02-105234 deral
City
Community Develop an Services Building - Single Family Permit #:02 - 105234 - 00 - SF
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: CHAVEZ
Project Address: 4260 SW 331ST PL Parcel Number: 327905 0010
Project Description: Grade and fill-Construct rockeries and grade/fill approx.470 cu.yds.of material on existing single
family lot,per plan.
Owner Applicant Contractor Lender
MARTIN CHAVEZ MARTIN CHAVEZ MARTIN CHAVEZ FIRST HORIZON MORTGAGE
33400 28TH PL SW 33400 28TH PL SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 33400 28TH PL SW
FEDERAL WAY WA 98023
Includes:
Census category: 999-Unkno #1 #2 #3 #4
Occupancy Group: na
Construction Type: na
Occupancy Load:
Floor Area(Sq.Ft.): r
Basic Plan No Census Category 999-Unknown
Mechanical No Occupancy Group#1 na
Plumbing No
CONDITIONS:
Prior to any clearing or grading on a lot,the owner/builder shall install temporary erosion/sedimentation control
facilities approved by the City.These facilities must ensure that dirt or sediment laden water does not enter the
public drainage system,adjacent lots or public streets.The owner/builder bears the responsibility to maintain the
facilities in proper working order,replacing as necessary.The facilities may be removed only after such time as
construction is complete&landscaping is installed.See site plan for location of silt fencing.
PERMIT EXPIRES July 1,2003,IF NO WORK IS STARTED.
Permit issued on January 2,2003
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 cordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: /li�, Date: OS 3
• • POHIS CARD ON THE FRONT OF BUILD
&El BUI ING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT#: 02-105234-00—SF
OWNER'S NAME: MARTIN CHAVEZ
SITE ADDRESS: 4260 SW 331ST
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
.... ,,., .: ....a.... n.. ,... .e.:_.... ®.. vut7497 ��0 laa o ...,.zB,,.t ®_9m..�
() DRAINAGE: Line („ — ' (� .• d 3 C () Connection
• � ® 'OU SL 0071';tom ;. ,... '
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
() ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof Floor
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS
i : m 34 TeY ' . i i W ® ® 4, ,t,4,001Tort
:.:-•, ! F saw. -
„-
( ) FRAMING/FIRESTOPPING
7716 fr'
( ) INSULATION: Floors Walls Attic
() WALLBOARD NAILING () SUSPENDED CEILING
®O '” iZO W OR T447: '41€`` IN4 t'II
() ELECTRICAL FINAL
() PLANNING FINAL
() PUBLIC WORKS FINAL
( ) FIRE FINAL
w, ¢ . 9=l . .. „tgWg P „OVER 'R1O :COT�. I ', SI)'
( ) BUILDING FINAL 67°
amisTo UNT : GTFIN° IS APPRO
INSPECTION LOG
DATE INSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION
Ot/fama —71 i?`titst'414/2 WA
dr,(„Ite
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• •
:or G RECEIVED ` CONSTRUCTION PERMIT APPLICATION
F_O L APPLICATION NUMBER: C� - D S',�
uVRY -�- - - 4,-- iSF
NOV 2 1 2002 APPLICATION NUMBER: -
APPLICATION NUMBER: - -
(ITVOF FEDERAL WAY - - - - -
**The r f61 3tedi Information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
•• ■ PROPERTY INFORMATION
SITE ADDRESS: '/Z Ce C_) cSa) $31 — PL ASSESSOR'S TAX/PARCEL#: 3 211 Q - 6 Q 1 t'
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PRO]ECT INFORMATION-.:>'
TYPE OF PROJECT(This application): V BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): C.0-40-(1-84-11(.4-4-AJ Oc—'� �'V l J�� lQ 41-C -SS
PROJECT NAME: �-''41Y
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME,:A A DAYTIME PHONE:
!la /v Y v\ r ort /
(T-53 ) 33 z.- S143
�QN,�,r f,✓
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
un• 3%406 Z --rte (Loci1.04, 5'c-z9 3
CONTRACTOR: NAME: DAYTIME PHONE:
V�,p-�2,�YV �4-►�,� — O tU N. (2,53 )35 z - l SCJ
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
g3'{06 Z (zr3) dry - >rte`�
OF FEDERAL WAY BUSINESS U NSE NUMBER: FAX NUMBER:
4 ONTRACTORS REGISTRATION NUMBS EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
/ � -A z (z53 ) 352 - j z(5
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
(Zg7 )S7 C - c 7
RELATIONSHIP TO PROJECT: �9 FAX NUMBER:
❑ ARCHITECT ❑ TENANT 'OTHER(DESCRIBE):Cf A(P_/L ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: 5�1L� PROPOSED VALUATION FOR IMPROVEMENTS: /5— C4542)
SPRINKLERED BUILDING? ❑ YES 0.I1O FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES I�NO
WATER SERVICE PROVIDER: (&LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) \\
SEWER SERVICE PROVIDER: Vi\LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTIO LY**
NUMBER OF BEDROOMS: ESTIMATED SELLING P $
■ PRO3ECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
.. :��. t.FIXTURES•x� ,•,F +t TS*4•.a+i IaT.i.W.'ic Yl .vw.{Fi ba
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penaltyof perjury that the information furnished by me is true and correct to the best of myt knowledge,and
further,that I am authorized by the owner of the above premises toi perform the work for which the permit application is made. I
further agree to hold.harmless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees incurred int the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the Cityof
Federal Way,but only where such dai arises out of the reliance of the dty,including its officers and employees,upon the accuracy
of the information supplied t e s a this application.
z —
o Z
NAME/TITLE: DATE:
❑ PROPERTY OWN ❑ APPLICANT ❑ CONTRACTOR
F.)ROFFT(E USE ONLY:
VEW, ADDITION �„ ALTERATION , ,REPAIR, _❑ TENANT IMPROVEMENT' ,
=CENSUSCOI)E :.- t,.-., ; . `� "`_ r _..
OIIING� ESIGNATION � 6 I'INGSHELLONLY.? #YES 0 NO _,.
COMA LEAN>DESIGNATiON � � BA.P A 'Y S �`.
SECTION £ TOWNSHIP RANGE , Oki
RE k 3 n Atto NNO=
kiEW DDRESS REQUIRED? E
a
FLATTED LOT?
CHANGE OF USE,?
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvoffederaiway.com