21-100022City of Federal way
Community Development DepL
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: JACKA
Project Address: 30114 17TH AVE SW
Building - Single Family
Permit #:21-100022-00-SF
Inspection Request Line: (253) 835-3050
Parcel Number: 005070 0110
Project Description: Remove shake roofing and install composition shingle roofing system.
Owner
Applicant
Contractor
Lender
THOMAS JACKA
THOMAS JACKA
ELITE ROOFING & REMODEL
OWNER IS LENDER
30114 17TH AVE SW
30114 17TH AVE SW
LLC
FEDERAL WAY WA 98023-3453
FEDERAL WAY WA 98023-3453
PO BOX 12721
MILL CREEK WA 98082
Census Category: 555 - Non-structural roofing permits 1
Includes:
#1
92
#3
#
Occupancy Class:
, 'e
Construction Type:
Occupancy Load:
Lf
Floor Area (sq. ft.)
Addition it Information too
Mechanical to be Included?....................................I No , Is this an Onli T.C. applica..Lion?.................. YI-s
Plumbing to be Included? .............................. -No
Total Valuation: 44,665.00r
No Fixtures Associated With Thi XM
it H
64
0*?RMIT EXPIRES >I"liday, 5 July, 2021
January 6 2021
Permit Issuerrrdance
day, ry ,
I hereby cert' t the above information ihat the construction on the above described property
rid the o ancy and the use will be iwith the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Ow agent: I t CI ! Date:
4 L 1 =2--
THIS CARD IS TO REMAIN ON -SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 21 100022 00 Address: 30114 17TH AVE SW
Project: KRISTEN JACKA FEDERAL WAY WA 98023-3453
Scheduled inspections may be failed if this card is not on -site. DO NOT LOST: 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.
Roof Sheathing (4220)❑ Final - Building (4050)
Ras� prov d to install roofing Approved
W
By Date By Date
Rough Electrical Final Electrical ❑ Right of Way
Approved Approved Approved
By Date 8y Date By Date
RECEIVED
c DEC 29 2020 PERMIT APPLICATIONr
CITY OF ry r
C11Y OF FEDERAL WAY PERMIT CENTER + 33325 8Lh Avenue South + Federal Way, WA 98003-6325
FCC£ �n'�l f
Federal zr ] GOMUNITYDEVELOPMENT 253-835-2607 + FAX 253-835-2609 + permif:.� ��ate:� ;cityuf(r;deralwac_colr<
{{ 1
PERMIT NUMBER _ e J/
TARGET DATE J f
SITEADDRESS
{ice 3
SUITEIUNIT #
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U1 �f _ 1�/ l.J 1
�..
PROJECT VALUATION
%�
ZONING
ASSESSOR'S TAX/P CEL
0
#
l _ V 0
-.._�
TYPE OF PERMIT
BU1LDq'1El PLUMBINIG/ ❑ MECHANICAL El IDFmoLrr10N ElENGINEEERIING El FIRE PREVEPdTION
NAME OF PROJECT
rY` f��
o
PROJECT DESCRIPTION
^ } 11
Detailed description of ruark to
'
be included on this permit only
VE
il ; �'`�=gym - t#4�.;�
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c7� C�ir� cf[�
1MARY,PRONB
C l� - �? r�
PROPERTY OWNER
MAILING D IL `,
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leer gl p
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750
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I1LING DRESS
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/ .r, Y.. t+ ?. l o
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CONTRACTOR
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srA
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F z as al _ 0 0 r,�
WA STATE CONTR T R''SS LICENSE A
C, "�
EXPIRATION DATE
UEI N .a
'ff H E
APPLICANT
ING?APDRESS 4�'
cPA[ . YrCr1.4�°.A
PROJECT CONTACT
xl ca
ot� t tl d I
nzAr�Ixs} ADA 1
o f
E-
1
E - I e r o
(The individuaZ to receive and
respond to all correspondence
CITY
STATE
ZIP
AX
concenzing this application)
PROJECT FINANCING
NAMECA If_t
1�t OWNER -FINANCED
Lilhen value is .$5,000 or more
(RCW 39.27.095)
MAILING ADDRESS, CITY. TATE, 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) ich may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises ou of th leant" of the city, including its officers and employees, upon the accuracy of the
information supplied the city as a of application_
SIGNATURE:
Q
DATE "
PRINT NAME:
Lr�1 y
Bulletin #100 — February 19, 2020 Page 1 of 2 k:lHandouts\Permit Application
MECH,kNICAL PERMIT
Indicate haw many of each
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
PLUMBING PERMIT
Indicate how many each tt
BATHTUBS (-Tub/Sh.111 omhn)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
to be installed or re!
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
GAS PIPING
as pOrt ❑ thts 7P 1- Dd not in
GAS PIPE OUTLETS
HOODS )Oommcrci d)
HOT WATER TANKS IGas)
REFRIGERATION SYST
WOODSTOVES
to be installed or relocated as
LAVS (fi—d si.kwl
RAINWATER SYSTEMS —
SHOWERS _
SINKS IKiirl:er./ut:::9) _
SUMPS _
RESIDENTIAL -NEW OR ADDITION
AREA DESCRIPTION (in square feet) I EXISTING I PROPOSED
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY,
DECK
GARAGE ❑ CARPORT LI
OTHER (describe) Y ry a1
EXISTING CO
Area Totals
**NEW HOMES ONLY"
ESTIMATED SELLING PRICE $ # OF SEDROOMN
COMINIERCIAL -- NEW ADDIT ON
AREA DESCRIPTION Area an Occupancy Group(s)
-Sauare Feet
NEW BUILDING
AiMITION
CG4. ;IiERCIAL — RFM0DEL/TENIALNT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s)
ware Feet
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
ff this projecp_ Do not in
TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (Electric!
WASHING MACHINES
VALUEOF-MECJ3ANICAL WORK
dude existing fixtures to rem
OTHER (Describe)
VALUE OF PLUMFM'G WORK
ig Tires to rerl
WATER PIPING
OTHER (Describe)
TOTAL FIXTURES
Construction I # of Additional Information
Type Stories
Construction # of Additional Information
Tvoe I Stories
Bulletin # 100 - February 19. 2020 Page 2 of 2 k:\Handouts\Pennit !Application