12-103912City 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: SHELTON
Project Address: 29826 10TH AVE SW
Building - Single Family
Permit #: 12 -103912 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 195460 0211
Project Description: REP - Inspection of water damage. **NO construction work approved under this permit**
Owner
A1212fican
Contractor
Lendg
PAUL SHELTON
KENCADE CONSTRUCTION INC
29826 10TH SW
8502 RIVERSIDE DR E
FEDERAL WAY WA 98003
SUMNER WA 98390
Census Category: 999 - Unknown
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 Associates! With This Permit It
PERMIT EXPIRES Sunday, March 17, 2013
Permit Issued on Thursday, August 23, 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 accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: Tl /0��
R NAWZ I /I at / 120w
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: SHELTON
Project Address: 29826 10TH AVE SW
quilding - Single Family
Permit #: 12 -103912 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 195460 0211
Project Description: REP - Inspection of water damage. **NO construction work approved under this permit**
Owner
Applican
Contracto
Lender
PAUL SHELTON
KENCADE CONSTRUCTION INC
2982610TH SW
8502 RIVERSIDE DR E
FEDERAL WAY WA 98003
SUMNER WA 98390
Census Category: 999 - Unknown
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load-
Floor
oadFloor Areas . ft. 0 0 1 0 0
Ad.
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 Penult 11
PERMIT EXPIRES Tuesday, February 19, 2013
Permit Issued on Thursday, August 23, 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 accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: pall ke- s t Date: ,J, 3 - C�l�
'e�-
CITY OF rr �v�D SP'ERMIT
Fedenj WW* MF
COMMUNITY DEVELOPMENT SERVICES 2012 APPLICATION
253-835-2607• FAX 2536
un;.�u�. r.,_tyr�rriernlu_• `,
F FeDE*'- W A
X03 q/A
CO ME PL DE EN FP
SITE ADD / � � /1/^ � SA-)SUITE/UNIT
d\ �- G- 6
#
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAX/PARCEL #
I % S
TYPE OF PERMIT
LDING ❑ PLUMBING ElMECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeoumer Last Name)
PROJECT DESCRIPTION
o' C�
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY -
STATE
ZIP-
NAME ! -
PHONE
LING ADDRESS
E-MAIL
CONTRACTOR
CITY
STA
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRA TE
FEDERAL WAY BUSINESS LICENSE #
NAME
PHONE
VE
MAILING ADDRESS
-MAIL
APPLICANT
CITY
STATE ._ZIP
FAX
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
MAILING ADDRESS
�—-------"` -
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
E-MAIL
ALTERNATE CONTACT NAME: -
ONE
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that 1 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 ban person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the'cety, in luding its officers and employees, upon the accuracy of the
information supplied tp'ihe city as apart of this application.
SIGNATURE:� ?y, r - X DATE
PRINT NAME
Bulletin #100 — January 1, 2011 Page 1 of 3 kAHandouts\Permit Application