05-103474 • 0
City of Federal Way Building - Seigle Family Permit #: 05 - 103474 - 00 - SF
CommuniyDevelopment 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: REZANKA
Project Address: 33435 33RD PL S Parcel Number:614360 0325
Project Description: Reroof; changeout of sheathing
Owner Applicant Contractor Lender
NICOLE REZANKA MAIN STREET BUILDERS MAIN STREET BUILDERS NONE
33435 33RD PL S 40305 S 302ND AVE SE MAINSBL982P2
FEDERAL WAY WA 98003 ENUMCLAW WA 98022 40305 S 302ND AVE SE
ENUMCLAW WA 98022 NONE
Includes:
Census category: 555-Non-st #1 #2 #3 #4
Occupancy Group: R-3
Construction Type: Type V-B ff 1
Occupancy Load:
Floor Area(Sq.Ft.): r
Census Category 555-Non-structural roofing p Mechanical No
Occupancy#1-Class R-3 Plumbing No
PERMIT EXPIRES January 14,2006.
Permit issued on July 18,2005
I hereby certi - .•.,- . :..,,do : correct and that the construction on the above described property and
the occ ..ncy and the use will b c • •.nce with the laws,rules and regulations of the tate of Washingto
the City o - ,-ra1 Way.
Owner or . ent: Date:
II �0S
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oilitosit
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THIS CARD IS TO *MAIN ON-SITE
CITY OF Pommunity Deyelo Ment Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-103474-00-SF
Owner: NICOLE REZANKA
Address: 33435 33RD PL S
FEDERAL WAY, WA 98001-9647
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) 0 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)
0 Shear Walls(4245)
Approved to install siding
El Sheathing (4220)
Approved to install flooring Approved to install roofing
By Date By Date By Date
❑ Fire/Draft Stops (4095) I NOTE: Prior to scheduling a Framing(4120) 1 0 Framing(4120)
Approved i inspection;Electrical,Plumbing&Mechanical I Approved to insulate
Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 109.3.4/UBC 108.5.4
By Date 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
❑ Final-Building (4050) ❑Temp.Erosion Maintenance(4370)
Approved Approved
By Date By Date
! ii, ft iLt
TY OF ` -w� !--C--
Federal Wa .1)0 -3 -f
—
PERMIT (f-s94FCO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8'9'AVENUE SOUTH•PO BOX 9718
53-3FEDERAL 07 FAX 253-835 2609 APPLICATION WAY,WA 98063-9718 / /
www.cituoffederalwati.com
The followin. is re.uired i ormation-an incom.lete a..lication will not be acce.ted. Please .rint le.ibl (in ink)or j.•.
• PROPERTY INFORMATION
SITE ADDRESS 53455 2 J6Q� -R 5. SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# Y/ t 4- 3Lc, 0 - Q 3 2 5 LOT SIZE(s_f)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) Lal Pt--(,5 Ip2, ra-lo w7DS • i✓e-✓Ci c.,7 ti cCi
,..:4..s.. !Attach s'.,ate page for lengthy legal rt riptlan) (J �11epn /
•
Fi S ►till 1/) VO•A 1�7 co r g b`�Y1 iti.5. c
• PROJECT INFORMATICN
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIQN(Provide detailed description of work included on this permit only)
Q,tLJ c \cL VCC\-- C tN7-' . -° \ s� t-,Qa..ie c e .
14.6,00.0-oa •.r, c crC-. .e(,-_ 3e G ,. . (ti-.-., . r'o 4;_-_-,.... .
PROJECT NAME(Name of Business or Owner Last Name) ()\)1•��� --6-7--AW l-(c
• PEOPLE INFORMATION
PROPERTY NAME PHONE
OWNER +CvL-r Zi1V-- 1 (BBBI '593 - ,021®
MAILING ADDRESS CITY,STATE,ZIP
i�0'- Z,C. k C 9 EAr(1p Yl,tr)s ) JA 9?(7tO
CONTRACTOR COMPANY NAME APPLICANT NAME ` OFFICE PHONE
OAAA,4 5tz •L� 5 ‘ 46C1►� VV CU (3W) Bic% - Q9
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
el—lo `�-z-='°- – SE- ti70icc.-+4,,12, J44 cl&o2L (Zvb) 555 -638to
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ / (3W) 8 -6355
B L
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME 1 APPLICANT NAME a OFFICE PHONE
V 1 v Cz 7,`p S ,„,e V,4. .-- ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
`.---12-1 i �1.)e ( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant Agent ❑ Other(Describe) ( ) -
CONTACT PRIMARY PHONE EMAIL ADDRESS
►cW1� +�• -•J (got-) �1s� �p3t�6d CIE.��r�Innitii�t-
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000 `
MAILING ADDRESS CITY,STATE,
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ (2 p WV
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? /❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
sq.FT. SQ.FT. SQ.FT.
BASEMENT
74 X4-4
FIRST I n �.• I V?,
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
357 357
GARAGE 741, CARPORT❑ ., / J (
NUMBER OF FLOORS EXISTING
PROPOS® ',, T71"1:7
ar tarot PROPOSED sr TOTAL SE
-2571 to
**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 \\) ,k
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
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(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 city, 'ncluding its officers and employees,upon the accuracy of the information supplied to the city as a part of
this applicayorc
•
NAME/TITLE ± �-' DATE 711.(11,g.--
(Signature) (Tltle)
RELATIONSHIP TO PROJECT 0 Owner la Agent 0 Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
NEW ❑ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES 0 NO BASIC PLAN? o YES 3 NO
ZONING DESIGNATION CHANGE OF USE? 0 YES c NO
NEW ADDRESS REQUIRED? ❑YES o NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? o YES 0 NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permit Application