23-101400City of Federal Way
Commuoiiy Development Dept .
33325 8th Ave S
federal W•y, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: LONG
Building -Single Family
Permit #:23-101400-00-SF
Inspection R~quest Line: (253) 835-3050
Project Address: 2625 S 287TH ST Parcel Number: 746690 0420
Project Description: This is only for a Post Damage Inspection Permit, to inspect damage due to fire.
Owner Applicant Contractor Lender
ALLEN RICHARD LO>iG SARAH RF.RGQUIST
2625 S 287Tll ST 600 UNIVERSITY ST SUITE 1001
f-EDERAL WAY WA SEATTLE WA 98101
98003
Census Category: 434 -Residential alt/add -no change in number of units
Includes: #I #2 #3 ff4
Occuoancy Class:
Construction Tvoc:
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Mechanical to be Included? ..................................... No · 1s this an Online or Q_T.C. application? .................. Yes
Plumbing to be Included? ........................................ No
No Fixtures Associated With This Permit !I
PERMIT EXPIRES Wednesday, 13 September, 2023
Permit Issued on Friday, March 17, 2023
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 · F tgto ~ the City ~f Federal Way .
Owner or agent: b Date : _________ _
CITY OF PERMIT APPLICATION
Federal Way PERMIT CENTER+ 3 3325 8th Av e nue South+ Federal Way, WA 98003 -6325
253 -835-2607 + FAX 253-835-2 609 + p ennitcenter@cityoffederalway.com
PERMJT NUMBER ·i 3. __ ) V _) 4 00 _ ~~
TARGET DATE -------------
SITE ADDRESS SUITE /UNIT I
2625 S 287th Street, Federal Way, WA 98003
PROJECT VALUATCON ZONING ASSESSOR'S TAX/PARCEL#
$ < ---------------------
TYPE OF PERMIT ~!..DING D PLUMBJNG D Ml:>CHANICAL 0 DEMOLITION O ENGIN EERING O F IR E PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION FI V"f' T ).:\ 1M ~ 11P i II\ <:.. 1{} t" r -h' n tA...
0 ' Detai led description. of work to
be included on ,his p ermit only
NAME Allen Richard and Margaret Long PRIMARY PHONE
PROPERTY OWNER MAILrNG ADDRESS E-111AIL
2625 S 287th Street
CITY Federal Way lswA ZIP 98003
NAM£ PHONE
MA!LlRG IU>DRESS E-~IAIL
CONTRACTOR
CITY I STATE ZCP J"AX
WA STAT £ CONTRACTOR'S LICENSE I EXl'lRATIO N DATE UBI#
I I
NAME Sarah Bergquist PRIMARY PHON&
APPLICANT MAILING ADDRESS &-MAIL
600 Universitv St. ~. !itP. 1 nn1
CITY I 6TWA I z98 101 "FAX
Seattle
NAME PRllllARY PHONE
PROJECT CONTACT
{The individual to receive an.d MAILING ADDRESS E-MAIL
respond to all corre spondence
co ncerning this application) CITY I STATE ZIP FAX
NAME D PROJECT FINANCING OWNER-FINANCED
When value is $5,000 or more
(RCW 19.27.09'J)
MAILING ADDRESS, CITY, STATE, ZIP PHONE
1 certify under penalty of perjury that 1 am the property owner or authorized agent of the propgrty owner. 1 certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct·, I certify that 1 will comply with
all applfcable 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 remollf/ the owner's responsibillttJ for compliance with loc al, state, or fedaral laws regulating
construction or environmental laws.
1 further agree to hold harmless tlu! City of Federal Way as to any clatm (including costs, expenses, and attonteys' fees incu.rred in
the lnucstfgation and tufan.se of such elaLmJ, which may be mmb, by any Jnrson, Including the undersigned, and filed agal.nrt the city,
but only whore such claim arises out of the relian c e of the city, Including Its officers and employees, upon the accuracy of the
tnformation supplied to the city as a part of this application .
SIGNATURE: . Sarah Bergquist, p E 0.gilally oigned by Sarall Be<gcµs1 , PE
Dale 2023.03.16 11:23:07-<>700' DATE
PRINT NAME: Sarah Bergguist
Bulleti n # I 0 0 -Feb ruary 19, 2 020 Page I of 2 k:\Handouts\Permit Ap pli ca tion