21-102853City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: CAMPUS VIEW FOURPLEX 38
Project Address: 34120 1ST PL S
Project Description: Tear off & reroof with some sheathing replacement.
Building - Multi Family
Permit #:21-102853-00-MF
Inspection Request Line: (253) 835-3050
Parcel Number: 132201 0380
Owner
Applicant
Contractor
Lender
SHACKLETON BRIAN L LIVING
ALISA BERKLANDNORTHWEST
NORTHWEST ROOF SERVICE INC
OWNER IS LENDER
TRUST
ROOF SERVICE INC
801 CENTRAL AVE N
385 LINGENBERRY LN SUITE A
801 CENTRAL AVE N
KENT WA 98032
SOLOTNA AK 99669-8041
KENT WA 98032
Census Category: 434 - Residential alt/add - no change in number of un\s
Includes:
# 1 #
#3
4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
-rdditional Permit InformatNN
Mechanical to be Included? ..................... .... No Number a ries.................... I
Is this an Online or Q.T.C. application?.................. No Permit wilding Shell Only? .............................. No
Plumbing to be Included? ........................................ No
Total Valuation: 2 0.0
No Fixtures Associated Ah This Permit li
PERMIT E3 Monday, 10 January, 2022
Permit is on Wednesday, July 14, 2021
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. he irt.,�ord�knr with the laws, rules and regulations of the State of
Washir7gtgn,-and the City of Federal Way.
{
Owner or agent: Date
THIS CARD IS TO REMAIN ON -SITE
Feder Federal THIS
Inspection Record
y INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 21 102853 00 Address: 34120 1ST PL S
Project: SHACKLETON BRIAN L LIVING Tl FEDERAL WAY WA 98003-6562
Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE 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.
Q hoof Sheathing (4220) 2❑ Final - Building (4050)
p NNAp sed [o install roofing Approved
BVy— P � Date . j . � By Date
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
Federal Wad o u°� o� OPMENT
PERMIT A•PPLICA'T`ION
PERN11T CENTiIR + :33325 81)' Avenou Sr Ul% + Federal Vlay, WA 95003-632'
253-835.2607 + RAX 253-855-' 6G9 + 1'ermitrenlelr :ty.offe[ieralwav,com
PERMIT NUMBER" ✓ l 3 �(�
v TARGET DATE �"
SITE ADDRESS - -
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PROJEUT VALUATION ZOMUG ASSr3 Ult'S TAX 1i( SSL w
TYPE OF PERMIT $UILI)iNG l ] PLUMBiN& C, U MEMIANICAL 0 E)Fm,)txrloN 0 ENGINEERING L; }SIREPREVF.,Nl'IUN
NAME OF PROJECT E k kf,Q4pj i, Ainlw'm
PROJECT DESCRIPTION
Detaii�:d description ni"work to
be inchided on this pennit only
PROPERTY OWNER
CONTRACTOR
APPLICANT
NAME
• LY Lt/I ���'�r�
MALL[ apnFZ.�'Ss - +A
NAME,
MAILING Anti] '
CITY
WA s ATAATTTE CONTRACTOR'S LIL'ENv
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MAILING ADDRf::Sa
CIT'i �-
NAME
P>zo,Il;cT conTlic'r
MY
(""he inch'✓iduai to receive. and.
MAILING APP S5
respond to a.li correspondence
C �'rt• ") L �.i 1
coric0rrrny this applwaliortj
CITY
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FROJLCT FINANCING
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STAT1's I 'Ir
STATE:
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FAX
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FEDERAL WAY BUSINESS UMNSB; N
PRIMARY PHONE
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FAX
PRIMARY I'lioNE��---�
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FAX
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PHONE
I certify unrier penalty of perjury that I um the property owner or authorized agent of the property owner. I certify that to trio best
of my knowledge, the informatiori submitted in supportt of this permit application is true; and correct. I certij'y that I will camply witlt
all applicable City of Feaeral Way regulations pertaining to the work authorized by the issuance of a per'rtit. I understand that the
issuance Of this per'ntit does not remove the owner's resporaslbility for compliance with local, state, or, federal laws regulating
construction or environmental laws,
I further agree su: hpltd harmless thu City afFuderal Way as to any claim (incliidiriy costs, crl"MMs, and tieterneys' fees incurred in
fire rnvttstifjatien and defense of wtch claimj, which may be math by arty person, lac&irling [i:a Icndr rstl1ned, artd ftictt against the city,
but only where Bitch claim arlses vat of the reliance of tliP city, i electing its Officers rind amplpyees, upon the accuracy of tha
information supplied to trte city al a pitl't Of t • appIicatid .
r
SIGNATURE: f
4 r� DA•rLI � C�
PRINT NAhIE;
Bid 1011:1, li0") - Tani€h1.y29, 2,015 'tlpc 1 sai 2 k:lHnndi)uis\i'ennit Applichtion