13-1040480
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: SIEMSSEN
rMia
FfLE
Project Address: 34518 10TH AVE SW
wilding - Single Family
Permit #: 13 -104048 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 1321710540
Project Description: REP - Remove cedar shake roofing & install plywood & composition shingle roofing
system.
Owner
ARRlicant
Contractor
1_ender
BRADFORD W SIEMSSEN
HORIZON CONTRACTORS INC
HORIZON CONTRACTORS INC
OWNER IS LENDER
REBECCA SIEMSSEN
PO BOX 24449
HORIZCII IOKR (5/19/15)
34518 10TH AVE SW
FEDERAL WAY WA 98093
PO BOX 24449
FEDERAL WAY WA
FEDERAL WAY WA 98093
98023
Census Category: 555 - Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Areas . ft. 0 0 0 0
Additional Permit Information
New / Additional Sq. Feet - 3rd Floor....................0
Mechanical to be Included?....................................No
New / Additional Sq. Feet - Basement...................0
Plumbing to be Included?......................................No
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Tuesday, March 11, 2014
Permit Issued on Thursday, September 12, 2013
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 Washington
and the City of Federal Way. #Ile by
Owner or agent: Date:
q (1 ;113
TRIS CARD IS TOMAIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -104048 -00 -SF Address: 34518 10TH AVE SW
Project: BRADFORD W SIEMSSEN FEDERAL WAY, WA 98023-8416
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.
13
SWM Precon Site Mtg (4400)
0
Initial Erosion Control (4365)
Walls (4245)
Underfloor Framing (4285)
1:1Approved
Approved
By
To be done prior to breaking ground
Approved to install siding
Approved to sheath floor
By
Date
By
Date
By
Date
Final Erosion Control (4375)
Approved
By Date
Final - Building (4050)
Approved
By µf� Date (1
Floor Sheathing (4105)Shear
Walls (4245)
E]Roof Sheathing (4220)
1:1Approved
Approved to install flooring
By
Date
Approved to install siding
Approved to install roofing
By
Date
By
By
Date
By Date
prior to scheduling a Framing inspection;
Fire/Draft Stops (4095)
Interim Erosion Control (4370)
Approved
Approved
Electrical, Plumbing & Mechanical Rough -in and
By
Date
By
Date
Fire/Draft Stop inspections must be signed -off and
approved IBC 109.3.4
Framing (4120)El
Insulation (4150)
Gypsum Wallboard Nailing (4130)
Approved to insulate
Approved to install wallboard
Approved to install mud & tape
By
Date
By
Date
By Date
Final Erosion Control (4375)
Approved
By Date
Final - Building (4050)
Approved
By µf� Date (1
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Ways
By
Date
By
Date
By
Date
GTY of
Federal Way
PERMIT NUMBER
PERMIT4KPPLICATION
RECEIVED
SEP 12 2013
_ TARGET DATE CM OF FEDERAI WILY
me
SITE ADDRESS
3`7 5 I% 1�� Avesu
SUITE/UNIT A
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL i
$GZ'1�
-----------
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
� 1 ) L-wG Sk.'n 'e
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be included on this permit only
NAME
PRIMARY PHONE
PROPERTYOWNER
^,
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T�'
CCITY
MAILING ADDRESS
E-MAIL
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STATE I
ZIP
NAMEPHONEr',2�•, T nA -
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MAILINGADDRESSx Zh h1
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E-MAIL
CONTRACTOR
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FAX
WA STATE CONTRACTOR'S LICENSE M
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
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NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
APPLICANT
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
V 1 e -Q
PRIMARY PHO
Z G L-2791— 2 Ll I?-
MAILING ADDRESS
E-MAIL
(The individual to receive and
(The
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095/
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
1 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 pa of this application.
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SIGNATURE: DATE
PRINT NAME: R—G U1 Gr -
Bulletin #100 — January 1, 2013 Page I of 3 k_\Handouts\Permit Application