03-104152 S
CitFederal Way
Community Development Services Building - in le amily Permit #:03 - 104152 - 00 - SF
33530 1st Way S f,
Federal Way,WA 98003-6210
Ph:253 661 4000 Fax:253.661.4129 .-+l I I / / �1 Inspection request line: 253.835.3050
Project Name: JENSEN
Project Address: 28922 5TH AVE S Parcel Number: 515298 0010
Project Description: Add-8'tall rockery/retaining wall
Owner Applicant Contractor Lender
TERRY JENSEN CONSTRUCTION( TERRY JENSEN CONSTRUCTION( TERRY JENSEN CONSTRUCTION( NONE
TERRY JENSEN CONSTRUCTION( TERRY JENSEN CONSTRUCTION( TERRYJC016OZ 5/15/01
PO BOX 1326 PO BOX 1326 TERRY JENSEN CONSTRUCTION
ISSAQUAH WA 98027-0058 ISSAQUAH WA 98027-0058 PO BOX 1326 NONE
Includes:
Census category: 434-Reside #1 #2 #3 #4
Occupancy Group: U-1
Construction Type: Type V-N f _ —J
Occupancy Load:
Floor Area(Sq.Ft.):
Census Category 434-.Residential alt/add-no Mechanical No
Occupancy Group#1 U-1 Plumbing ` No
Zoning Designation RS 9.6
CONDITIONS:
1)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 attached for standards and site plan for location of silt fencing.
2)This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES March 23,2004.
Permit issued on September 25,2003
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 accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: ' 2-5-°3
PO ''HIS CARD ON THE FRONT OF BUILD.
CITY OF
Federal Way BUILDING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT#: 03-104152-00-SF
OWNER'S NAME: TERRY JENSEN CONSTRUCTION CORP
SITE ADDRESS: 28922 5TH S
(-
Te"*Vonein T "(7 '. bV Vw%SuJ -/t..ro S T.c) C.cOr'. fl_
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: PWV Water piping
() ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof Floor
( ) SHEAR WALLS
() ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS
ALL THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTION
( ) FRAMING/FIRESTOPPING
THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCKING
( ) INSULATION: Floors _Walls Attic
THE'ABOVE,MUST BE APPROVED PRIOR TO APPLYING SHEETROCK
( ) WALLBOARD NAILING ( ) SUSPENDED CEILING
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
() ELECTRICAL FINAL
( ) PLANNING FINAL
( ) PUBLIC WORKS FINAL
( ) FIRE FINAL
THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL
() BUILDING FINAL
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL ISAPPROVED
do ps �,��
• • /5266
CONSTRUCTION PERMIT APPLICATION
$'R
CITY of '1';',`" RECEIVED.���-" APPLICATION NUMBER: o3' 4 Q y.� i"2 ig'
Federal Way APPLICATION NUMBER: - _ -
SEP 0 8 2003 APPLICATION NUMBER: _ - "
**T(rouLOI�gifl f tem T fprmation-Please print(in ink)or type**
Please note: Electrical,FirR PAevkthtldItdms and Engineering permits may require a separate application.
�j /� U PROPERTY INFORMATION
/�
SITE ADDRESS: G 1 2 2 5111 A vL. Sou-16 ASSESSOR'S TAX/PARCEL#: 1 .5-2.a 7- Q U L 0
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING a PLUMBING o MECHANICAL o DEMOLITION
o ELECTRICAL a ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 07' g2
PROJECT NAME:
5011
in PROJECT INFORMATION
PROPERTY OWNER: NAPE: DAYTIME PHONE:
Ter- kje,s-e (12.5) 31 C1-500
75's. &,X)8 " /ssywah /t 9802?
, W
CONTRACTOR: NAME: DAYTIME PHONE:
r'r�TLIID,',','�,ss c— s c, 1-izx1 -1 nE� (92s) sy 7- fs cry
MAILING/�D✓, `,✓i J/1 /32&"A�"ZIP): /�ti / �f ``II �+� Q /�� / EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: - C•L Gtii� /�'/CX2+5L FAX NUMBER:`` _
ii - Ig / 075 - (' 25) 55'? 9553
CONTRACTORS REGISTRATION NUMBER: n rr/^ EXPIRATION DATE;
(copy of card required) /� Z-.sl 5 / ' /2
3(
APPLICANT: r DAYTIME PHONE:
(r-er/ �J 511 ,-744—/— s Cy c1 i'7 11 ` b Ck, ) � �� - WC-)
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
14i0 7 5A� ?/f J 5t ( )
RELATIONSHIP TO PROJECT:
❑ARCHITECT C TENANT ❑OTHER(DESCRIBE): L( Q):g25- /214�
' E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT ¢UCONTRACTOR
• PROJECT INFORMATION
EXISTING USE: /VFW H 6 al ve, EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES o NO
WATER SERVICE PROVIDER: a LAKEHAVEN o HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER: n LAKEHAVEN o HIGHLINE o PRIVATE(SEPTIC)
I
do . •
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
N PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD I
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
U FIXTURES
Indicate number of each type of fixture
4
MECHA CAL
AIR HANDLING UNITS) EVAPO TIVE COOLE (S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLA• NSE ( ) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE
DUCT(S) GAS PIPE ' ( ) ° HEAT SOURCE: a ELECTRIC a GAS
LU N
BATHTUB(S) LAVATO (S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WA S. VACUUM BREAKER(S) ❑ ELECTRIC ❑GAS
DRINKING FOUNTAIN(S) SHOWER(S WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
• DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the i . tion 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 . - • of Federal Way as to any claim(Including costs,expenses,and attorneys'fees incurred in the
investigation and defense of ' �..m),which may be made by any person,including the undersigned,and flied against the City of
Federal Way,but only wh Aj• . -im a out of the reliance of the city,including its officers and employees,upon the accuracy
of the information su
rIll
•
led.y-1. - • as rt of this application. c
NAME TITLE: L/`t / e,� DATE: �3 —al '—C)
o PROPERTY OWNER m PPLICANTNTRACTOR
FOR OFFICE USE ONLY:
a NEW a ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? a YES a NO
COMP PLAN DESIGNATION BASIC PLAN? a YES a NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? a YES a NO
PLATTED LOT? ❑<YES a NO CHANGE OF USE? a YES a NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718.253661-4000•FAX:253-661-4129
www.cltvoffederalway.aom