13-100937 3
• wilding - Single Family
City of FederalWay Permit #: 13-100937-00-S F
Community&Econ.
Dev.Services
33325 8th Ave S ��
Federal Way,WA 98003 i Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609
'
Project Name: FORD
Project Address: 4911 SW 330TH ST Parcel Number: 802951 0250
Project Description: ALT-Tearing off shake roof,resheeting,the covering with shingle.
Owner Applicant Contractor Lender
RONALD L FORD ACHTENS QUALITY RFING CON ACHTENS QUALITY RFING CON
VALERIE J FORD INC INC
4911 SW 330TH ST 410 112TH ST S ACHTEQR923CM(2/16/14)
FEDERAL WAY WA 98023-3312 TACOMA WA 98444 410 112TH ST S
TACOMA WA 98444
Census Category: 555 -Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0 0 0 0
Additional Permit Information
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement. 0
Mechanical to be Included? No Plumbing to be Included? No
Zoning Designation RS 9.6i Ai, l t
No Fixtures Associated With This Permit II
PERMIT EXPIRES Tuesday, August 27, 2013
Permit Issued on Thursday, February 28, 2013
I hereby certify that the above info-tion is correct and that the construction on the above described property and
the occupancy and the -~ willl,- In acco 4,nce w the laws, rules and regulations of the State of Washington
nd t► - City of Federal Way.
Date: .2- //
Owner or agent: '1�
THIS CARD IS TO MAIN ON-SITE
CITY
of
~� •
Federal WayConstruction In ection Record
INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-100937-00-SF Address: 4911 SW 330TH ST
Project: RONALD L FORD FEDERAL WAY, WA 98023-3312
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.
0 Roof Sheathing(4220) 0 Insulation(4150) 0 Final-Building(4050)
Approved to install roofing Approved to install wallboard Approved
PiG S Date -.e,13 By Date By Date s,\q,.,vl
0 Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
REA. , •
CITY OP EB 28 2013 PERMIT APPLICATION
Federal WayY344
CIT(OF FCDE LL WAY
PERMIT NUMBER / (
70 32-_ d
TARGET DATE
SITE ADDRESS SUITE/UNIT#
Li CA I I .stio 330 t-11
ST Fei-JLA wAy cig02-3
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ -�.ti - - -
TYPE OF PERMIT BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT r-.O £
PROJECT DESCRIPTION A RPXD c SinAke 1-t oc
Detailed description of work to P i y woo"- (CJ X , e sleet
be included on this permit only C GA 2A/,)r n/�` CO�
/`I J ��Jl ,(1-3
s� e
NAME PRIMARY PHONE
PROPERTY OWNER ROA)
YOILD
MAILING ADDRESS E-MAIL
q i 1 Sw 33019" 3
CITY eA`A LJA/y-�1, STATE/•/ ' ZIP 9n B 023
PHONE
NAME // tfikC %) Q V,"l I`--a3c o 7UC ?.c 'DI-764
MAILING ADDRESS / �.L
CONTRACTOR l�o S f IZ rn
S '' O Ll1P/Vj 'NJ
CIT STATE ZIP FAX
/q cA, WA ��y�c/ 744q
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
.4�/6/ 9 23 C70 / /
NAME 1 PRIMARY PHONE
/4
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME /A /�/;/' PRIMARY PHONE `'
PROJECT CONTACT CCArdS0/0 (2
? 77e) CJ
(The individual to receive and MAILING ADDRESS E-MAIL j/
respond to all correspondence C 4AIL A(i,Fitif ) "
concerning this application) CITY STATE ZIP FAX
NAME OWNER-FINANCED
PROJECT FINANCING
Required value of$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 arty claimd eluding costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim),which may be ma• by any p -on,including the undersigned,and filed against the city,
but only where such claim arises out of t reliance oft ' ty, inc ng its officers and employees, upon the accuracy of the
information supplied to the cit as a part .,this applicatio,.
SIGNATURE: DATE ? -(7,7. //
3
PRINT NAME: (7/61/9 tCl/J
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application