01-102472 City of Federal Way Building - Single Family Permit #:01 - 102472 - 00 - SF
Community Development Services
33530 lst Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: ZrJ3.g35.3050
Project Name: BAXTER
Project Address: 4735 SW 312TH PL Parcel Number: 211570 0030
Project Description: RES RE-ROOF-Tear off roof down to decking and replace sheathing and re-roof with composition
shingles for existing single family residence.
Owner Applicant Contractor Lender
Wade O Baxter NORTHWEST ROOF SERVICE[NC NORTHWEST ROOF SERVICE INC NONE
4735 SW 312TH PL P O BOX 1697 NORTHRS088DW(]0/14/00)
FEDERAL WAY WA KENT WA 98035 P O BOX 1697
9802 3-20 1 8 KENT WA 98035 NONE
Includes:
Census category: 434-Reside #1 #2 #3 #4
Occupancy Group: R-3
Construction Type: Type V-N
Occupancy I.oad:
Floor Area(Sq.Ft.):
Census Cate o 434-Residential aldadd-no� Mechanical................................................. No
S ry.................................................
OccupancyGroup#1...........................................R-3 Plumbing................................................. No
Zoning Designation.............................................RS 7.2
PERMIT EXPIRES December 17,2001,IF NO WORK IS STARTED.
Permit issued on June 20,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy a�the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Feder��,Way.
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Owner or ageni`_ � ����.%�'����� ;���' ���� Date: �;� � � �� � ,�-j��� �I
POST THIS CARD ON THE FRONT OF BUILDING '
� ���� BU��,�ING DIVISION
uv F�' INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT #: 01-102472-00-SF
OWNER'S NAME: Wade O Baxter
SITE ADDRESS: 4735 SW 312TH
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
x;;;� °DO NOT POUR CONCRETE UNTIL THE ABO�E IS APPROVED ' �` ';
( ) DRAINAGE: Line ( ) Connection
" DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
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( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
( ) ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof�Z'2—d� SS Floor
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS .
�'R���'�,�n; �- ALL THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTION
( ) FRAMING/FIRESTOPPING
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' ' THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCHING `'
( ) INSULATION: Floors Walls Attic
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�._', . -�-��- ., THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROGK : ' �� '"",� ''` � , "
( ) WALLBOARD NAILING ( ) SUSPENDED CEILING
' s 3 �� Y THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
( ) ELECTRICAL FINAL
( ) PLANNING FINAL
( ) PUBLIC WORKS FINAL "
( ) FIRE FINAL
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� '; < THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL `
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� ) BUILDING FINAL �!���1 ���v
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��`�O�O OCCUPY THIS BUILDING��C�TTIL�BITILDING�FINAL IS AP �� �-��� D.. ���;
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��°� �- ���,�`��� CONSTRUC . �JN PERMIT APPLICATION
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� ��.`� PPLICATION NUMBER: _ _ - _ _ _ _ _ _ -
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� � ��������;�t PPLICATION NUMBER: — — — — — — — — — —
**The foll�i ���pt�?i�a information-Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
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SITE ADDRESS:` � � � JV " ° ���� F\ � I . ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• • • • �
TYPE OF PRO]ECT(This application): �BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
� PRO CT DESCRIPTION (Provide detailed description) ���t "'�� ����" 1 ^
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PROJECT NAME: ���. `�� L_�.� I?-.'�r �i .�_��
• • • • •
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PROPERTY OWNER: NAriE:.� -.-_� �AnIME P�+oN�:
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�A�y ADDRESS(STREET ADDRESS;CCiY,STATE,ZIP): ��- �
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CONTRACTOR' NAME: D ME PHONE:
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M NG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: I
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CifY OF FEDERAL WA BUSINESS IICENSE NUMB ' FAX NUMBER:
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CONTRAC70R'S REGISTRATION NUMBER: EXPIRATION DATE: j
(copy of card required) �� � � � � l,J � ����J � L.J / I —1 � I�/VJ
APPLICANT: NAME: DAYTIME PHONE:
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MAILING ADDRESS(STREET ADDRE55;CITY,STATE,ZIP): EVENING PHONE: �
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RElATI0N5HIP TO PROJECT: ,�,� FAX NUMBER: !
❑ ARCHITECT ❑ TENANT L7 OTHER(DESCRIBE): �z:�/������"�� � � - . �
6MAIL ADDRESS: -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT �CONTRACTOR
. . . . • .
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ � O . `�f�J v���
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIREO: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRNATE(SEPTIC)
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**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ _ _ _ _____
• • • . •
FLOOR EXISTING S .FT. PROPOSED SQ. FT. TOTAL
E3ASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
/
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S)
FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
DUCT(S) GAS PIPE OUTLET(S)
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(5)
DISHWASHER(5) RAIN WATER SYS. 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)
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I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,a�d
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, t only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the informa 'o supplied to the city as a part of this application.
NAME/TITLE: "'�J�� � DATE: ���l��`-' `� �
❑ PROPERTY OWNER ❑ APPLICANT lJ9�CONTRACTOR
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FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
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