05-105590 • •
City of Federal Way Building -Single Family Permit #: 05 - 105590 - 00 - SF
Community Development 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: BEDNARSKI
Project Address: 33218 2ND PL SW Parcel Number:729800 0140
Project Description: Shingle to comp reroof
Owner Applicant Contractor Lender
Zdzislaw F Bednarski Zdzislaw F Bednarski Zdzislaw F Bednarski NONE
33218 2ND PL SW 33218 2ND PL SW
FEDERAL WAY WA FEDERAL WAY WA 33218 2ND PL SW
98023-6161 98023-6161 FEDERAL WAY WA NONE
Includes:
Census category: 555-Non-st #1 #2
_L #3 L #4
Occupancy Group: 3 -
Construction Type: Type V-B 1
Occupancy Load: +
Floor Area(Sq.Ft.): i _
Census Category 555-Non-structural roofing p Mechanical No
Occupancy#1 -Class R-3 Plumbing No
. PERMIT EXPIRES April 29,2006.
Permit issued on October 31,2005
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 .- in accor .nce wh the laws,rules and regulations of the State of Washington and
the City of Federal Way -
Owner or agent: 1 4 Date: l 1
.44%,.
• THIS CARD IS TO *MAIN ON-SITE
CITY OF — Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105590-00-SF
Owner: ZDZISLAW F BEDNARSKI
Address: 33218 2ND PL SW
FEDERAL WAY, WA 98023-6161
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 Plumbing Groundwork(4190) ❑ 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) 0 Shear Walls (4245) 0 Roof Sheathing(4220)
Approved to install flooring Approved to install siding pproved to install roofing
By Date By Date By /1-/ — Date /1/17/05
❑ Fire/Draft Stops (4095) e
i NOTE: Prior to scheduling a Framing(4120) 0 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
By Date
❑ Insulation (4150) 0 Gypsum Wallboard Nailing (4130) ❑ Final-SWM(4375)
Approved to install wallboard Approved to install mud&tape Approved
By Date _ By Date By Date
O Final-Building (4050) ❑Temp.Erosion Maintenance (4370)
Approved Approved
By 0/ - Date j/fr.g/DS By Date
A16. RECeitiEr
•
CITY OF 11111
Y S - j
T
Di
_ 0 Way OCT 3 1 2005 PERMIT < SF FCO ME EL PL DE EK F
PCOMMUNITYDEVELOPMENTSERVICES
33325 CH AVENUE SOUTH•>b BOX 9718
k-EDERAL FEDERALWAY,WA9806 ,,ILDING DEp, PPLICATION / /253-835-2607•FAX253-835-2609
wwwcituofederalwaycoat
The ollowi • is re•uired in ormation-an incom.fete a..lication will not be acce•ted. Please •rint le.ibl (in in or .e.
• PROPERTY INFORMATION
SITE ADDRESS 33 0. 1 - - VW' T 1_ c. t..,,j SUITE/UNIT# to
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal des,fption)
t ■ PROJECT INFORMATION
TYPE OF PERMIT BUILDING 0 PLUMBING ❑ MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
4,
i S
r. �., V` , _ ,,,..4,,,,I, „:3--A.,\„,)\, ,. Lam, P.tO,�../ 1
,fix-.,,. k , o),' .
e."'-‘3-
PROJECT NAME(Name of Business or Owner Last Name) lJ\ v\
0\ v `) \
.. PEOPLE INFORMATION
PROPERTY NAMErr�� ( \l t PRIMARYPHONE
__�
OWNER q��_L .1/�' 11 A .\; @.27.)\.\.A& -c--,K . ( `�' -
MAILING ADDRESS CI ATE,ZlP
CONTRACTOR COMPANY NAME APPLICANT NAME . FICE'HONE
!LING ADDRESS
`1 `W\y =ITY/\S\TAT., IP CELL PHO (�
1��V�121''Y I F- \,. L WAYBUSINESS L E�E NUMBER t.•+�J�V1�l� f� (k � �-l .
EXPI• . DATE FAX NUMBER
. / / ( ) -
-BL
CONTRACTOR'S REGISTRATION NUMBER .• of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME ` t
MAILING ADDRESS
APPLICANT NAME OFFICE PHONE
,�(�/W�v�
CITY,STATE,ZIP - CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
0 Architect o Tenant ❑Agent 0 Other(Describe)
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
LENDER ' _
it ...f94.1(:w.-$:. -•e � o 'sem� NAME
l',,d'^a, X6.:. IIF rau�h: 0�w✓l!
MAILING ADDRESS CITY,STATE,ZIP
v\.`.i-- \A
. M DETAILED BUILDING INFORMATION '
EXISTING USE S.Fo 1 . . PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ " ,"I CtS
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
' . PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ. FT.
BASEMENT
^FIRST
SECOND
THIRD
FOURTH •
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE O CARPORT❑
EXISTING
PROPOSED TOTAL %::. OT Y "F TOTAL PROPOSED SF �' TOTAL EF{�'
NUMBER OF FLOORS ` ,f•,,r%:':71`,14 ... -0 ,. a 4 a r ."`
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES. •
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
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commertial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Showercombo) SHOWERS WATER CLOSETS crone) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWAYT
WASHING MACHINES URINALS HOSE BIBTERBS
SS
LAYS(Behr..sus.) 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 understgned,and filed against the Ctty of Federal Way,but only where such claim
arises out of the reit. . f - ty,including its cers and employees,upon the accuracy of the information supplied to the city as a part of
this application. ��
1
NAME/TITLE ` , ) (j(y\( elr DATE \\� -3\ 0�
(Signature) (Title)
RELATIONSHIP TO PROJECT Owner 0 Agent 0 Contractor ❑ Architect ❑ Other
P4P', ' N ADDITION70. ,{ 'aa'TEItA I • € B;,,..N.,'"."'2EPAIR' e �' 1 . • ENT �`Vc '"`A
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Bulletin#100–January 7,2005 Page 2 of 4 k\Handouts\Permit Application