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THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 102845 00 Address: 125 SW CAMPUS DR Bldg 19
Project: N/A CEDAR HEIGHTS-52 FEDERAL WAY WA 98023
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.
v Initial Erosion Control(4365) ' El Footings/Setback(4110) al Foundation Wall(4115)
To be done PRIOR to breaking ground Approved to place concrete Approved to place concrete .
By Date By Date By Date
•
El Drainage/Downspout(4040) I 5❑ Re-steel(4215) ; ® Slab/Concrete Floor(4255)
Approved to backfill I Approved to place concrete or grout I Approved to place concrete
1
By Date ' By Date I By Date
❑ Underfloor Framing(4285) ' ® Floor Sheathing(4105) ® Shear Walls(4245)
Approved to sheath floor Approved to install flooring Approved to install siding
.By Date 'By Date By Date
D Roof Sheathing(4220) ; El Fire/Draft Stops(4095) 12 Interim Erosion Control(4370)
Approved to install roofmg Approved Approved
By Date ' By Date By Date
Prior to scheduling a Framing inspection; 0 Framing(4120) ® Insulation(4150)
Electrical,Ph►mbiag&Mechanical Rough-in Approved to insulate Approved to install wallboard
and Fire/Draft Stop inspections must be sued-
off and approved. IBC 1093.4 By Date By Date
..
•rn 5 Gypsum Wallboard Nailing(4130) ® Suspended Ceiling Grid(4265) ID Final-SKF&R(4060)
Approved to install mud&tape Approved to drop tile Approved
4By Date ;`By Datee.By Date
El Final Erosion Control(4375) ® Final-Building(4050)
Approved ; Approved
.By Date . By<ric Date 7-4 3—C7
El Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED 21 ��
�ITMaF - PERMIT APPLICATION
��/����' Way
` JUN 1 3 201/ PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
a+t Y V y 253-835-2607 +FAX 253-835-2609 +pennitcenter@cityoffederalway.com
CITY OF FEDERAL WAY
COMMUNfTY DEVELOPMENT
PERMIT NUMBER J _ 1 V 7... — '-7
/
_ ((JJ TARGET DATE. 41/ 01 1
SITE ADDRESS TE/UNIT#
1.S- S, i ). Cam()AAs I3r SU1 l
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ AX CE
OCJC), CI, i 9 z I G 41 - 9 Q ± 7
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION "
NAME OF PROJECT A Uer\' + f/Q.
ae,-e1
PROJECT DESCRIPTION I Pte- C1 ! 1)04A kll\e 1. Cr T A:rc h'r- nirIC) ?z'' f.)P/ / ' G
Detailed description of work to Reo c,ce cal,/ nac r - eJ -/,, G(J.-he (, e 1
be included on this permit only r�� I l v t 1 L i� g� 1
t G1 /1 .0 1S 14 �� T 4111( �. )( ilJr: E�I�C'A j1{'(�l on fe,'`e.s.?eGtIeJ
TI`Al/ neUl- 3G `iii. Lamrltii • Sk' �f �
NAME PRIMARY PHONE
CoA A hA / napled- FS -6741 -73 k
PROPERTY OWNER MAILING ADDRESS ii 1.\
390 ' f►'n Ac SAI'f 100 EMAIL
C binJ`2 Cc+ui ih . cc n,
CITY � 3 STATE 123
�e
,(�NAME cu
PHONE 7 n
.).—Orw) t, Y&Gc/ +r1� API-v,'Ce.0 1V-s-d 1 "0/3S
ING ADDRESS CC
CONTRACTOR
CITY/ STATE
� /C:eGlt�1 Way/ "i., -4 I;-5- (' a.')I& 0rnc,h l-C r ,l'er•L t(
Lgicwcc�,} ZIP/r/,/3/ FO�+s3-STI-o1?6' J
WA STATE CONTRACTOR'S LICENSE# `V A EXPIRATION TTIO�N DATE FEDERAL WAY BUSINESS LICENSE#
NAME _- / /). //P 0910019e _ .
akie j / h le PRIMARY PHONE
APPLICANT• MAILING ADDRESS E-MAIL
Scrn� C s Ccnf t�.c�-o r
CITY STATE ZIP FAX
NAME ri
w PRIMARY PHONE
PROJECT CONTACT
ave 1 u 1 �� �S3_ �z_,���
(The individual to receive and MAILING ADDRESSE-MAIL
respond to all correspondence SGme as _,G j'\+ Gl
(_ --
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING
0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP
(RCW 19.27.095) PHONE
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
ail applicable City of Federal Way 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 officers and employees, upon•the accuracy of the
information supplied to the7 ity as a part of this application.
SIGNATURE: -� /14-' ' DATE Vl Cf 1.7
ff
/
PRINT NAME: /Dale LciIC11G/`{,,
•
,t
Bulletin#1009January 29,2016 Page 1 of 2 k:\Handouts\Permit Application