05-106121 411 •
City of Federal ay Building - Single Family Permit #: 05 - 106121 - 00 - SF
CommunityDevelopment Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: CONNEWAY/SKIDMORE
Project Address: 29834 11TH AVE SW Parcel Number: 195460 0125
Project Description: ALT-Non structural alterations in kitchen/dining room area to remove non-bearing walls, replace
siding door with window and window with french door. No mech/plumb.
Owner Applicant Contractor Lender
ELAINE SKIDMORE &RICHARD( RICHARD CONNEWAY RICHARD CONNEWAY NONE
29834 11TH AVE SW 29834 11TH AVE SW
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 29834 11TH AVE SW
FEDERAL WAY WA 98003 NONE
Includes:
Census category: 434-Reside #1 #2 #3 #4
Occupancy Group: R-3
1 Construction Type Type V-B
Occu anc Load
H,Floor Area(Sq.Ft
Census Category 434-Residential alt/add-no Mechanical No
Occupancy#1 -Class R-3 Plumbing No
PERMIT EXPIRES May 29,2006.
Permit issued on November 30,2005
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: � ?� �/Z '
Date: //'5e)-Cis
1'
414116.
THIS CARD IS TO•MAIN ON-SITE
CITY OF ''.. ItommunitY Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-106121-00-SF
Owner: ELAINE SKIDMORE
Address: 29834 11TH AVE SW
FEDERAL WAY, WA 98023-8210
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.
O Temp. Erosion Control (4365) ❑ Plumbing Groundwork(4190) 0 Underfloor Framing(4285)
To be done prior to breaking ground Approved to cover Approved to sheath floor
By Date By Date By Date
❑ Floor Sheathing (4105) ❑ Shear Walls (4245) 0 Roof Sheathing(4220)
Approved to install flooring Approved to install siding Approved to install roofing
By Date By Date By Date
❑ Fire/Draft Stops (4095) NOTE: Prior to scheduling a Framing(4120) ❑ Framing(4120)
Approved inspection;Electrical,Plumbing&Mechanical Approved to insulate
Rough-in and Fire/Draft Stop inspections must be
ByDate signed-off and approved. IBC 109.3.4/UBC 108.5.4 B Date
Y
Et Insulation (4150) 0 Gypsum Wallboard Nailing(4130) 0 Final- SWM (4375)
Approved to install wallboard Approved to install mud&tape Approved
By Date B Date /
‘74.,___•t, �'�-�i4-�a Y 1213 /6 By Date
❑ Final-Building(4050) ❑Temp. Erosion Maintenance (4370)
Approved Approved
By / Cdt) Dat% /0 . 01 By Date
RECEIVED •• (�aa�
crrrnF':
Federal Way 414PERMI OVV .40 MF CO ME EL PL DE EN FP
COMMUNlI]'DEVELOPMENTSERVICES OF FEDERAL W O205
33325 S^t AVENUEWA 98063•
63. BOR 9718 AP P LI CA '
FEDERAL WAY.WA 980 63-9718 DEPT. To / /
253-835-2607•FAX 253-8352609
www.cituoffederulwau.com
The oUow' is •aired' ormation-an incom.lete a,,lication will not be acce•ted. Please .rint ler 1bl- in or .1.
/� / • PROPERTY INFORMATION
SITE
9 �� �J�
SITE ADDRESS 9934/ //fry"'
�[ / F`�ir "/� l�/ y, IVA 9l1IZ UITE/UNIT#
ASSESSOR'S TAX/PARCEL# / 9 �7��,6 Q - (�J /1 2 J5 DJLOT SIZE(sf) • 30 ac2e S
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)cD)//uRI�O04 Add her Jg o/IC 2-
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
Al
PAI"'s77 U tins d ANT •OW s ii,1 k)'1-CAP.�[/d &i. q W M/ ,
�P elc.
/G'
(/ �io1e Vet /VJ/)-seetJI?/N, vv�1 -- /CGL- /•I • i •/r/ -
__A-iti ' /? ee. G[l/et).tSOGJ Gad lv /.e-attic i doO1e . .
EXw-/,✓6 /rf)eet 70 /Ze- 1,4l,✓. t'7 -i _e- ciG15Z" ,/Taitee-,11
.6)
�X5 ,79,! 0 vc.
PROJECT NAME(Name of Business or Owner Last Name)
/ ineke- ,
U PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER ?[' ,i-iEd . eONJV t.//T/jt/E Si4 Vntie4 Q_.. (,53) 416 -D35`i
MAILING ADDRESS CITY.STATE.ZIP
/19.g32/ 1171E 5 -edt J Mitt/, f M1 %fie2 3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
L,c- ( )
MAILING ADDRESS CITY,STATE.ZIP CELL PHONE
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
_ / / ( )
B L
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
5e-t_. ( )
-
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT NAIY A��. PRIMARY PHONE E-MAIL ADDRESS
/J� eu ��it1AVeLvecci (.?53J 4 IM - .03 '5
LENDERPeriRCW 19.27.195 Lem information Is NAME
required fpr+oJect value exceeds*4000
MAILING ADDRESS CITY.STATE,ZIP PHONE
( )
• DETAILEDJBUILDING INFORMATION
EXISTING USE /712)>/144‘./ 1Pes).6-4.1 CZ-, PROPOSED USE ,.,.,,4/'74/)!4.4.41 Aid/
EXISTING ASSESSED/APPRAISED VALUE $ / 3, DOD VALUE OF PROPOSED WORK $ / o
DQ
SPRINKLERED BUILDING? i i YES iO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES XN0
WATER SERVICE PROVIDER 7LAKEHAVEN HIGHLINE TACOMA r! PRIVATE(WELL)
SEWER SERVICE PROVIDER ?CLAKEHAVEN I HIGHLINE i! PRIVATE(SEPTIC)
• •
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ.FT.
BASEMENT L
FIRST I/•T�/CL/oti/Alf ,Qoo sr9 2y 3 243 .243
SECOND /�-
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS EXISTING PROPOSED Tam. ms'rn
TO ALEi (G SP 'tOTh*. Orosti) TOTAL SP
Z Z 2.
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
:,,w .:::. .:...,....
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL Ale dam
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial/ WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING /UG.tE
BATHTUBS(or TUb/Shower Combo) SHOWERS WATER CLOSETS male) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS _ ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
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 authorized 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 filed against the City of Federal Way,but only where such claim
arises out of the reliance of the ci includin,9 its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application. • //4-Vrd
NAME/TITLE oese;i4,770?t (91-07U.4_,/ DATE
(Signature) ' (Title)
RELATIONSHIP TO PROJECT Owner n Agent ❑ Contractor ❑ Architect ❑ Other
.......................................................................
......................................................................
E r use ONLY
........................................................................
. ........................................................................
.........................................................................
i NEW ADDITION c ALTERATION REPAIR E TENANT IMPROVEMENT
BUILDING SHELL ONLY? YES [[NO BASIC PLAN? N YES n NO
ZONING DESIGNATION CHANGE OF USE? D YES o'NO
NEW ADDRESS REQUIRED? ❑-YES r)NO UP/SEPA/SU? ❑YES oNO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES o'NO
Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permit Application