07-103318j�
l Commun�ityDof Federal ay
eveopmentServices BuAn - Single Family Perm #:.07- 103318 -00 -SF
P.O. Box 9718 g Y
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835 -3050
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Project Name: LARSON
Project Address: 33618 5TH PL SW
Project Description: Remove shake roof and install comp shingles
Parcel Number: 729805 0520
Owner
Applicant
Contractor
Lender
DAVID A LARSON
GARRY BAKER
MOSS MASTERS
DAVID A LARSON
DEBRA LARSON
MOSS MASTERS
MOSSMM *956OW 9/16/07
33618 5TH PL SW
33618 5TH PL SW
11840 RENTON AVE #109
11840 RENTON AVE #109
FEDERAL WAY, WA
FEDERAL WAY WA
SEATTLE WA 98178
SEATTLE WA 98178
98023
98023 -8306
Base" k
New Additioniit - 3rd
Census Category: 555 - Non - structural roofing permits
Includes:
# 1
#2
#3 #4
_e ccupancy Class:
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truction Type:
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" O ancy Load:
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Floor ....... * t
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- ........' ....it
Mechanical to be Included? ......
.............................No
Plumbing to be Included?
......
................................ No
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Friday, June 19, 2009
Permit Issued on Tuesday, June 19, 2007
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and t will be in accordance with the laws, rules and regulations of the State of Washington,
/ and the of Federal Way.
Owner or agent: _L 1" of ZL e Date: 4— lg�� 0 ;T
THIS CARD IS TO RRMAIN ON -SITE ` "
j
CITY OF tommunity Developm t Inspection record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 103318 -00 -SF
Owner: DAVID A LARSON
Address: 33618 5TH PL SW
FEDERAL WAY, WA 98023 -8306
This card is part of your required inspection documents 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.
Final - Building (4050) ❑ Interim Erosion Control (4370)
Approved Approved
By Date By Date
For inspector reference only
O Rough Electrical 0 FINAL - Electrical
Approved Approved
By Date By Date
❑
SWM Preconstruction Site Mtg
❑ Initial Erosion Control (4365)
❑
Underfloor Framing (4285)
Ap ("00)
To be done prior to breaking ground
Approved to sheath floor
—
By
❑
Date
1)Y Date
JDY
Date
❑ Shear Walls (4245)
Floor Sheathing (4105)
❑
Roof Sheathing (4220)
Approved to install flooring
Approved to install siding
Approved to install roofing
By
Date
By Date
By
e-s Date , t -,,J/r'
❑
Fire/Draft Stops (4095)
NOT:Prior o scheduling a Framing (4120)
❑
Framing (4120)
Approved
inspectrical, Plumbing & Mechanical
Approved to insulate
Rough -ie/Draft Stop inspections must be
By
Date
signed -oroved. IBC 109 3.4/UBC 108.5.4
By
Date
❑
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
❑
Final Erosion Control (4375)
Approved to install wallboard
Approved to install mud & tape
Approved
By
Date
By Date
By
Date
Final - Building (4050) ❑ Interim Erosion Control (4370)
Approved Approved
By Date By Date
For inspector reference only
O Rough Electrical 0 FINAL - Electrical
Approved Approved
By Date By Date
city aF
Federal Way C5,jV I? R -M IT a �H
COMMUNITY DEVELOPMENT SERVICES • •� SF MF CO ME EL PL DE EN .FP
33325 870 AVENUE SOUTH • PO BOX 9718x' p L I C A T I Q N TD
FEDERAL WAY, WA 98063.9718 1
253- 835 -2607• FAX 253 -835 -2609 JUN J / .
www.dlyoffederalwau.mm 1
11A1 way
The follaiving is regr lei ni �pitn incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS _ 33Co
14�1 --57-A A, -� ,
ASSESSOR'S TAX /PARCEL #
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate pagelor lengthy IeVW description)
PROJECT • •
TYPE OF PERMIT
PROJECT
, SUITE /UNIT #
LOT SIZE (sj
B'SGILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
(Provide detailed description of work included on this permit onW
PROJECT NAME (Name of Business or Owner Last Name) �SL9Ir
PEOPLE •- •
PROPERTY
OWNER
CONTRACTOR
COPY of card ngairsd
with each appltcattoa
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
AP CANT NAME
PRIMARY PHONE
MAILING ADDRESS f
CITY, STATE, ZIP
E -MAIL ADDRESS
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPI I N DATE
FAX
COMPANY NAME
AP CANT NAME
OFFICE PHONE
MAILINGAD�E� ��� SJ�
GATE,ZI ' ��
CELL PHONE - � iia
[.NUMBER
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPI I N DATE
FAX
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL ADDRESS
1nUs�J�1�Yt r YSI�a LJ
/xr�g,
/Lr'7
VA.. Per RCW 19,27.095.-
,(,� �( Lender information is required if project value exceeds $5,000
EXISTING ASSESSED /APPRAISED VALUE $
SPRINKLERED BUILDING? OYES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER ❑ LAKEHAVEN
PROPOSED USE
VALUE OF PROPOSED WORK
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
• HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
• HIGHLINE ❑ PRIVATE (SEPTIC) j
AREA DESCRIPTI EXISTING PROPOSED TOTAL
S . FT. S . FT. S . FT.
BASEMENT
FIRST
.SECOND
THIRD
ADDITIONAL FLOORS (DESCRIBE)
DECK. (0 COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS suattdo rnoros= TOTAL ToTALXXIsrsroer rorAarsoroes Ar TOM Of
"NEW HOMES ONLY- NUMBER OF BEDROOMS ESTIMATED SELLING PRICE' $
Indicate number of each type of f xture to be installed or relocated as part'of this project. Do not include existing fwures to remain.
MECHAMCAL
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WVH APPLICATION)
AIR HANDLING UNITS
BBQS-
BOILERS
COMPRESSORS
DUCTS '
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOO SETS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (commerdat
RANGES
REFRIG., SYSTEMS
WOODSTOVES
MISC (Describe)
BATHTUBS torTuu /shawercombo)
LAV.S (sau„com Sb*.)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (roikq
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
q YES
I certify under penalty of perjury that the information furnished by me is true and correct to the best of Tny knowledge, and further, that I
am authorised by the owner of .the above premises to perform the work for which the permit application is made. 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 elaiml, which may be made by any person, including the undersigned, and filed -against the City of Federal Way, but only where such claim
arises out of the reliance Of t3iricity, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application. jj
.il A
NAME /TITLE
(signaturey / (Title)
RELATIONSHIP TO PROJECT / ❑ Owner O Agent .CAntractor O Architect O Other
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLX?
DYES a NO .
BASIC PLAN?
D YES"
D NO
ZONING DESIGNATION
CHANGE OF .USE?
q YES
D NO
NEW ADDRESS REQUIRED?
D YES D NO
UP /SEPA /SU?
D YES
D NO
PLATTED LOT?
D YES 'D NO
DEMO PERMIT REQUIRED?
o YES
D NO
Bulletin #) 00 — April 2, 2007 . Page 2 of 4 MandoutslPermit Application