13-104575wilding - Single Family
City of Federal
Community & Econ. Devw. Services Permit #: 13 -104575 -00 -SF
33325 8th Ave S . a
Federal Way, WA 98003 r Inspection Request Line: 253 835.3050
Ph: (253) 835-2607 Fax: (253) 835-2609 ,pp ',yt�µ , '" p q
Project Name: SIMMS
Project Address: 32106 11TH AVE SW
Parcel Number: 926493 0080
Project Description: REP - Tear off existing shake roofing; over skip sheathing, install plywood sheathing and
composition shingle roofing system.
Owner
Applicant
Contractor
Lender
ROBERT E SIMMS
R & C ROOFING INC dba
R & C ROOFING INC dba
SANDRA L SIMMS
CHINOOK ROOFING & GUTTERS
CHINOOK ROOFING & GUTTERS
3210611TH AVE SW
5013 PACIFIC HWY E SUITE 7
RCROOCR917M8 (7/28/15)
FEDERAL WAY WA
FIFE WA 98424
5013 PACIFIC HWY E SUITE 7
98023-5550
FIFE WA 98424
Census Category: 555 - Non-structural roofing permits
Includes: # 1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Areas . ft. 0 1 0 0 1 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 Monday, April 14, 2014
Permit Issued on Wednesday, October 16, 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
the City of Federal Way.
Owner or agent. Dater
F1 �A_,D
THIS CARD IS TOMAIN ON-SITE
CITY OF AConstruction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -104575 -00 -SF Address: 32106 11TH AVE SW
Project: ROBERT E SIMMS FEDERAL WAY, WA 98023-5550
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.
Roof Sheathing (4220)Final - Building (4050)
Approved to install roofing ,,.{� Approved
By / I Date �/ Il �1 i;a` 1 110
\ Date V.0 ' Z2r t,3
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF PERMIT APPL�F WN
Federal Way
() .. OCT 16 2013 30
PERMIT NUMBER e f -7
TARGET DATE CITY OF FEDERAL WAY
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SITE ADDRESS _____fSUITE/UNIT
ii
321 li*+ Ave w�
PROJECT�%VAfLUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$
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2 l� A-4 - o D S' 0
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(m S !' ) D lot S 5401dy OVIIrS lG(
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PROJECT DESCRIPTION
Detailed description of work to
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be included on this permit only
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PROPERTY OWNER
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PRIMARY PHONE p
253 - /2� -727 D
MAILING ADDRESS
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CONTRACTOR
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(EXPIRATION
FAX
-922-1ny1
WA STATE CONTRACTOR'S LICENSE #
DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
APPLICANT
CITY
STATE I
ZIP
FAX
NAME I
PRIMARY PHONE
PROJECT CONTACT
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MAILING ADDRESS '
CJC_J 1 1 5TE
E-MAIL
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(The individual to receive and
respond to all correspondence
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STA
ZIP
concerning this application)I
PROJECT FINANCING
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NAME &I Q F- %��)
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❑ OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
LING AD SS, CITY, STATE, IPI
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PHONE
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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 ty as art of this application.
2
SIGNATUR DATE
PRINT NAME: '
Bulletin #100 — January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application
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