18-102091City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
building - Single Family
Permit #:18 -102091 -00 -SF
Inspection Request Line: (253) 835-3050
Project Name: MADDOX
Project Address: 516 SW 353RD ST Parcel Number: 066231 0290
Project Description: gpp - Remove cedar shakes and install CDX plywood decking and composition shingles.
Owner
Applicant
Contractor
Lender
LISA MADDOX
PETE GIEREHORIZON ROOFING
HORIZON ROOFING LLC
OWNER IS LENDER
516 SW 353RD ST
LLC
PO BOX 24449
FEDERAL WAY WA 98023
PO BOX 24449
FEDERAL WAY WA 98093
FEDERAL WAY WA 98093
Census Category: 555 - Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
PERMIT EXPIRES Monday, 12 November, 2018
Permit Issued on Wednesday, Mav 16, 2018
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 accordance with the laws, rules and regulations of the State of
Washin t d the City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18102091 00 Address: 516 SW 353RD ST
Project: MATTHEW D MADDOX FEDERAL WAY WA 98023-8125
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE TRIS 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.
El
Roof Sheathing (4220)
0
Final - Building (4050)
Approved to install roofing
Right of Way
Approved
By
i Date 5
Approved
By
iV Date 16 21
Approved
By
Date
By
El
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
4ik
CITY OF
Federal Way
PERMIT NUMBER
RECEIVED
MAY 16 2018 PERMIT APPLICATION
PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325
CITY OF FEDERAL WAY253-835-2607 + FAX 253-835-2609 + permitcenteracityoffederalway.com
COMMUNITY DEVELOPMENT
ti-%-
- TARGET DATE
SITE ADDRESS
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ q` ,(#
Q ( /4J l.7 -z- � / - 7 r
TYPE OF PERMIT
`6 BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
fr( 1 i/1J C�jr �'/WF
Detailed description of work to
% lG� G✓�
'
co
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
q/('0 5 (til Ss 3�cA S+{ir�
E-MAIL
CITY
F�4cr�1 (.�
STATE
ZIP
a F�l1L 3
NAME ( A
S
LS3-838-583
MAILING ADDRESS
N4)e 21174
E-MAIL
1h I`er h*M&';I' cu wt
CONTRACTOR
CITY /� Lf') C r
I/ V V
STATE
ZIP ��
FAX
WA STATE CONTRACTO 'S LICENSE #
N�1zt2 t, �� Ll
EXPIRATION DATE
-2 -7, ( i�
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT-
MAILING ADDRESS t `
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME n rte,
I � t V ' �L
PRIMARY PHONE
106, Z; % -ZI 5i
MAILING ADDRESS
E-MAIL I
GI he y' `c4 1, C�
(The individual to receive and
respond to all correspondence
1 C
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $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 apart of this application.
SIGNATURE: tio
DATE
PRINT
NAME:
Bulletin #100 - January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
E