08-101295 City of Federal Way Builtn Single FamilyPerm!#: 08-101295-00-SF
Community Development Services g - g
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: PICKENS *
Project Address: 1107 SW 348TH PL Parcel Number: 542242 0610
Project Description: REP-Remove shake roof/install plywood composition roof shingles
Owner Applicant Contractor Lender
LAURA L PICKENS MOSS MASTERS MOSS MASTERS
1107 SW 348TH PL 6922 S 125TH ST MOSSMM*956OW 9/16/09
FEDERAL WAY WA 98023-7029 SEATTLE WA 98178 6922 S 125TH ST
SEATTLE WA 98178
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
No Fixtures Associated With This Permit !!
PERMIT EXPIRES Thursday, March 18, 2010
Permit Issued on Tuesday, March 18, 2008
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the will be in accordance with the laws, rules and regulations of the State of Washington
7,,v,:2d e City of Federal Way.
7 Owner or agent: Date 4-09.
THIS CARD IS TO*MAIN ON-SITE
CITY OF � -- Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-101295-00-SF
Owner: LAURA L PICKENS
Address: 1107 SW 348TH PL
FEDERAL WAY, WA 98023-7029
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.
Roof Sheathing(4220) El Fire/Draft Stops(4095) 0 Insulation (4150)
Approved to install roofing Approved Approved to install wallboard
Date By Date By Date
Final-Building(4050)
Approved
By Date 51V14- OR
For inspector reference only
0 Rough Electrical ❑ FINAL-Electrical
Approved Approved •
By Date By Date
C,>~OF RECEIV D g _ j 0 2 9 9
Federal Way IlrPERMITW
COMMON rI DEVELOPMENT SERV/CES ,4 AR 18 20C?r WSJ MF CO ME EL PL DE EN FP
33325 8rx AVENUE SOUTH•PO BOX 971 fir' A � ' I C A T I O N
FEDERAL WAY,WA 98063-9718 TD
253-835-2607•FAX 253-835-2609
wura,.cituo/jr.•derglwa0.cwnl� OF FEDEr ------1----,.. ___
Thefollowin is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPEf.TY INFORMATION -
SITE ADDRESS_ /1Y y"t 5(.O 3'4 9 (- eO P/ law./ SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 5.'`f L ,01--- D (Q ( 0 LOT SIZE(sJ
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION •
TYPE OF PERMIT '(UILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work inclu ed on this permit onlq)
Cam 6s; o, <h),05.1, S
PROJECT NAME(Name of Business or Owner Last Name) f S
II PEOPLE INFORMATION
PROPERTY NAM
� ^ � PRIMARY PHONE
OWNER �-�''T (4 1 B L S _
MAILING ADDRESS CITY, TATE,ZIP E-MAIL A D DRE� �
/lam 5w 3y8 f't-r pt L.,
`t-�
CONTRACTOR, C‘ COMPANY NAME - APPJICANT NAME OF CE PHONE
l � 4 �f l_s C�/� t� J � ti (4,6; ) -,}2.-- c t l 3
\\ 7M�jLING ADD��/RR/E��SS 2� CITY,STAT ZIP `nom
CELLPHONE
CY EDERAL WAYU3[N it y LICENSE NUMBER ��S (RAIL FAX,NUM) Le3
\ .....,k'\\----? o� - /0/37(- Dp / .3t p//p�� ( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
� 0 s�'/la,. " 1:5'66 LV
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
cS� `nom p E1, /f4/1"----- ( 4 ) > i,f/3
(Al
Q (i) 2-015
,, C ILIENG ADDRESS/jam ATE, P jg � -�1[(/y�� CELL. %P�HON
RELATIONSHIP TO PROJECT /7P59-
FAX NUMBER
❑ Architect 0 Tenant A e ❑ Other ( ) -
PROJECT NAM ' PRIMARY PHONE E-MAIL ADDRESS
CONTACT (y- ) 7yj 3 _-__._. _.
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ // 7 S 0
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
a PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL Eng TING Sr TOTAL PROPOSED Sr TOTAL sr
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
■ FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower comm) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roller)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 th chance of the city, including its officers and employees, upon the accuracy of the information supplied to
the city as a part of this appiica - .
SIGNATURE: AO ' I DATE �"�G—GI
Prop rty Owner and/or Authorized Agent
a NEW o ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? ❑YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application