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17-105000 e•— r ,. . - y .. • . *.,., Building - Single,Family City of Federal way Permit #:17-105000-00-SF Community Development Dept. 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax(253)835-2609 Project Name: DMITROYCHUK Project Address: 29513 1ST AVE S Parcel Number: 119600 3610 Project Description: NEW-Construction of a 3021 square foot 2-story single family residence,with basement,a 40 square foot covered entry,200 square foot deck and a 432 square foot attached garage. Includes plumbing and mechanical. ***5 Bedrooms;$450000 estimated selling price*** Owner Applicant Contractor Lender IRINA DMITROYCHUICLL ALEXEY ANCHEYEVURBAN TERRAMAX GNRL OWNER IS LENDER MANAGEMENT LLC DESIGN GROUP CONTRACTING LLC 27634 25TH DRS 2724 IST AVE S SUITE A 10602 41ST ST E �.. FEDERAL WAY WA 98003 SEATTLE WA 98134 EDGEWOOD WA 98372 Census Category: 101 -New Single Family House Includes: #1 #2 #3 #4 Occupancy Class: R-3 Construction Type: Type V-B Occupancy Load: Floor Area(sq.ft.) 3,021.00 0.00 Additional Permit Information New/Additional Sq.Feet-1st Floor 1164 New/Additional Sq.Feet-2nd Floor 1116 New/Additional Sq.Feet-3rd Floor 0 Occupancy#1-Area(Sq.Feet) 3021 New/Additional Sq.Feet-Basement 741 Basic Plan" No Occupancy#1-Construction Type Type V-B New/Additional Sq.Feet-Deck 200 New/Additional Sq.Feet-Garage 432 Mechanical to be Included" Yes Plumbing Work Valuation" 15000 Mechanical Work Valuation" 10000 Number of Stories 2 New/Additional Sq.Feet-Other 40 Plumbing to be Included" Yes New/Additional Sq.Feet-Total 3693 Will Certificate of Occupancy be Issued" Yes Occupancy#1-Use Residence(1 or 2 family) Comprehensive Plan Designation SF-High-Density Zoning Designation RS 9.6 Residential Total Valuation:375,394.59 -£n Ducting 1 Fans 6 Furnaces Gas Piping 1 Gas Pipe Outlets 5 Hot Water Tanks I '410,41, a, >� E, 1. 4 g•on u a S� „„,. :�. sp m. „av,- Bathtubs 2 Dishwashers 2 Laundry Washer Outlets 1 Lavatories 6 Showers 1 Sinks 3 Water Closets 4 Hose Bibbs 2 CONDITIONS: 1. Geo-tech report to be onsite for footing inspection per Geo-tech recommendations in new report dated 4/30/18 and revised report 1/24/19. 2.All GeoResources recommendations must be followed per the updated geotechnical engineering report, revised report dated 1/24/19. • ' 3.$MFs,:must•be installed prior to beginning construction. ,,,, 4. GeoResources staff must evaluate subgrade condtions after removal of vegetation,topsoil,and old fill, prior to placement of strutural fill. 5.Prior to Building Final,the owner shall dedicate 16-feet of property along 1st Ave S. 6.The applicant is required to obtain a City Right of Way(ROW)Permit to connect into the public storm drain system,as well as for the driveway connection to 1st Ave. Contact John Cole,Street Systems Engineering Technician at(253)835-2725 for the ROW Permit application materials. PERMIT EXPIRES Wednesday,26 February,2020 Permit Issued on Friday,August 30,2019 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. t/�1 Owner or agent: Date: 46 . 11 City of Federal Way Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 111 of the International Building Code or Section R110 of the International Residential Code is certifying that at the time of issuance,this structure was in compliance with the various ordinances of the City regulating building construction or use.This certificate is valid ONLY when endorsed by City staff. Tenant Name: DMITROYCHUK Permit# 17-105000-00-SF Address: 29513 1ST AVE S Includes: #1 #2 #3 #4 Occupancy Class: R-3 Construction Type: Type V-B Occupancy Load: Floor Area(sq.ft.) 3,021.00 0.00 Owner Name: IRINA DMITROYCHUKLL MANAGE Owner Address: 27634 25TH DR S FEDERAL WAY WA 98003 Building Official Date The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which experience has shown most severely affect the health and safety of the general public. Although the City has made as complete a review and inspection as is reasonably possible(within budgetary time and personnel limitations),the City neither guarantees nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises. r . . + THIS CARD IS TO REMAIN ON-SITE ' cru Construction Inspection Record Federal way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 17 105000 00 Address: 29513 1ST AVE S Project: IRINA DMITROYCHUK FEDERAL WAY WA 98003 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 appivps late. Work must not be covered until it is approved. Cheek with your iii,pcc.tvi if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. ® SWM Precon Site Mtg(4400) ' El Initial Erosion Control(4365) 1E1 Footings/Setback(4110) Approved To be done PRIOR to breaking ground Approved to place concrete By Date By Date By ,b Date t) ' , Foundation Wall(4115) El Drainage/Downspout(4040) � Plumbing Groundwork(4190) Approved to place concrete PP Approved to backfill Approved to cover B Date 0416 Date By A,4 Date I f) J Ji I . ., ; ® Slab/Concrete Floor(4255) ® Underfloor Framing(4285) ® Floor Sheathing(4105) / Approved to place concle Approved to sheath floor Approved to install flooring .By Ct►? Date 01 /1 ,,Byt/A/5 Date (P242 �'�By Date • El Shear Walls(4245) El Roof Sheathing(4220) 12 Rough Plumbing(4230) Approved to install sidiApproved to install roofing Approved By bAJS Date7"/t/;o?..c ..By 61,0 Date 2 •2°)0 ...By Date El Mechanical Rough-in(4165) El 1 Gas Piping(4125) El Fire/Draft Stops(4095) Approved ffj Approved to release test Approved 04.10b; By Date By/ws Date , 2,0 .0 ^By Date I=1 Interim Erosion Control(4370) Prior to scheduling a Framing inspection; 37 Framing(4120) Approved Electrical,Plumbing&Mechanical Rough-in Approved to insulate and Fire/Draft Stop inspections must be signed- By Date off and approved. IBC 109.3.4 By Date El Insulation(4150) ® Gypsum Wallboard Nailing(4130) ® Final Erosion Control(4375) Approved to install wallboard Approved to install mud&tape Approved By Date , By Date By Date • El Final-Mechanical(4065) ® Final-Plumbing(4075) ng Final-Building(4050) Approved Approved Approved .By Pp V., Date L`0113 L'1?ii4) By AN) Date IDI ` ),4By L Date `i,� 1 5e!lc Kc for 6147 -4.(T• S7r,. /% (1E,q -OK -mss / /, Q Rough Electrical 0 Final Electrical 0 Right of Way Approved Approved Approved By Date By Date By • Date • • _ r1 •• "••••1Z) • 4 • • • e • • • • • �' r • , DAILY FIELD REPORT PROJECT NO.: Dmitroychukl.istAVeS G E O R E S 0 U R C E S REPORT DATE: Monday September 23,2019 REPORT NO02 earth science & geotechnical engineering GR FIELD REP.: EJF 5007 Pacific Hwy E.,Suite 16 I File.WA 94424 1253.696.1011 I www.poresources.rocks PERMIT NO.: 17.105 SF PROPOSED SINGLE-FAMILY RESIDENCE PROJECT NAME/LOCATION 295131sT AVENUE SOUTH FEDERAL WAY,WA PN:119600-3610 REPORT SUBMITTED TO: Contractor Name and Contact: WEATHER Cloudy Client Mr.Igor Dmitroychuk General: &TEMP. High 60's cc Becky Chapin-City of Federal Way Subcontractors for Geotechnical Construction TIMES OF SITE VISITS: Earthwork: Max-253.533-5243 From 1530 To 1615 From To From To General We arrived onsite at the request of Mr.Igor Dmitroychuk to verify setback distance and that a cut for a proposed single-family residence extends below undocumented fill. Upon our arrival onsite,we observed that the contractor had finished the cut to the footing elevation(s) for a proposed single-family residence located at 29513 lst Avenue South in Federal Way,WA. We observed that the cut extended approximately 3 to 5 feet below the relict topsoil layer/observed documented fill at the site. The exposed footing soils was consistent with poorly to well graded SAND (outwash sands). The approximate location and depths below the relict topsoil layer are labeled on page Field Observations/ 2. We also observed that the daylight basement footing,located along the northern building footprint, extends an additional approximately 5 feet below the proposed basement floor elevation. This depth Undocumented Fill, should provide sufficient setback from the face of the northern slope to satisfy the 2015 International Setback&Footing Building Code(BC)setback requirements(as outlined in our Geotechnical Plan Review Letter dated Probe January 24,2019). We also probed the exposed native soils along the general location of the footing lines with Y:-inch diameter steel T-probe. We observe approximately 1 to 4-inches of penetration into the outwash sands, indicating a firm and unyielding condition and should be in a suitable condition to support the anticipated design loads. LIMITATIONS: The GeoResources field representative is present on site solely to observe the field activities of the contractor identified and keep REVIEW BY(PM initial/date) our client informed of the progress and quality of the work. The presence and activities of the GeoResources field representative and our acceptance of any non-conforming work or failure to reject any non-conforming work does not relieve the contractor from complying with its contract documents. GeoResources does not hove the authority to direct the contractor's work. Any information provided by the GeoResources field inspector is intended solely to advise the contractor of the technical requirements of the plans and specifications and/or design concept. The WRITTEN BY(initial/date) contractor is solely responsible for its means,methods,sequences,construction site safety,quality of work,and adherence to the contract EX 9/23/i 9 documents. Page 1 of 2 • DAILY FIELD REPORT PROJECT NO.: Dmitroychukl.lstAveS ____....m.1010.j.11.11111.11."100111111111111 . GE O R E S 0 U R E S REPORT DATE: Monday September 23,2019 REPORT NOOT earth science & geotechnical engineering GR FIELD REP.: EJF 5007 Pacific Hwy f..Suite 16 I rise.WA 91426 1253.696.1011 I www.georesources.rocks PERMIT NO.: 17.105 SF PROPOSED SINGLE-FAMILY RESIDENCE PROJECT NAME/LOCATION 295131'AVENUE SOUTH FEDERAL WAY,WA PN:119600-3610 Location of observed relict topsoil layer Location of footing cut for daylight basement - adjacent to northern slope I *WI Cut approximately 5 feet below23E — — O ��j .• proposed basement floor elevation \-,—, — 238tir ....,. ..„ ... . . / o.r. : — _ >_ ._ iia_\ _,Y_,_240 O I o "� Approximately 2 , v,lo a N O 't \\� U, v, >_ • to 3 feet below r a o • _. Approximately 3 observed relict P z to f to 5 feet below \ \\ D' topsoil layer m rT1C7 observed relict \ s\ `�s:D -_a' iLli ..— topsoil layer \ :: �� ra 3�_ NN �fE 1 N I '2.,i0•1......r Approximately to 5 feet below J \2° I 2Sr8 \ ' observed relict topsoil laver PAs \ 125R . 7. I - SI., ...11• . • ,,... --- 111111% -,0 I —�- --_ -• _ — —l' _qv _ 52,98' \ \ Sq� I t v / s 9 01'O0'42" E o rpt I } ( SI �v,oCtin ' � 8 1ST AENLE S. =poi m VARIABLE WIDTH RIGHT OF WAY ® aP ED ___w._________W .` W _ ... i o.1 LIMITATIONS: The GeoResources field representative is present on site solely to observe the field activities of the contractor identified and keep REVIEW BY(PM initial/date) our client informed of the progress and quality of the work. The presence and activities of the GeoResources field representative and our acceptance of any non-conforming work or failure to reject any non-conforming work does not relieve the contractor from complying with its contract documents. GeoResources does not have the authority to direct the contractor's work. Any information provided by the GeoResources field inspector is intended solely to advise the contractor of the technical requirements of the plans and specifications and/or design concept. The WRITTEN BY(initial/date) contractor is solely responsible for its means,methods,sequences,construction site safety,quality of work,and adherence to the contract OF c1/13/1i documents. Page 2 of 2 VII!' CWA CONSULTANTS,P.S. STRUCTURAL ENGINEERING BUILDING CODE CONSULTANTS ill 8675 E.Caraway Road,Port Orchard,WA 98366 (360)871-5433 FAX: (360)871-5633 E-Mail:chucknsultantsnet February 27, 2020 RE: Dmitroychuk Deck Construction I have reviewed photos of the roof deck construction. The following are my conclusions 1. The design dead load for the roof design construction is 20 psf. This is more than adequate for placement of the sloped 2x, the additional layer of 7/16" OSB and the proposed lx decking material. 2. Using the tapered 2x material to obtain the necessary roof slope for drainage purposes is acceptable. The minimum connection of the 2x tapered members to the joist below should be 10d toenailed @ 24" oc staggered. The nailing as shown appears to comply with this minimum requirement. If you have any questions, please call Sincerely Ci- Gla) - Chuck Williams PE, SE CWA Consultants �OSR;��✓ . G °). ,r 02/27/2020 . , ,,....• ,.. . FILE , /4 Lakehaven WATER&SEWER DISTRICT Lakehaven Water&Sewer District - Development Engineering Section 31623 - 1st Ave S * PO Box 4249 • Federal Way, WA 98063-4249 Telephone: 253-945-1581 or 253-945-1580 * Email: DE@Lakehaven.org This certificate is intended to provide the applicant, land use agencies &/or public health departments with information necessary to evaluate development proposals. Lakehaven Water & Sewer District, at its sole discretion, reserves the right to delay, or deny, sewer service based upon capacity &/or supply limitations in Lakehaven's or Other Purveyor's system facilities. Proposed Land Use: ® Building Permit-SFR 0 Building Permit-MFR 0 Building Permit-Other ❑ Subdivision 0 Short Subdivision 0 Binding Site Plan ❑ Rezone 0 Boundary Line Adjustment ❑ Other(specify/describe) Tax Parcel Number(s): 1196003610 Site Address: 295XX- 1st Ave S Lakehaven GIS Grid: H-05 Ex. Bldg. Area to Remain: N/A sf New Bldg.Area Proposed: 2.500 sf Applicant's Name: CM Investments LLC SEWER SYSTEM INFORMATION 1. 0 Sewer service can be provided by service connection to an existing E.diameter sewer main that is approximately 75+/-feet from the site and the sewer system has the capacity to serve the proposed land use. 2. 0 Sewer service for the site will require an improvement to Lakehaven's sanitary sewer system of: ❑ a. feet of "diameter sewer main or trunk to reach the site; and/or ❑ b. The construction of a sanitary sewer collection system on the site; and/or ❑ c. A major portion of Lakehaven's comprehensive wastewater system plan would need to be implemented and/or constructed; and/or ❑ d. Other(describe): 3. El a. The existing sewer system is in conformance with Lakehaven's Comprehensive Wastewater System Plan. ❑ b. The existing sewer system is not in conformance with Lakehaven's Comprehensive Wastewater System Plan and an Amendment to this Plan will be required.This may cause a delay in issuance of land use approvals or permits. 4. ® a. The proposed site land use is within the corporate limits of Lakehaven Water&Sewer District, or has been granted Boundary Review Board approval for extension of sewer service outside of Lakehaven's sewer service area. ❑ b. Annexation or Boundary Review Board approval will be necessary to provide service. 5. Sewer service is subject to: ❑ a. Payment of connection charges(to be determined by Lakehaven); ❑ b. Proof or reservation of easement(s)as required by Lakehaven; ® c. Other: Sewer Service Connection Permit reauired. Comments/special conditions: . I hereby certify that the above sewer system information is true. This certification shall be valid for one (1) year from the date of signature. Name: BRIAN ASBURYfTitle: DEVELOPMENT ENGINEERING SUPERVISOR d Signature: r..., Date: l .51/ 741/1/6_ -77/ I 1196003610 swr.docx(Form Update 1/3/17) Page 1 of 2 1 1198003431 29423 1195003438 5437200010 29438 103 1195003428 29501 { 5437210180 ■ 120 .d t. 1196003590LI f 1195003585 got 5437210190 1, 29507 621, 104 L '0 vc r' Accessible Sewer , Sentice POC 1190003595 1198003510 :,,":1. .t 5437210020 105 5437210010 3 29530 5137300130 0021049089 f k1 7183000010 29608 29803 ,`ma 104 • ti ft3TE: lakehaven Water and Sewer SewerCertificate of Ava ilabiity District nether warrants nor guarantees I Ow accuracy of any fact tifoortation o Parcel 1L96003610 too 6+ hided.Facility locations and conditions icusaimmaimi are syEgect to fiat!verification. Feet 6/15/2017 BIA 1196003610 swr.docx(Form Update 1/3/17) Page 2 of 2 11 FILE Lake h tv. avers WATER&SEWER DISTRICT Lakehaven Water & Sewer District - Development Engineering Section 31623 - 1st Ave S • PO Box 4249 k Federal Way, WA 98063-4249 Telephone: 253-945-1581 or 253-945-1580 * Email: DE@Lakehaven.org This certificate is intended to provide the applicant, land use agencies &/or public health departments with information necessary to evaluate development proposals. Lakehaven Water & Sewer District, at its sole discretion, reserves the right to delay, or deny, water service based upon capacity &/or supply limitations in Lakehaven's or Other Purveyor's system facilities. Proposed Land Use: ® Building Permit-SFR 0 Building Permit-MFR 0 Building Permit-Other ❑Subdivision 0 Short Subdivision 0 Binding Site Plan ❑ Rezone 0 Boundary Line Adjustment ❑Other(specify/describe) Tax Parcel Number(s): 1196003610 Site Address:,295XX- 1st Ave S Lakehaven GIS Grid: H-05 Ex. Bldg. Area to Remain: N/A sf New Bldg.Area Proposed: 2.500 sf Applicant's Name: CNI Investments LLC WATER SYSTEM INFORMATION 1. ® Water service can be provided by service connection to an existing diameter water main that is approximately 30+/-feet from the site. 2. 0 Water service for the site will require an improvement to Lakehaven's water distribution system of: ❑ a. feet of "diameter water main to reach the site; and/or ❑ b. The construction of a water distribution system on the site; and/or ❑ c. A major portion of Lakehaven's comprehensive water system plan would need to be implemented and/or constructed; and/or ❑ d. Other(describe): 3. ® a. The existing water system is in conformance with Lakehaven's Comprehensive Water System Plan. ❑ b. The existing water system Is not in conformance with Lakehaven's Comprehensive Water System Plan and an Amendment to this Plan will be required.This may cause a delay in issuance of land use approvals or permits. 4. a. The subject property is within the corporate limits of Lakehaven Water&Sewer District,or has been granted Boundary Review Board approval for extension of water service outside of Lakehaven's water service area. ❑ b. Annexation or Boundary Review Board approval will be necessary to provide service. 5. Water service is subject to: • a. Payment of connection charges(to be determined by Lakehaven); ❑ b. Proof or reservation of easement(s)as required by Lakehaven; ® c. Other: Water Service Connection application required. 1 Comments/special conditions: Service pressure greater than 80 osi indicated. Pressure Reducing Valve indicated, contact local building official for requirements&/or additional information. The nearest fire hydrant is approximately 235+/-feet from the Property (as marked on map on the back of this page). Fire Flow at no less than 20 psi available within the water distribution system is 1,000 GPM (approximate) for two (2) hours or more. This flow figure depicts the theoretical performance of the water distribution system under high demand conditions. Fire flow rates greater than this may be accommodated through water distribution system improvements, contact Lakehaven for additional information. 538 Pressure Zone Est. Future Meter Elevation-GIS: 260+/- Est. Pressure Range at Future Meter(psi): 111-120 I hereby certify that the above water system information is true. This certification shall be valid for one (1) year from the date of signature. Name: BRIAN ASBURY Title: DEVELOPMENT ENGINEERING SUPERVISOR Signature: Date: 6/45-7/ 1196003610 wtr.docx(Form Update 1/3/17) Page 1 of 2 - 1198003431 p 1198003438 29423 Hydrant 29438 1 VC 8" , 2 c .4.1 5437200010 103 1196003428 29501 5437210180 120 1191003590 1198003585 5437210190 29507 104 la 30.- ..,..........e.„0,07"s., 111.111111111111 .�, 1198003595 1198003810 ;',„,,„„q ," 5437210020 tz ' 105 ,-,, „),,,, Ly �4 := 5437210010 29530 re io, 5137300130 0821049089 2811M8 29ee3 .1.7.1111.. 104 1 718300001i? - % ,;�. , , (JOTE: takehaven Water and Sewer District netwr her arrards nor guarantees titer Certificate of av iaDd tp I the19accuracy of any tac8ty Matron 0 Parcel"[sO t! /00 b'+ provided-Facility iodations and conditions are subject field verification. d 4f15/2017 Bu{ 1196003610 wtr.docx(Form Update 1/3/17) Page 2 of 2 CITY OF �..�i RECEIVED PERMIT APPLICATION L PERMIT CENTER+ 33325 8th Avenue South +Federal Way,WA 98003-6325 Fed�i,`j��' way 253-835-2607 + FAX 253-835-2609 +pennitcenter@cityoffederalway.com k OCT 172017 PERMIT NUMBER / L -__LaZED,N DEM C CL� CLW - 5 TARGET DATE /11//9- -/V274/94 / -ec/ SITE ADDRESS 9R 5/3 • 5 / Ave_ S SUITE/UNIT# L. _CJIt ) I9 6o036 )0 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARC L# O C� r b TYPE OF PERMIT BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT 'c-pro t-\- U C.V1 u)(-- Res C6erkcs New $• t2 ©')-1 -)c . PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME PRIMARY PHONE LL. ma1-,A,;. .,,a_ c 1-c (y1 S)oZ 6 9— c 6'39 PROPERTY OWNER MAILING ADDRESS E-MAIL z 64 et l 3 i 0(-a''- Avg 5 E / Da_ !4 ot holm A;L•400.-.#CITY STATE ZIP o * gr03� NAME PHONE MAILING ADDRESS S E-MAIL CONTRACTOR 16‘6 .C_: SS`io- A- C cc "�" /e lP oc STAVE,_ ZIP,y73 7 n _ FAX WA STATE CONTRACTOR'S LICENSE# �/`T T `EXPPIRATION DATE FEDERAL WAY BUSINESS LICENSE# lecr - c8106 l / Pi a NAME 1 PRIMARY PHONE 'J 1_00-- .1, X53 ' -6()___ cOc t 1 APPLICANT- MAILING ADDRESS, E-MAIL _ STATE IP CITY 5 ea4(&. A r\ Z _`t 134 FAX t J NAMEk 25,6 �- PRIMARY PHONE PROJECT CONTACT A,V- ._e�J `z cc• � iS3 45`"�S (The individual to receive and MAILING ADDRESS A E-MAIL respond to all correspondence 22-2 111'1- AV E S \luxI' €')\ kptc e51gt/IS•OS concerning this application) C ""��K STATE ZIP F •!I NAME PROJECT FINANCING 1— OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) 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 supplied to the city as a part of this application. SIGNATURE: .--- 2; › DATE /. ` 7 /7 PRINT NAME: Bulletin#100—January 29,2016 Page 1 of 2 k:\I-Iandouts\Permit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ k,t_ I oe>�h-"' Indicate how manyofeach offixture to be installed or relocated as art ofthis project.Do not include existingres to remain. type .fJ ' � f�u AIR HANDLING UNITS L. FANS GAS PIPE OUTLETS OTHER(Describer AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) BOILERS I FURNACES I HOT WATER TANKS(cos) COMPRESSORS I GAS LOG SETS REFRIGERATION SYST I DUCTING ` GAS PIPING WOODSTOVES I VAn,..., IV 1 PLUMBING PERMIT i OFPLUMBING VV V1C1 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. 2, S BATHTUBS(or Ihb/shower combo) b LAVS(HandSnks( TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS I SHOWERS A.h VACUUM BREAKERS DRINKING FOUNTAINS _ SINKS(Kitchen/Utility) lit WATER HEATERS(Electrk( 9— HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR - SEWER PURVEYOR VALUE OF Pk-k) IMPROVEMENTS L—u D 'l0 $ /V EXISTING!PREVIOU USE LOT SIZE(Ia Square Feet EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? 1 i\I/ A. ' c , 7 Q© ❑Yes No ❑YesNo RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE ,A. f ,„i,1;7t r ii 5 b''''-c,,,,-,.. •;,.U} €, Yw:-.4.k.:-_, 5,.:4t _^n -,,k- , . ,t-.` ' ' FIRST FLOOR(or Mobile Home) `*-.aft¢ rc9 ss�� ..(�+� ,s, s '', r R $. ' ,"' -# `EIt '*-:;'''''..'`.;:3"1,,,:.,r-:'f +,Tu, ....?2, 4_--1_.__--__.._.........—...._.__..__.._.._..........._...._____........_.._._.___..._._____- i. • { 1tpds e(+.a'/1 L ? i M J,: -,,Z,..7.i. c1Y 'C",& 41 P:N ', ,I k( I,v'S'✓_ " ICOVERED ENTRY 1-43 t nj ; 17 M1 a""q* r*tt . s. ''''' ''4: -,,,..4 .2,>7':a! >, .a.. :,,.. " yP �>" ,c -- (( D.. ---'------ GARAGE y CARPORT ❑ L.3 Z ' 91"` . fL O - x 7L' • _gd, k " l&tt vLPRPOSED " TOT, '1 EXISTING Area Totals r3 r- r ESTIMATED SELLING PRICE$ y.119 , 03n # OF BEDROOMS COMMERCIAL-NEW/ADDITION Area in Construction :•.,�; p .a.yConstructionI #of I Additional Informatio nAREA DESCRIPTION Occupancy Group(s) I � 0`FeBf:, ,, w, „a9 EvF ° nXa .,* C : Av,A4-iC }.F 7kngettd{sP r}- a ' ”- � -`MwsAbw : 1_ x b's n,$r„§a uY .3a n€ fI "n ;;t.,Ya. a ADDITION I f COMMERCIAL-REMODEL/TENANT IMPROVEMENTS Area in Construction #of AREA DESCRIPTION Occupancy Group(s) Additional`Information S.uare Feeta Stories ,� rN,rx Q«:fir * F' ,a .c s k f e ''.'4' r r P ,:t-•,,'.-. i " . ,x - § p " c 7+. s �' ?* a ". y. x >. :ws�R-,V,- xFt ,- t ..a ss,a R ,.* ,,r ., ' i s 3° '' nu A * a t %"iu �"„r,. ,'as�'r ,:4°'.. 1;3e'�s�,�A, .�.� _._,...�a:� z,.. y :� � � .�'�^,a .,. � .. ^:.,n. .-,x,,',,,-1-m-: - .. ,. P '? .`%�- .. �„rr ,,.,.".7 .r`, !M.-r��' TENANT AREA ONLY zx '.'* € A Y s,c • 4.t4 .A z '?t'{, -4m '',a 5 ` . , +V ^sh 'F ErA , 'tCa `r r 'k . t s ,. sc ' ., v f P. ;-- ::,:`,',1,,,r; Ir G„ ", �w k ,s ,,,,,g0; hy : w.? 3kI,411z: "F ., , = Bulletin#100-January 29,2016 Page 2 of 2 k:\Handouts\Permit Application