04-103778 cmoF` ..
Federal Way • - 0 3 _7 1- R
PERMIT SF(O ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8*„AVENUE SOUTH.PO BOX 9718 SEP APPLICATION
FEDERAL WAY,WA 9803-9778 -TD /
253-835-2607•FAX 253-835-2609 - /
unuwatgoffederahuaqcom
r(Tv f).r- -tsr-
The following is required information-an incomplete ap.lication will not be accepted. Please print legibly(in ink)or type.
2 I. PROPERTY INFORMATION
SITE ADDRESS S Z z 3�� ?LA c.� � �' SUITE/UNIT# `�
rs+
ASSESSOR'S TAX/PARCEL# ( 3 I - 0 3 3 0 LOT SIZE(sf)
-t{e J 4 t
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desriptioo)
. . >.,. , >":. ■..PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL D ENGINEERING D FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onit)
,4-ter?s- .2 LA,/ e�f tJ r ire,0A 17 L y t ..-...--,-1 M"0 :_i-i.)S in-i f )�►;..J ;::i.1{L
C s c5i'rio* +,) OOF SySikwl t,J,rt-F /4.6A€. 12E-5;s—irt Q.,-AL\Tlt2' ,
PROJECT NAME(Name of Business or Owner Last Name) CA AA pui, V Q-teE. 1
• PEOPLE INFORMATION
PROPERTY NAME ,.., PRIMARY PHONE
OWNER i�o zo,(t. ,ze,f)i,t2^1Ri�emE.A.)— (257, ) (L35 -S02,L
MAILING ADDRESS CITY,STATE,ZIP
i 10; 5, ' 14:+k Sc. du•rle "C " Yc0E(!A, WA-1 , W4 1..),--c,r5
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
140 -r14\ALST Ism r12-v10ic -►1I 4. 3 k)ic7i) (1 t (.2c, ) ;``) - mi.: ',
MAILING ADDRESS CITY,STATE,ZIP _ CELL PHONE
PD. \�;,X 1641 4, 6,30035 ( z . ) 42..3 - `3L,,)Gi
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - - B L / / (o24;3 ) qsc 77Sbt1
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE
S .042- T \1 \' S o 2, 2 D .._4 )O / i5 / OS
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
CO ts)7 (IAC (- ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT NAME _ PRIMARY PILON E-MAIL ADDRESS
A� C�iQ (; O(R) 423 - )�i
LENDERPer RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
.■ DETAILED BUILDING INFORMATION ,
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 02t 0 010 `�
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
: . • P-OJECT FLOOR AREAS
--"_-
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
•
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
TOTAL EXISTING
TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
HOW MANY FLOORS?
"NEW HOMES ONLY"` NUMBER OF BEDROOMS
ESTIMATED SELLING PRICE $
s . FIXTURES -
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 $
REFRIG.SYSTEMS
BBQS
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGSREF G.SYSTEMS
FANS HOODS(commerd.')
VES
RANGES MISC(Describe)
BOILERS FIREPLACE INSERTS
COMPRESSORS
FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING WATER CLOSETS(-rode) MISC(Describe)
BATHTUBS(or Tub/Shoms«comtol SHOWERS
SINKS DRINKING FOUNTAINS
GAS PIPEEHERS OUTLETS SUMPS
DISHWASHERS
RAINWATER SYST
WASHING MACHINES
URINALS HOSE BIBBS
ELECTRIC WATER HEATERS
LAVS(sactvoomsi.ilcs) VACUUM BREAKERS
MSCLAIMER/SIGNATUREBLOCK
I certify under penalty of perjury tha the information furnished by me is true and correct to the best of my knowledge, and ficrther, that Iam
authorized work for which the permit
cation
made. I
ht
e City of Federal Way as o•ny premises costs, expenses,(including , and attorneys fees incurred is further agree hold
urred inthe nvestigationanddefense
harmlessof
such claim), which may be made by • y •-rso ,includ• g the undersigned, and filed against the City of Federal Way,but only where such claim
arises out of the reliance of the city n.. di its off ers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
/ DATE
NAME/TITLE \)% q/Z4 Oc
(Sign. (Title(
RELATIONSHIP TO PROJECT ■ Owner o Agent 0 Contractor ❑ Architect ❑ Other
F
E FOR OFFICE USE ONLY I
IMPROVEMENT
o NEW o ADDITION ❑ALTERATION o REPAIR a TENANTDYES a NO
BUILDING SHELL ONLY? o YES o NO BASIC PLAN?
E CHANGE OF USE? ❑YES o NO
ZONING DESIGNATION D yES ❑NO
1 NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU?
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? DYES a NO
Bulletin#100—March 30,2004 — Page 2 of 4 k\liandouts—Revised\Permit Application
City of Federal Way I
Community Development Services Building - Multi Family Permit #: 04 - 103778 - 00 - MF
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 &'ll
Project Name: CAMPUS GREEN I,BUILDING 10
Project Address: 532 S 321ST ST Bldg10 Parcel Number: 132150 0330
Project Description: ALT-Tear off 2 layers of composition. Install a new Owens Corning 30-year algae resistant
composition roof system.
Owner Applicant Contractor Lender
PROTOCOL PROPERTIES NORTHWEST ROOF SERVICE INC NORTHWEST ROOF SERVICE INC PROTOCOL PROPERTIES
1703 S 324TH ST SUITE C PO BOX 1697 NORTHRS088DW 10/14/05 1703 S 324TH ST SUITE C
FEDERAL WAY WA 98003 KENT WA 98035 PO BOX 1697 FEDERAL WAY WA 98003
KENT WA 98035
Includes:
Census category: 555-Non-st #1 #2 #3 #4
Occupancy Group: R-1
J
Construction Type: r Type V-N F P--
Occupancy Load:
FloorFArea(Sq.Ft.): — __
Census Category 555-Non-structural roofing p Mechanical No
Plumbing No Zoning Designation RM 1800
PERMIT EXPIRES March 19,2005.
Permit issued on September 20,2004
I hereby certify that the above info ation is correct and that the construction on the above described property and
the occupancy and the use will .; accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: 1
mils
DATE INSPECTOR AREA AND TYPE ( ,INSPECTION
THIS CARD IS TO,MAIN ON-SITE •
CITY OF " tommunityDevelopmentInspection Ins ection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103778-00-MF
Owner: PROTOCOL PROPERTIES
Address: 532 S 321ST ST Bldg 10
FEDERAL WAY, WA
This card is part of your required inspection documents. Scheduled inspections maybe 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.
❑ Footings/Setback(4110) ❑ Foundation Wall(4115) 0 Drainage/Downspout(4040)
Approved to place concrete Approved to place concrete Approved to backfill
By Date By Date By Date
❑ Re-steel(4215) 0 Plumbing Groundwork(4190) 0 Slab/Concrete Floor(4255)
Approved to place concrete or grout Approved to cover Approved to place concrete
By Date By Date By Date
o ..
• Underfloor Framing (4285) • �❑ Floor Sheathing(4105) [0_ Shear Walls (4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date _ By Date ) By Date
•❑ Roof Sheathing(4220) ❑ Fire/Draft Stops (4095) NOTE: Prior to scheduling a Framing(4120)
Approved to install roofing Approved inspection;Electrical,Plumbing&Mechanical ,
IRough-in and Fire/Draft Stop inspections must be '
By Date f Q.( 4/ By Date signed-off and approved. IBC 109.3.4/UBC 108.5.4
.......Li
.❑ Framing (4120) 0 Insulation (4150) ❑Gypsum Wallboard Nailing (4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date By Date By Date
❑ Suspended Ceiling Grid (4265) 0Final- Fire Department(4060) ❑ Final-Planning (4070
)
Approved to drop tile Approved Approved
By Date By Date By Date
O Final-Public Works(4080) ❑ Final-Building(4050)
Approved �Approved T
By Date By 4" iate /1(_/