13-104310si `+
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
4 Ouilding - Single Family
Permit #: 13 -104310 -00 -SF
Inspection Request Line: (253) 835-3050
Project Name: GOLUBOVICH
Project Address: 34440 10TH AVE SW
Project Description: REP - Remove and replace existing roofing
Parcel Number: 1321710490
Owner
ARRIicant
Contractor
Lender
YURIY GOLUBOVICH
NORTHWEST ROOF SERVICE INC
NORTHWEST ROOF SERVICE INC
OWNER IS LENDER
3444010TH AVE SW
801 CENTRAL AVE N
NORTHRS088DW (10/15/13)
FEDERAL WAY WA 98023
KENT WA 98032
801 CENTRAL AVE N
KENT WA 98032
Census Category: 555 - Non-structural roofing permits
Includes: # 1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Areas . ft. 0 1 0 1 0 1 0
Additional Permit Information
New / Additional Sq. Feet - 3rd Floor....................0
Mechanical to be Included?....................................No
Permit for Building Shell Only?............................No
New / Additional Sq. Feet - Basement...................0
Number of Stories.................................................2
Plumbing to be Included?.......................................No
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Wednesday, March 26, 2014
Permit Issued on Friday, September 27, 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 apeprdance with the laws, rules and regulations of the State of Washington
and,#16 City of F deral Way.
Owner or age t- z v t, 421 Date: X? �7
THIS CARD IS TO MAIN ON-SITE '
"T' OF Construction Ins ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -104310 -00 -SF Address: 34440 10TH AVE SW
Project: YURIY GOLUBOVICH FEDERAL WAY, WA 98023-8414
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD Inspections are Iisted 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 lagged on the back of this card.
Roof Sheathing (4220) ❑ Final - Building (4050)
Approved to install roofing Approved
By Date j 0 123 1f f -7 Byo \&. a Date
El
Rough Electrical
Approved
Final Electrical
Approved
n
Right of Way
Approved
By
Date
By
Date
By
Date
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Federal Jay
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TYPE OF PERMIT
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PROJECT DESCREMON
Retailed descrptwn of work to
be v=4ded on ins Permit only
PROPERTY OWNER
APPLICANT
PROJECT CONTACT
P -he zndwidual W reoevx and
respond to a.0 correspondence
concerning this apphcation)
PROJECT FINANCING
Required v"c c $5, 000 or more
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I certify under penalty of perjury that I am the property owner or authorized agent Of the Property owner, I cvrt!N that to the best
of my knowledge, the information aubmit%-ed in support of this permit application Is true and correct. I certify that I LptU coay, iy with
ail applicable City of Pedes! Way regulations pertaining to the work authorized by the issuance of a perrmit. I understand that the
issuance of this permit does not ranuma the ow"P�v rvsponsitzifity for compUance: with local, state, or fvdcral Laws rcfu,ta4irV
construction or environmental laws.
J)Urthar agree to hold harmless the City vfFederal Way as to any claim (intruding costs, expanses, and attorneys fees incurrad in
the investigation and defense of such claizN, which may be made by any person, including the undersigned, and flied against the city,
kna only who" such claim arises out of the raltanpe of the city, tnrludtn�Atj offloers and employees, upon the accurat7. of the
information supplied to the city as a part of this appAcatton.
SIGNATURE: DATE
PRINT NAME;
Bulletin # I C9) - J ai uary 1, 2013 Pag,I of 3k:'�HandouulPerr;� : °-r plication
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I certify under penalty of perjury that I am the property owner or authorized agent Of the Property owner, I cvrt!N that to the best
of my knowledge, the information aubmit%-ed in support of this permit application Is true and correct. I certify that I LptU coay, iy with
ail applicable City of Pedes! Way regulations pertaining to the work authorized by the issuance of a perrmit. I understand that the
issuance of this permit does not ranuma the ow"P�v rvsponsitzifity for compUance: with local, state, or fvdcral Laws rcfu,ta4irV
construction or environmental laws.
J)Urthar agree to hold harmless the City vfFederal Way as to any claim (intruding costs, expanses, and attorneys fees incurrad in
the investigation and defense of such claizN, which may be made by any person, including the undersigned, and flied against the city,
kna only who" such claim arises out of the raltanpe of the city, tnrludtn�Atj offloers and employees, upon the accurat7. of the
information supplied to the city as a part of this appAcatton.
SIGNATURE: DATE
PRINT NAME;
Bulletin # I C9) - J ai uary 1, 2013 Pag,I of 3k:'�HandouulPerr;� : °-r plication