09-104963Building - Single Family
City of Federal Way
Community Development Services Permit #: 09-104963-00-SF
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: LEMUS
Project Address: 29653 20TH AVE S
Parcel Number: 367440 0206
Project Description: REP - Initial inspection and assessment of fire damage. NO construction work included.
Owner
Aololicant
Contractor
Lender
MAYRA Y LEMUS
PAUL DAVIS RESTORATION OF
PAUL DAVIS RESTORATION OF
29653 20TH AVE S
SKC
SKC
FEDERAL WAY WA 98003-4241
6405 VICKERY AVE E
PAULDDR960PM (10/18/10)
TACOMA WA 98443
6405 VICKERY AVE E
TACOMA WA 98443
Census Category: 434 - Residential alt/add - no change in number of units
Includes:
#1
#2
#3
#4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
0
0
0
1 0
Additional Permit Information '# - W It .11 I
New / Additional Sq. Feet - 3rd Floor....................0 New / Additional Sq. Feet - Basement ................... 0
Mechanical to be Included? ................................... No Plumbing to be Included? ........................................ No
No Fixtures Associated With This Permit II ~
PERMIT EXPIRES Saturday, June 19, 2010
Permit Issued on Monday, December 21, 2009
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and th�,use will be in accordance with the laws, rules and regulations of the State of Washington
C. Wd toe -City of Federal Way.
Owner or agent: Date: Z f
�INAWD I7w/Z3/01
MY OF
Federal Way.
THIS CARD IS TO REMAIN ON -SITE
Construction Ins action Record
INSPECTION REQUF§TS: (253) 835-3050
PERMIT #:
Owner:
09-104963-00-SF Address: 29653 20TH AVE S
MAYRA Y LEMUS FEDERAL WAY, WA 98003-4241
Scheduled inspections may be failed if this card is not on -site. DO NOT LASE 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.
SWM Precon Site Mtg (4400)
Initial Erosion Control (4365)
Underfloor Framing (4285)
Approved
To be done prior to breaking ground
Approved to sheath floor
By
Date I
By
Date
By
Date
Floor Sheathing (4105)
ElShear
Walls (4245)
Roof Sheathing (4220)
Approved to install boring
Approved to install siding
Approved to install roofing
By
Date
By
Date
By Date
❑
Fire/Draft Stops (4095)
Interim Erosion Control (4370)
prior to scheduling a Framing inspection;
Approved
Approved
Electrical, Plumbing & Mechanical Rough -in and
By
Date
By
Date
Fire/Draft Stop inspections must be signed -off and
approved. IBC 109.3.4
[]Gypsum Wallboard Nailing (4130)
Framing (4120)
Insulation (4150)
Approved to insulate
Approved to install wallboard
Approved to install mud & tape
By
Date
By
Date
By Date
Final Erosion Control (4375)
Final - Building (4050)
Approved
Approved
By
Date
By
Date12 - r
Rough Electrical
Approved
Final Electrical
1:1Approved
Right of Way
1:1Approved
By
Date
By
Date
By
Date
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 Wh Avenue South
CITY OF , "4�---- PO Box 9718
Federal Way Federal Way WA 98063-9718
253-835-2607; Fax 253-835835-2609
www.cityoffbderalway.com
INCIDENT DAMAGE CHECKLIST
Case #�� •
Owner's Name: - gg /,w .S Phone: — _
Date of Incident: A " �, —err Date of Inspection: / Z — 23 O 9
Site Address:Ct_�,�_� Gy'�_',Qst•��. __ .
Nature of Incident/Scope of Damage: _Iz "4= �61,44-r Ib pbw7c n��.6 ,_
5�7�7�r:� lS vy 1A.)0d i . �.I� . .1--M. �J. _ � 0 01� Tea A ►ate b`f
(If the value of the damage is greater than 75 percent of the assessed value of the structure, a site plan is required.)
Building Posted:
❑ NO OCCUPANCY ❑ DANGEROUS BUILDING ❑ OTHER
PRequired:
zDING ❑PLUMBING Ml:: 13AN1CAL /ELWTRICAL
Plans Required: ❑ Yes a Plans to Show:
❑ DEMOLITION
Li NOT POSTED
Engineering Required: Yes ❑ No Specifically: ✓—wb S
Demolition Complete: ❑'Yes ❑ No ❑ N/A 2"d Inspection Required: ❑ Yes ❑ No
Permit Application Information Provided to Applicant:
❑ Demolition Permit Application ❑ Building Permit Application
❑ Submittal Checklist ❑ Electrical Permit Application
❑ Other
(253) 835-2_ v t
nspector Phone Number
"APPLICANT: PLEASE BRING THIS FORM TO THE CITY WHEN APPLYING FOR PERMITS*
CITY OF
Federal WaygPRMIT
COMF1UNf tt'nEV WPAIEN• S0WC& P LI CATI O N
359&453Q7.7�FA7C253�835-2608 ��
i141UI'.iifl 1, iYi, •f,lfll'IIItv CV
-SF F CO ME EL PL DE EN FP
1
-... - t-; ,.
- - - PROPERTY =- _ . -• -U,
SITE ADDRESS rT A [' /� x"f4/.��
SUITE/UNIT #
ZONING
ASSESSOR'S TAX/PARCEL 0
3 �-(- 0-- t� C�-
_ -�t _
PROJECT
NAME OF PROJECT
p
1 s
(Tenant or Homeowner Name)
BUILDING PLUMBING MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION El ELECTRICAL El ENGINEERING ❑FIRE PREVENTION
PROJECT DESCRIPTION
Detailed description of work to
be Included on this permit only
PEOPLE
PROPERTY OWNER
NAME
PRIMARY PHONE
MAILING ADDRESS, CITY, STATE, ZIP
E-MAIL
653 c if1 A V S F613Wf
CONTRACTOR APPLICANT PROJECT CONTACT
OWNER IS ALSO:
NAME n,q � 1, �` / �li� � � �,� � ��
J �/. �+
( PRIMARY PHONE
q� �
CONTRACTOR
MADdNG ADDRESS,, CITY, STATE' ZIP
6 qc�5- V1111KCA IV hV MOr fX.Nd
[l y���
-1 f q'u 3 FAX
(111!� ) q,7-5-- F, PEA[
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
Pl u k q_5 7 04
FEDERAL WAY BUSINESS LICENSE #
NANIE
PRIMARY PHONE
APPLICANT
MAEUNG ADDRESS. S ATE, ZIP ✓ /
FAx
62
PROJECT CONTACT
NAME �
PRIMARY PHONE
(The individual to receive and
FAX
respond to all correspondence
concerning this application)
NMLINO. DRESS. C3TY. STATE, ZIP s
(0 3 A v [
ALTVRHATE CONTACT NAME:
nur,unnv manxE
E-MAD.
PROJECT FINANCING
NAME
OWNER -FINANCED
Required for projects with
value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PRIMARY 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 CertVy 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 any claim (including costs, expensest and attorneys' fees incurred
in the investigation and deense of such claim), wlxich may be made by any person, including the undersigned, and filed against the
city, but only where such claim a ' es out of the rel ce of the city, including its ofcers and employees, upon the accuracy of the
irtformation suppiie the c' a part of this appal' anon.
/ C
DATE `
SIGNATURE:
PRINT NAME:
Bulletin #100 — 4/21/2009 Page 1 of 4
k:\Handouts\Permit Application