05-104146City of Federal Way
Community Development Services b Single Building - SinQle Family Permit #: 05 - 104146 - 00 - SF
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -7000 Fax: (253) 835 -2609 Inspection request line: (253) 835 -3050
Project Name: NAM
Project Address: 320211 ITH AVE SW
Parcel Number: 926493 0880
Project Description: Removal of existing shake roof. Installation of new 50 year composition shingle. Not removing
sheathing, but installing plywood over skip sheathing.
Owner
Applicant
Contractor
Lender
Kyung S Nam
NORTHWEST ROOF SERVICE INC
NORTHWEST ROOF SERVICE INC
NONE
32021 11TH AVE SW
PO BOX 1697
NORTHRS088DW 10/14/05
FEDERAL WAY WA
KENT WA 98035
PO BOX 1697
98023 -5549
KENT WA 98035
NONE
Includes:
Census category:
Occupancy Groul
Construction Tin
Occupanc4J41 -W
Floor Arefi-f n
#3
#4
This parcel is located within a Wellhead Protection Area (Capture Zone 1) and must comply with FWCC, Chapter 22,
Article XIV "Critical Areas" and fill out a Hazardous Materials Inventory Statement, if applicable.
PERMIT EXPIRES February 13, 2006.
Permit issued on August 17, 2005
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 Washington and
the City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON -SITE
CITY OF Wommunity Develop t Inspection Record
p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 05- 104146 -00 -SF
Owner: KYUNG S NAM
Address: 32021 11TH AVE SW
FEDERAL WAY, WA 98023 -5549
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.
❑
Temp. Erosion Control (4365)
❑ Plumbing Groundwork (4190)
❑
Underfloor Framing (4285)
To be done prior to breaking ground
Approved to cover
Approved to sheath floor
By
Date
By Date
By
Date
❑ Shear Walls (4245)
❑
Roof Sheathing (4220)
0
Floor Sheathing (4105)
Approved to install flooring
Approved to install siding
Approved to install roofing
By
Date
By Date
By
4C t Date - L,2 • v
NO or to scheduling a Framing (4120)
❑
Framing (4120)
❑
Fire/Draft Stops (4095)
Approved
inspectElectrical, Plumbing & Mechanical
:and
Approved to insulate
Rough -i Fire/Draft Stop inspections must be
By
Date
signed -of approved. IBC 109.3.4/UBC 108.5.4
By
Date
'0 Gypsum Wallboard Nailing (4130)
❑
Insulation (4150)
❑
Final - SWM (4375)
Approved to install wallboard
Approved to install mud & tape
Approved
By
Date
By Date
By
Date
Li Final - Building (4050)
Approved
By e_—CA) Date " r
Erosion Maintenance
Approved
By Date
RECEIVES ��°� �
CITY of
Federal Way PERMI'UG 17
COMMUNITY DEVELOPMENT SERVICES SF F CO ME EL PL DE EN FF
33325 8" TM AVENUE SOUTH • PO BOX 9718 E RAL W
FEDERAL WAY, FAX 98063-9718 -260 AP P LI CATION DEPT.
253- 835 -2607• FAX 253 - 835 -2609
u>tr>u>, ctUtol fgderalwaa. rotn
The ollowin is re uired information - an incomi2lete a i2lication will not be acce ted. Please qrint le ibl (in ink) or
PROPERTY INFORMATION
SITE ADDRESS 7 tV �. J ..� SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # - LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Altach separate page for lengthy legal descriptioN
TYPE OF PERMIT /BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
PROJECT NAME (Name of Business or Owner Last Name)
PROPERTY
OWNER
CONTRACTOR
IVA
APPLICANT
CONTACT
LENDER
PEOPLE INFORMATION
NAME
K "
APPLICANT NAME
OFFICE PHONE
PRIMARY PHONE
( 2-55 -3) *35-
-D`tX7
MAILING AD RESS ,,.
3 aoIt
ti+1. AVC- 5
CITY, STATE, ZIP
as-e�0
el2.
N E ,
C,d (
PRIMARY PHONE
20 Ark, - 2-
E -MAIL ADDRESS
Per RCW 19,27.095: Lender ir(formation is
required tf project value exceeds $5,000
NAME i q
Pi JA
COMPANY NAME
CITY, STATE, ZIP
APPLICANT NAME
C'
OFFICE PHONE
(a-57) X57
- 0Y03
4el
MAILING ADDRESS
CITY, STATE, ZIP
)r �. & �� 3
CELL PHONE
(- o b) )0
CITY OF FEDERAL WAY
-Q 3
BUSINESS LICENSE NUMBER
-1 Q 1 J -B
EXPIRATION DATE <
/
FAX NUMBER C
(/�l)�J0
/
- 3591
L J
CON'TRACTOR'S REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION
DATE
o C±
-�r 5 2 -f 2- Pu%
l0 /i5--
/aocl
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT -
❑ Architect ❑ Tenant Agent ❑ Other (Describe)
FAX NUMBER
N E ,
C,d (
PRIMARY PHONE
20 Ark, - 2-
E -MAIL ADDRESS
Per RCW 19,27.095: Lender ir(formation is
required tf project value exceeds $5,000
NAME i q
Pi JA
MAILING ADDRESS
CITY, STATE, ZIP
/PHONE
1 ) -
EXISTING USE —Y IA4 [-e-- F64AA l t1 H C « e, PROPOSED USE i L►ti"I �-- yy
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK AI I . q co, tc
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 13 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
J
J .
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING
PROPOSED
TOTAL
TOTAL EMTWG 8F
TOTAL PROPOSED 8F
TOTAL SF
1—NEWHOMES ONLY ** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (or 7\tb /Shower Combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bathroom Sinks)
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (Commercial)
RANGES
GAS WATER HEATERS
WATER CLOSETS rrwet) _
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized 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 claim), 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 the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application. "'' j�
NAME /TITLE -r r0 &c ` C�V1 `d 6- - 4 DATE �✓' C� / d
(Signature) Mtle) �
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ri"Contractor ❑ Architect ❑ Other