18-105195City of Federal Way
Community Devdopmeat Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835.2607 Fax (253) 835-2609
Project Name: NGUYEN
Project Address: 31527 27TH AVE SW
Building - Single Family
Permit #:18 -105195 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 122103 9157
Project Description: REP - Inspection of fire damage. ***NO construction work approved under this permit***
Owner
Applicant
Contractor
Lender
TUY THI NGUYEN
TUY THI NGUYEN
PO BOX 88204
PO BOX 88204
SEATTLE WA 98138
SEATTLE WA 98138
Census Category: 434 - Residential alt/add - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: T V - B
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Occupancy #I -Construction Type ......................... Type V - B Mechanical to be Included? ..................................... No
Is this an Online or O.T.C. application? .................. Yes Plumbing to be Included? ........................................ No
Occupancy #1 -Use ................................................ Residence (1 or 2
si
PERMIT EXPIRES Tuesday, 30 April, 2019
Permit Issued on Thursdav, November 1, 2018
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: GAG Date: A
RECEIVED
NovPERMIT APPLICATION
CITY OF � O ZO10Qp
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal Way CITY OF FEDERAL WAy 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER J x _ S1 —43 _ TARGET DATE
SITE ADDRESS � � 7 ve
I�
v - � v
SUITE/UNIT #
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAX/PARCEL #
522 0
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
( (�} Imo( A
be included on this permit only
NAMEPRIMARY
_
PHONE
"v,6 53 _ 77
PROPERTY OWNER
MAILING ADD
60X 92
E-MAIL
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NAME tv EP
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
MAILING ADD �6
E-MAIL
APPLICANT.
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 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,
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 ap i
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SIGNATURE: DATE i(N v , M `, �/ d ,
PRINT NAME: -7-6&t4 A l G3/Lt. ,eg t