PERMITS** I- A _ - - / b ° I ( ( CIT/OF -.•., E R M I T Federal Way ;r w F CO ME PL DE EN FP IES APPLICATION COMbfC+N1TYDEVELOP ENT SERVICES 253-835-2607•FAX 253-835-2609 )I f 1. A►-w AY SITE ADDRES r 0rSUITE/UNIT# '�-L'� ;- ,Z ".•1 7cry 4 5. PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# TYPE OF PERMIT )UILDING )2QLUMBING XCMECHANICAL DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT (Tenant Name/Homeowner Last Name) el ` ►�IS !.t9OLD EGec Pim a .,�. •G�� IQ04,c: 7-RI/SS-es '4iZ2 7S, fl/2-4 O4, / PROJECT DESCRIPTION / Detailed description of work to _gLoae/ a 4 / vi / ' -Ai , I be included on this permit only V' . f" _ _ N PROPERTY OWNER EPRIMARY PHONE �M ^JaAn i C 61-1.5 tOP 1-2) 02.43 - ei-0.7,3 MAII,ING ADDRESSIL 9/0 -. .3O /gut3 -P ere6t...JrAileAd e fj n/ y tap,cvA7 r -A)c4bg e_6 Pit r.,4 PHONE. -2)99'- aeo MAWNG jADDRESSS - E L O v CONTRACTOR A, /6 yersa'Az- 7) ' £ 154 e.- ell e a . Gerr) ATE 2--,....1 �%O _ &.--3-_O 73_,DC e / / 7 _ wA%STATE cONTRAg XD'S LICENSE# a�TION DATEFEDERAL WAY BUSINESS LICENSE# NAME //hVVJ(/�Jf//], 77/j N��Y/ 1/� PHONE --- -_ .-S- E S f vt= APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX PROJECT CONTACT ` ) ki ,(�i _ 1.5-. ONE 7 7 (The individual to receive and ��� v' �r"r�� , c7 ' �O��/7�i respond to all correspondence MAILING ADDRESS �o • E- L �p ,/ concerning this application) 5,1-in As �436ve. - /j5e .6/ / cade, CITY STATE ZIP FAX as3 -,h0.3-9 i9 9 ERNATE COETACTCO NAME: PHONE E-MAIL Z1I,Y► K f m bri e. ,Z-3735 5-ST37 <1 i ni e ten ea. e •C o'r' PROJECT FINANCINGE OWNER-FINANCED Required value of$5,000 or more C^� � 04) d e 'I)c�I t� LI Y� ��t,rr/^ ,moi l iiiii (RCW 19.27 095) MAILING ADDRESS,CITY,STATE, 1P //`,ry PHONE I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to arty claim(including costs,expenses, and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information suppli:o;�;• tpart of this application. ily ` \� SIGNATU- - ., I DATE i44- f//'•2- PRINT NAME: -g) 1 ' J ,e y/e Bulletin#100-January I,2011 Page 1 of 3 k:\Handouts'\.Permit Application r ! :,---5,,,,,,,, �. s • r' ,t? . .* rte'$` 4 `. d- VALUE OFMECIiAMCAL WORK $ goo,V' (a copy of bid or estimate must be provided) Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS 3 GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER 1 FIREPLACE INSERTS HOODS ieommerrms BOILERS FURNACES / HOT WATER TANKS)Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING I GAS PIPING WOODSTOVES � ... .v, .a `. eelzC, Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. Z BATHTUBS(or Tub/shower Combo) 3 LAVS)Hand sinks) , 3 TOILETS WATER PIPING 1 DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS / SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS # I SINKS)Kitchen/utiiiy) WATER HEATERS(electnr) .3 HOSE BIBBS SUMPS / WASHING MACHINES9-1TOTAY.bP'2IC'i1ZREl a� ,,,,.,--,:41 .:,';;-::: gra uy,; 4s' € ,r ,. . t, ,' a z r �� 4�" 5 x fif r & $ A A r }0� 4 42 .a R ',. CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $ EXISTING/PREVIOUS USE LOT SIZE IIn Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes` No E Yes o)4o "�T � ...g ge "+s t-t �a s 2 s^ € a :,-- ,, •,:.-- p"� r�'�` 3 '--ARE' REA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE ��'747x _ - 'li. r Asa^ g : ter; ! ',A-11%7, � giA ia'� � tea: � 4 + ,, 7 � . ,'^, 4� 4 • � � FIRST FLOOR(or Mobile Home) �..� b " ,5.. . "s b��„� . COVERED ENTRY GARAGE ❑ CARPORT ❑ if% t. ' STINA6 't ' s3 ; ' "ai : _ ' .°, - � ,yzs EXIG . PROPOSED TOTAL Area Totals ESTIMATED SELLING PRICE$ I #OF BEDROOMS AREA DESCRIPTION Occupancy Group(s) Construction #of Additional Information ' • .e Stories • £ ?.} < -. i y�14 gig,� �ros, A Evr,• ir ” , 2 � i � : � �a° r' ADDITION ''-..*“074.1-':.'''-.c . ter1.,7,—,,,,,...,,,n;°7 E`" ' ' '," Fya ' ,- � ' Y'Y" ,---,-.-----77,----K.�; 4=i2-4.'A73 -.-.,‘,477-11 7 ' � 6 dwi 31 Pf ,..t,,,,;,,,,,,,;,,,,,,..-Tv„,,,,,,.;.,,,...„-",„r..... ..' „,.- . a .esr-.- ' • }} 9 r & °aI'-1y -9 il „„, - '. kl� , % dA % AREA DESCRIPTION Area Occupancy Group(s) # °f Additional Information in S.uare Feet • . Stories ._a..+A .rf, ;.:4' q . F „.r Fes.$%N ,ric ,. •y a'"I,'•' "s.a;.-gfi ^.3d, s_a .-.ti`'' ” ... TENANT AREA ONLY '414-'''',.?"-''''''*',4%'74.-I'4,A t � '1 i'''' _'A r� _...� . Bulletin#100-January 1,2011 Page 2 of 3 k:\Handouts\Permit Application