15-100400Clty of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S LM
Federal Way, WA 98003
Ph: (253) 835-2807 Fax (253) 835-2809
Project Name: MALMO
Project Address: 30230 17TH AVE SW
wilding - Single Family
Permit #: 15-100400-00-S F
Inspection Request Line: (253) 835-3050
Parcel Number: 005070 0160
Project Description: REP - Tear off shake roofing & install CDX plywood sheathing and composition shingle
roofing system.
Owner
ARRImcant
Contractor
Lender
JEFFERY L MALMO
HORIZON ROOFING LLC
HORIZON ROOFING LLC
OWNER IS LENDER
NANCY L MALMO
PO BOX 24449
HORIZRL867L7 (6/27/16)
3023017TH AVE SW
FEDERAL WAY WA 98093
PO BOX 24449
FEDERAL WAY WA
FEDERAL WAY WA 98093
98023-3454
Census Category: 555 - Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type.
Occupancy Load-
Floor
oadFloor Areas . ft. 0 0 1 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 It
PERMIT EXPIRES Sunday, July 26, 2015
Permit Issued on Tuesday, January 27, 2015
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
d the City of Federal Way.
Owner or agent: 7 Date:
• THIS CARD IS TO MAIN ON-SITE •
"TM OR - Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 15 -100400 -00 -SF Address: 30230 17TH AVE SW
Project: JEFFERY L MALMO FEDERAL WAY, WA 98023-3454
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 roofmg Approved
By Pte- Date I - ;k8 , � By Pte- Date1.30-15-
1-1
Rough Electrical
Approved
Final Electrical
Approved
11
Right of Way
Approved
By
Date
By
Date
By
Date
VA�CITY OF
Federal Way
0 PERMIT IPPLIOWWWA
PERMIT NUMBER [� — 10 0 400 _v1
TARGET DATE
JAN 2 7 2015
CITY OF FEDERAL WAY
CDS
SITE ADDRESSI Ave36 � F(dt* I V� 69-U2�
SUITE/UNIT #
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAR/PARCEL #
0 0 �;_ O 7 0_ ( (0 0
6rO-("
TYPE OF PERMIT
VFBUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
( O
PROJECT DESCRIPTION
Detailed description of work to
/ ^
be included on this permit only
PROPERTY OWNER
NAME
(f /vF�1C7 /^K 061e
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME(L�F�
P2NE
51-838
MAILINGADDRESS MN`
I _1
E-MAIL
CONTRACTOR
CITY Fid -4f1 I - /
jr'7
STATE
Grp,
ZIP _ o� �
FAX
WA STATE CONTRACTOR'S LICENS #
HeIRS
EXPIRATION DA�E
�
FEDERAL WAY BUSINESS LICENSE #
NAME !fit el'c
PRIMARY PHONE
VIC -20
MAILING ADDRESS
E-MAIL
APPLICANT
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
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 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 Iaws 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 application.
SIGNATURE: DATE
PRINT NAME: C rL Ill VL
Bulletin #100 —January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application