17-104494City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835.2607 Fax (253) 835-2609
Project Name: SIMPSON
Building - Single Family
Permit #:17 -104494 -00 -SF
Inspection Request Line:
Project Address: 31604 12TH AVE SW
Project Description: REP - Remove existing roof system and sheeting. new
shingle roof system `
416810 0320
and Malarkey Vista
Owner
Applicant
t ctor
Lender
ROBERT F SIMPSON
FIELDS ROOF SERVICE INC
FI OOF SE
SZ
OWNER IS LENDER
31604 12TH AVE SW
25924 78TH AVE S
`25 4 78
FEDERAL WAY WA
KENT WA 98032
, KENT 98032
98023-4706
_,
Census Category: 555 - N�stru = r permits
Includes: #1 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.) 0.
Mechanical to be Included?.............I
Plumbing to be Included? ....................
Total Valuation: 14,511.00 i
I herell
and
Owner or nt:
Mormation
Is this an Online or O.T.C. application? .................. Yes
.00- Jr
rIRES Sunday, 18 March, 2018
on Tuesday, September 19, 2017
/n is correct and that the construction on the above described property
be in accordance with the laws, rules and regulations of the State of
hington pd the City of Federal Way.
Date: �� l7
,. THIS CART) IS TO REMAIN ON- SITE
arr COW
Federal Way Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERIMT #: 17104494 00 Address: 3160412TH AVE SW
Project: ROBERT F SIMPSON FEDERAL WAY WA 98023-4706
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections atelisted 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 we loured on the back of this cant
El
Roof Sheathing (4220)D
Final - Building (4050)
Approved to install roofing
Right of Way
Approved
By
JV4 Date 1011 1111By
Date
13
RougAh�Elec rical
Right of Way
Final Electrical
Approved
Approved
By
Date
By
..Date. ..
By
- Date
CITY OF 'A
Federal Way
PERMIT APPLICATION
PEREIIT CENTER + 33325 8th Avenue RE �7 U ,IWA &D3-6325
253-835-2607 FAX 253-835-2609 + permitcenter(aitvoffederalway.com
SEP 19 2017
PERWT NUMBER � �- � v � 4914 - S��CfTY OF FEDERAL WAY
TAROET DATE COMMUNfTY DEVELOP'MEN'T
SITE ADDRE�S(S�
BUTTE/UNIT 0
+ JI
�10/1 )Q ^ 1 � S- vJ
PROJECT VALUATION
$
ZONMO
ASSESSOR'S TAR/PARCEL •
H -L Le I v- 0� 2
TYPE OF PERMIT
� BUILDING ❑PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT—
PROJECT DESCRIPTION
Detailed description of work to
j
V)Abe
included on this permit only
WAKE
PRDIIARY PHONE
PROPERTY OWNER
KJ4MI G ADDRESS I
ItKAM
QII'Y
STATE
ZIP
VIP
aL
�
NniL j rvVf:._
PHONE
fuanra wDDREee
Ll "1 Frn fl-rc1 5
aarAn
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CONTRACTOR/54710
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(BUSINESS
WA STATE CONTRACTOR'S LICENSE •
ERP%RATION DATE
FEDERAL WADY LICENSE I
PRnfARY PHONE
APPLICANT
NAMING ADDRESS
E-KAU.
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
PRDfARY PHONE
VINO ADDRESS
E-1fAD. �
(Me individual to receive and
respond to all correspondence
��
CITY
BTATE
ZIP
FAX �Um
concerning this application)
PROJECT FINANCING
NAItE
❑ OWNER -FINANCED
When value -is $5,000 or more
(RCW 19.27.095)
KAnjN0 AD , CITY, STATE, ZIP
PHONE
I cert(& under penalty of perjury that I am the property owner or authorised agent of the property owner I cert(N that to the best
of my knowledge, the ir{jormation submitted in support of this permit application is true and correct. I cert(fy that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorised 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 parson, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its ulcers and employees, upon the accuracy of the
ir}formation supplied to the city as a part of this application.
H rr `�,
SIGNATURE: s C/ �j DATE p� \ ` !�v
PRINT NAME:,
Bulletin #100 - January 29, 2016 Page 1 of 2 kAHandouts\Permit Application