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05-102945 Tc 21M R r‘Federal Way 1V p - . PERMIT F CO ME EL PL DE EN FP COWMAN 81VENUE SOUTH•PO 971 I'A I 33325�AVENUE 06 9BOX 97I�(,1 fit_ 253-83S-2607•FAX 253-8351602 ? r zA�P P LI CATI O N iyww.dtuotfedsralwatt. ITY Qr'FIIFEDERAI The ollowi • is re• $ii ed Tin'. ••: •, aYn inco •fete a••lication will not be acce•ted. Please •Tint le•ibi in i or ■ PROPERTY INFORMATION SITE ADDRESS 3 3 4 3'i 7 P) 5& SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - _ _ _ LOT SIZE(sj) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach reparate page for lengthy legal description) ■ PROJECT INFORMATION TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) RQS/X4trt4'1,,AP : g-C--`rat G ska , will. c cry P/ wo e9( etVR-e- .k ;p sA ,s47..11 Cov . bJI111 A sio PROJECT NAME(Name of Business or Owner Last Name) k.A►•`a►' • PEOPLE INFORMATION PROPERTY NAME �� PRIMARY PHONE OWNER Jc.c. k C,-.I €l14,.4A ( ) - MAILING ADDRESS CITY,STATE,ZIP 33634{ 1 Pl Sw lccd'& / w‘-i qga23 CONTRACTOR COMPANY NAME APPLICANT NAME . _M OFFICE PHONE Pl A h N ox P.Drt J E.v.Ic.ST ZIP j ATE, CELL PHONE MAILING ADDRESS 13/ . ttV''" S')'' NL ) Afr■bu.ry. tAA gi6ol (,L64)660 1.-7 4_3 art OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER - _ -B L / / ( ) - CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE I / APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE 1a4�1I11wv1n �oaE ert< De 1.414 _ ( ) - AILINGG ADDR(ESSS /� /C�CITY,STATE,ZIP J CELL PHONE !31 1 "V ', .5* -7 I W Au 6irr1 jigl$) 147601 (Za )lhc RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect o Tenant ❑Agent ❑ Other(Describe) ( ) - CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS C r-i c lie (zcL) 6611 - &h t13 LENDER ,.,d•l,: f'- ;0,.m ,.1,.'r r 1;(4,r,,,,..-,..r.17, 7 NAME MAILING ADDRESS CITY,STATE,ZIP • DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK ($ 2) Da o°— f ' SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES o NO WATER SERVICE PROVIDER ❑ LAKEHAVEN a HIGHLINE ❑TACOMA ❑PRIVATE(WELL) SEWER SERVICE PROVIDER O LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL _ SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE ❑ CARPORT❑ RIIt81IX0 PROPOSED TOTAL ..5�„uL'T2 NUMBER OF FLOORS **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of facture 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 EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS . FANS HOODS(eomme,ef4 WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS toilet) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(eathroomStai s) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK 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. NAME/TITLE DATE (Signature) (Title) RELATIONSHIP TO PROJECT ❑ Owner ❑Agent ❑ Contractor ❑ Architect ❑ Other � 14: i,)4•tF.rj, ta 4 c)fi atlt ; ? § lie t�5�� tfT i�a�reF�4¢�it� Sl.I ©�� j�(�� .. a_ a l e7r7 7 y pro c zf } : f° �. „. t,; ee56©X3r r�i `t}}� a�� Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application i W Cmmuni B Way Building - Single Family Permit #: 05 - 102945 00 SF Community Development Services P.O.Box 9718 ik Federal Way,WA 98063-9718 Ph:(253)835-7000 Fax:(253)835-2609 * ' Inspection request line: (253) 835-3050 Project Name: GOLDMAN Project Address: 33634 7TH PL SW Parcel Number:729804 0380 Project Description: Residential re-roof shake to comp; re-sheathing Owner Applicant Contractor Lender Jack Goldman PLATINUM ROOFING PLATINUM ROOFING NONE 33634 7TH PL SW 1319 V ST NW platir1961p6 10/26/06 FEDERAL WAY WA AUBURN WA 98001 1319 V ST NW 98023-5004 AUBURN WA 98001 NONE Includes: Census category: 555-Non-st L #1 #2 #3 #4 Occupancy Group: R-3 Construction Type: Type V-B Occupancy Load: Floor Area q.Ft);, Census Category :.. ,..., 555-Non-structural roofing p Mechanical 'Y Occupancy#1-C ..1.,..-,, R 3 Plumbing d R PERMIT EXPIRES December 18,2005. Permit issued on June 21,2005 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: // 6 Z r e 44) f/47 J THIS CARD IS TO WAIN ON-SITE CITY OF Pommunity Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-102945-00-SF Owner: JACK GOLDMAN Address: 33634 7TH PL SW FEDERAL WAY, WA 98023-5004 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 ❑ Floor Sheathing(4105) ❑ Shear Walls(4245) a Roof Sheathing(4220) Approved to install flooring Approved to install siding Approved to install roofing By Date By Date Bye s Date (Q 234,,s,J ❑ Fire/Draft Stops(4095) NOTE Prior to scheduling a Framing(4120) l ❑ Framing(4120) Approved inspection;Electrical,Plumbing&Mechanical Approved to insulate Rough-in and Fire/Draft Stop inspections must be By Date signed-off and approved. IBC 109.3.4/UBC 10854 By Date ❑ Insulation(4150) ❑Gypsum Wallboard Nailing(4130) ❑ Final-SWM(4375) Approved to install wallboard Approved to install mud&tape Approved By Date By Date By Date. ❑ Final-Building(4050) ❑Temp.Erosion Maintenance(4370) Approved Approved By Date By Date