23-104970City of Federal Way
Community Development Dept
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: CLARK
Project Address: 30255 25TH AVE SW
Building - Single Family
Permit #:23-104970-00-SF
Inspection Request Line: (253) 835-3050
Parcel Number: 893760 0180
Project Description: Tear off (1) layer of cedar roofing - to be replaced with composition. Plywood to be replaced
Owner
Applicant
Contractor
Lender
STEPHANIE CLARK
SARAH POWERSSTATE ROOFING
STATE ROOFING INC
30255 25TH AVE SW
INC
PO BOX 53
FEDERAL WAY WA 98023
431 N KELSEY ST
MONROE WA 98272
MONROE WA 98272
Census Category: 555 - Non-structural roofing permits
Includes:
#1
92
#3
#4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Mechanical to be Included? ............ I ........................ No
Plumbing to be Included? ........................................ No
Total Valuation: 61,465.00
Is this an Online or O.T.C. application? .................. Yes
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Monday, 8 April, 2024
Permit Issued on Wednesday, October 11, 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'FLEc'ty of Federal Way.
Owner or agent: Date:
A
CITY OF
Federal Way
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 23 104970 00 Address: 30255 25TH AVE SW
Project: STEPHANIE CLARK FEDERAL WAY WA 98023-2316
Scheduled inspections maybe failed if this card is not on -site. DO NOT LOSE T111S 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 Roof Sheathing (4220) Q Final - Building (4050)
Approved to install roofing Approved
By Date By C) Date
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Rough Electrical
ElFinal
Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
rntt,Cf Vk: 3
OCT 05 2023 PERMIT APPLICATION
CITY OF F MY OF FEDERAL WAY
Federal 1Na PERMIT CENTER + 33325 8� Avenue South +Federal Way, WA 98003-6325
MUNrr�' DEVELOPMEI�Fi' 253-835-2607 + FAX 253-835-2609 + permitcenter a cityoffederalway.com
PERMIT NUMBER `Z-1D t-to 4o ..
TARGET DATE
SITE ADDRESS
os 5 25 -►�„�. Svc/
PROJECT VALUATION ZONING
$
TYPE OF PERMIT 2 BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
d" V ,v'q�v'I�Z3
ASSESSOR'S TAIL/PARCEL #
NAME�� 1 e, M1
PROPERTY OWNER LING ADDRESS
0ZS� 2� Ai./
CITYSTATE ZIP
YV �C f
CONTRACTOR
APPLICANT
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
SUITE/UNIT #
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PRIMARY PHONE
33
E-,MAIL
MAILING ADDRESS
CITY
fnwa
STATE
,
ZIP
L1 J V
FAX
WA 9T T ONTRACTOR'S LICENSE tl
EXPIRATION DATE
LP / 30 /T4
UBI #
(POU-326 2
N� �dUvS
RI Y PHONE
53 3 (a I
-'E-�25
MAILING ADDRESS
PO
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CITY
u1 i
T�V
FN
NAME
1
PRY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE I ZIP
FAX
PROJECT FINANCING NAME ❑ OWNER -FINANCED
When value is $5,000 or more MAILING ADD 9 TE, ZIP PHONE
(RCW 19.27.095)
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 Lag 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 afficers and employees, upon the accuracy of the
information supplied to the apart of this application.
aqu��SIGNATURE: DATE
PRINT NAME:
Bulletin #100 — February 19, 2020 Page I of 2 k:\Handouts\Permit Application