17-102736 :a;ea3 id :;ua6e Jo JeUM0
*ABM IeJapa.d;o A;!3 ay;pue uo46uiyseM
;o a;e;s ugly)suogeln6ai pue salru `sMel ay;y;Inn aouePJ000e ui aq i lnn asn ay;pue Aouedn000 ay;pue
adoJd paguosap anoge ay;uo uo4OnJ;suoo ay;;ey;pue pauoo sl uogeuuo;ul anoge aq;;eg;ftpuao Agaiay
LIOZ`L aunt°AnpsaupaM uo pains'mtuiad
LTOZ`aagtuaaaj ti',Cnpuoyti S3211dX31IW213d
00.000`ZZ:uotlenleA 1010.1
oN ipapnloul aq of 36qumid
oN 6110 Pits 2u1PIME1.io3 Iiuuad oN Luolleoljdde*OTO io auqu0 ve SIT SI
Sauo;S 30.laq hI ON LpapnlouI aq col ieatuegaayi
UOpBuuvjul Utuaad Ieuoprppd
(g•bs)nary ioold
:peo1 iCousdnoo0
:ad iZ uo►lolulsuoD
:ssnIJ iCouednoo0
17# £# Z# 1# :sapnioui
Sl!ivaad Sullooa Ivan;anJ;s-uoM-SSS:,Qo aie3 snsuaj
b£0S8 ZV XIN3OHd b£0S8 ZV XIN3OHd
2IU A.LIS2IHAINf l 3 6ZZZ 2IU A.LIS2IHAINf13 6ZZZ EZ d0 003IU NYS
DNI DNI S3DIA2I3S DNId002I 001 3.LIf1S CRI NIddfRl 066£
2I30N31 SI 2I3NMO S331MI3S DNId002I NVIARIO9 NVIA1 1003QNO1 13AVQ 311 3NMO 3DIA2I3S32I VH
Jepue-j Jo;ae.';uoo ;ueo1,ddy JauMp
•sa i�u! s a oulauu Jea,C Mau C SII soma sa ea uo a atu a;1 a du u6 a
1 q 3 [ 0£ I[ I I' "8 �[ 1 � P P ,.Z X,lZ P II 3 glSi
Mau IILsuI•papaau se 2upiaap jooa pug Aim aaeldaa pue salguigs;o saa,Cel q;oq go Jeal,-dJI :uoi;duosau pofoid
L106 1701Z6 :JaqulnN P°JEd 2IQ SfldI 1V)MS SZI :ssalppv;oafoJd
06 9018 SIN3IN121Vdy 3A2138321 3H1 IV A2I3AV :aUIRN a.oafoad
090£-9£8(£9Z) :Gull;senba21 uol;Oadsul soszsee( 'Losz-Wil z) Lid£008866zVVM`SEM I812PO3
5 2AV q/8 SZ£££
A 00 9£LZOI LI:# ldaauuuioanaalAun
muop
isMWJo
Ana
�Iiu><�� zliny� - 2uipiing
THIS CARD IS TO REMAIN ON-SITE
"�� Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 102736 00 Address: 125 SW CAMPUS DR Bldg 10
Project: CA RESERVICE OWNER LLC 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.
® Roof Sheathing(4220) ' El Final-Building(4050)
Approved to install roofmg Approved
By Date .�By �'i� Date L (1 L( .
o Rough Electrical El Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVE®
CITY 6 i s--7(3-
OF PERMIT APPLICATION
Federa 1 WayPERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
JUN 0 7 2017 253-835-2607 +FAX 253-835-2609 +permitcentel@cityoffederalway.com
CIT,'OF FEDERAL WAY r
PERMIT
NUMBER / COM!y1GN(�Y DEV{L"'%'EI�, / - F
l(�/ n( ( / `(f� TARGET DAT
SITE ADDRESS
1 SUITE/ NIT#
S SP int- Camp(AS- Or (P4' 0A1 RJ * /0
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL# ..)
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION "
NAME OF PROJECT
Atieryr,
( .Je aesNerVQ.
iee4r- e !lelf\ /4yeti' Cf .�'d1�re Q r- Cine) ro f c/ /a' .l� t )_
PROJECT DESCRIPTION /� 1A� /r ) �// ) y C' Q
Detailed description of work to Re /c,CQ erfl) J t(., r t (kc-/(,' &s beedeCal
be included on this permit only TINS. r ,g�
X11 nevem 1 S l� IT q O(11(' /'�x Or 10 er�)<-A ri-ef-/cn mke'f?Paue,.
Its_Bili net,}. 2G `ir.1-anNA . 34,'')9/ .1:... / '�
NAMEPRIMARY PHONE
PROPERTY OWNER CC11 AhA / n� pAefif FS'-6W -73h'
MAILINr.
G ADDRESS
l (A 1-/A i -fkel No E_MAII.
e(xnric,l`2 ccl,cn, • Cpm
OITY,1� CA ZIP,1 1 23ie)a
PHONE
7ar1nc►, flocf- SPl-V Ce.r 25.?-So 3 -•Gz3.s
ISO ADDRESS _ E-MAIL • cc
CONTRACTOR G G� S %con-,c^ t4c 1� �,,�� L— (�Jct,.'(�l a7 J<'Gr ih Kc ,�Teri)
CITY,'A \ I IA ZIP i /?9 aV -sig-o1?G
WA STATE CONTRAACTOJR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
,r� GQRPIf�'_S9(3LL 7 0, //P 09100 19
NAME"av Q �'i C���. ... ... PRIMARY PHONE ..
APPLICANT-
.ADDRESS EMAIL
SQmQ, (AY Ccrtf tcte-J4 r
CITY STATE ZIP FAX
•
Y PHONE
PROJECT CONTACT NAME V, )O tjc La L{ 1�k 2P�3 72)s d C I
(The individual to receive and LING ADDRESS S EMAIL
respond to all correspondence G1l1e as CG Atte-IL—
concerning
tte r,1•--
concerning this application) CITY STATE ZIP FAX
PROJECT FINANCING NAME 0 OWNER-FINANCED
•
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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
all 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 the ty as a part of this application.
SIGNATURE: •ii-K./4!" . DATE /
f 1 7
PRINT NAME: i0a,)V L toIly cl..,,
Bulletin#1004CJanuary 29,2016 Page 1 of 2 k:WandoutslPermit Application