12-103955Project Name: CROSS
Project Address: 30313 17TH AVE SW
Wilding - Singie Fhmily
Permit #: 12 -103955 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 005070 0020
Project Description: REP - Tear off existing cedar shake roofing & install OSB sheathing and composition
shingle roofing system.
Owner
THOMAS L CROSS
AQRlican
HORIZON CONTRACTORS INC
Contractor
HORIZON CONTRACTORS INC
City of Federal Way
LYNN D CROSS
PO BOX 24449
Community & Econ. Dev. Services
33325 8th Ave S
3031317TH AVE SW
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
t=,
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Project Name: CROSS
Project Address: 30313 17TH AVE SW
Wilding - Singie Fhmily
Permit #: 12 -103955 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 005070 0020
Project Description: REP - Tear off existing cedar shake roofing & install OSB sheathing and composition
shingle roofing system.
Owner
THOMAS L CROSS
AQRlican
HORIZON CONTRACTORS INC
Contractor
HORIZON CONTRACTORS INC
Lender
OWNER IS LENDER
LYNN D CROSS
PO BOX 24449
HORIZCII IOKR (05/19/13)
3031317TH AVE SW
FEDERAL WAY WA 98093
PO BOX 24449
FEDERAL WAY WA 98023-3452
FEDERAL WAY WA 98093
Census Category: 555 - Non-structural roofing permits
Includes: # 1 #2 #3 #4
Occupancy Class:
Construction Type.
Occupancy Load:-
Floor
oadFloor Areas . ft. 0 1 0 1 0 1 0
AdditioInal'Pelrnnit Infor7n n
New / Additional Sq. Feet - 3rd Floor....................0
Mechanical to be Included?...................................No
New / Additional Sq. Feet - Basement...................0
Plumbing to be Included?.......................................No
No F%dur�:Associs d 1 ThiPorth 11
PERMIT EXPIRES Saturday, February 23, 2013
Permit Issued on Monday, August 27, 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:Z� Z
FMA11�FD s���i
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
12 -103955 -00 -SF Address: 30313 17TH AVE SW
THOMAS L CROSS FEDERAL WAY, WA 98023-3452
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.
0
SWM Precon Site Mtg (4 00)
❑
Initial Erosion Control (4365)
Shear Walls (4245)
Underfloor Framing (4285)
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) Final - Building (4050)
Approved Approved
By Date By Date
El
Floor Sheathing (4105)
Shear Walls (4245)
Roof Sheathing (4220)
Approved to install flooring
By
Date
Approved to install siding
Approved to install roofing
By
Date
By
By
Date
By 01r�_ Date
Fire/Draft Stops (4095)
Interim Erosion Control (4370)
prior to scheduling a Framing inspection;
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)
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) Final - Building (4050)
Approved Approved
By Date By Date
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
�nroF #A� RECEIVE
Federal Way HERMIT
COMMUNITY DEVELOPMENT SERVAL G 2 I "A p p L I CA T 10 N
253-835-2607• FAX 253-835-2609
u.u•�..�, EaF.�r_.2_l£1'IY OF FEDERAL WAY
CDS
i o -3 9 -5S-
S MF CO ME PL DE EN FP
g69a-
SITE ADDRESS G 3 ) 3 I-7-f� ted
3 A�� 5
SUITE/UNIT i
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAX/PARCEL i
oO 5o-70-_ 0 00
11641ffu
❑ PLUMBING ❑ MECHANICAL
TYPE OF PERMITBUILDING
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/HomeoumerLast Name)
C 10SS
PROJECT DESCRIPTION
r7 ,_ _
-I �� k,,) + �h j I OS
Detailed description of work to
��'
1�/"�
a pq%
be included on this permit only
NAME
Lip SI
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY
3TATE
ZIP
NAME kACA 20n Li'#.11+ &441`, IC
PHONE 7,53 �8 '- I
MAILING ADDRESSJ A
Cl'�X A
E-MAIL
CONTRACTOR
r P 4 y
CITY rt)' 1 ' `r'
STATE
W rl
ZIP
FAX
WA ST4TN,tQNTR CT R'S LICENSE 8�
N z
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE 9
f' 2 G
S
ciL.•
NAME
PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME�L („C � ��
PHONE
(The individual to receive and
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
El OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW ] 9.27.095)
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 city as apart of this appiicatio
611'-7/11
SIGNATURE: DATE
PRINT NAME:
Bulletin #100 - January 1, 2011 Page I of 3 kAl-landoutsTermit Application