12-103106 r
0 'Funding - Single Family.
City of FederalWay Permit #: 12-103106-00
Community Econ.& D
Dev.Services
33325 8th Ave S
Federal Way,WA 98003 M
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050 • •
Project Name: RIVERSTONE APTS-BLDG 7 UNITS 53,55,56
Project Address: 27314 24TH PL S Parcel Number: 720480 0004
Project Description: REP-Inspection of fire damage. **NO construction work approved under this permit**
Owner Applicant Contractor Lender,
FSC RIVERSTONE ASSOCIATES L BELFOR USA GROUP INC BELFOR USA GROUP INC
18818 TELLER AVE#277 3826 WOODLAND PARK AVE N BELFOUG99OBJ (12/20/12)
IRVINE,CA 92606 SEATTLE WA 98103 3826 WOODLAND PARK AVE N
SEA 1ILE WA 98103
Census Category: 434-Residential alt/add-no change in number of units
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 Wednesday, January 2, 2013
Permit Issued on Friday, July 6, 2012
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordan•-'with •- laws, rules and regulations of the State of Washington
-.0 e wr o,Federal Way.
Owner or agent: "�z-1-1, ty Date: 7/b//1.-
FI' ' "
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CITY OF E�
Federal Way
R ECEIVPERMIT moi'Aihr _ CO ME PL DE EN FP
,
COMMUNITY DEVELOPMENT SERMt
06 2012 APPLICATION �,�
253-835-2607•FAX 253-835-2 Ql
wu'w.ca offedercdwaij.co n 0-
CITY OF FEDERAL WAY
SITE ADDRESS CDS / SUITE/UNIT#
Z731 `f Zq4- !?` f S s3 SS 56
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ ? Z o t( 8 0 - o 0 0
TYPE OF PERMIT ilt
BUILDING ❑ PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant
(Tenant Name/Homeowner Last Name) IV eV5+C/yi
PROJECT DESCRIPTION F I re, elama�l rta r--
Detailed description of work to
be included on this permit only
r
NAME PRIMARY PHONE
PROPERTY OWNER iAY Ion- LAND ie-)O eO#-t Pi40V
MAILING ADDRESS E-MAIL
CITY STATE ZIP
PHONE
NAME ��o� k�� Roo P /4l/ 7.66 d37 oSoo7
MAILING ADDRESS a'� E-MAIL
413U:' 5 at i '
CITY
rrter: STATE'A `f$i d, FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
-6ELcou -9qo 13S t2/ jo / 1.7 20.01 - to3 9'17 -3(.
NAMF�o m in blItA PHONE
11KKJJ l 1,04 631 0%'D0
APPLICANT MAILING ADDRESS s E-
LI3� s ►�t Pl )) ress. tri wll us. �wl�oe.tett
CITY
STATEZIP���bO FAX t;aZ b��
PROJECT CONTACT NAMEIC�► PHONE
(The individual to receive and Art 6
respond to all correspondence MAILING ADDtri' E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
rgi OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP 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
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 city as a part of t�.�icat
iiiii)
SIGNATURE: �yl�. N4. + DATE 7/411-1---PRINT NAME: (2.0SS jt.1 S�'14 L jt
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application