18-102410City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 8355-2607 Fax: (253) 835-2609
Project Name: FULMORE
Project Address: 2622 S 301ST ST
Building - Single Family
Permit #:18 -102410 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 798500 0140
Project Description: REP - Tear off existing composition shingle roof; install 1/2" CDX sheathing and new
composite roofing system.
Owner
Applicant
Contractor
Lender
TEROME FULMORE
VALENTINE ROOFING INC.
VALENTINE ROOFING INC.
2622 S 301ST ST
910 INDUSTRY DR
910 INDUSTRY DR
FEDERAL WAY WA 98003-4238
TUKWILA WA 98188
TUKWILA WA 98188
Census Category: 555 - Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Mechanical to be Included? ..................................... No Is this an Online or O.T.C. application?.................. Yes
Plumbing to be Included? ........................................ No
Total Valuation: 12,570.00
PERMIT EXPIRES Saturday,1 December, 2018
Permit Issued on Monday, June 4, 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
Washinilton and the City of Federal Way.
1 6F
Owner or agent: Date: 6/Q//1
F►'?r-)tA,
� a �
THIS CARD IS TO REMAIN ON-SITE
Federal Way THIS
Inspection Record
Y INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18102410 00 Address: 2622 S 301ST ST
Project: TEROME FULMORE FEDERAL WAY WA 980034238
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential ordet 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 Approved
7 Date (,, - G-1.6 By t,3 Date
Rough Electrical
Final Electrical....
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
4f► PERMIT APPLICATION
CITY OF JUN 0 4 201
PERMIT CENTER + 33325 81" Avenue South +Federal Way, WA 98003-6325
Federal Way cn OF FEDERALWA`�53-835-2607 + FAX 253-835-2609 + dermitcenter(cbcitvoffederalwU.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER _ o O _ s F
1_ _L TARGET DATE
SITE ADDRESS
SUITE/UNIT #
3o sr s� a 9960
PROJECT VALUATION
ZONING ASSESISOIVS TAR/PARCEL #
13, 5 S
-cL —,a 5 o c- - sz '� Q
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Fes(
PROJECT DESCRIPTION
FJ%r
Detailed description of work to
YMI/• w
I M
be included on this permit only
NAME PRIMARY PHONE
Mor w^ d 26-,- 275 -
PROPERTY OWNER
MAILING ADDRESS
EMAIL
aL(A-1:Z 4=13 t sf sT
CITY
STATE
ZIP
f4deV4
lwr&6
NAME
PHONE
c
SSS -7
MAILING ADDRESS I
4op XnA r2144 WV4e
EMAIL
• V @ VG *Ah t 1264f. ton
CONTRACTOR
CITY STATE
ZIP
FAX
T,J %A Luk
yalge
7 -
77- '515-64) 1,
WA STATE CONTRACTOR'S LICENSE #
WA
i O1 Z- 1 1b
EXPIRATION DATE
z 16 zo 20
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
rn QS Gr
MAILING ADDRESS
EMAIL
APPLICANT
CITY STATE ZIP
FAX
PROJECT CONTACT
NAME /
/ iI %lC I✓
PRIMARY PHONE
MAILING ADDRESS
EMAIL
(The individual to receive and
respond to ail correspondence
CITY STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING}
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I cert(fy 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 authorised 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 thil application.
SIGNATURE: , DATE f, eii
PRINT NAME:
Bulletin #100 — January 29, 2016 Page I of 2 k:\Handouts\Permit Application