12-100370City of Federal Way •
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
wilding - Multi Family
Per it It: 12 -100370 -00 -MF
1= Inspection Request Line: (253) 835-3050
Project Name: ST CROIX APARTMENTS BUILDING 14 (Phase 1)
Project Address: 32114 20TH LN SW NOW Parcel Number: 132103 9101
Project Description: REP - Remove existing shingle roof and replace with shingles. Install 301b felt, ice and
water shield. All metal flashing, 30 yr certainteed shingle.
Owner
Applicant
Contractor
Lender
LEEWARD STRATEGIC
CENTIMARK
CENTIMARK
LEEWARD STRATEGIC
PROPERTIES
3416 'B" ST NW SUITE D
CENTIC*009NZ (6/16/13)
PROPERTIES INC
4 EMBARCADERO CENTER SUITE
AUBURN WA 98001
3416 "B" ST NW SUITE D
4 EMBARCADERO CENTER SUITE 1
SAN FRANCISCO CA 94111
AUBURN WA 98001
SAN FRANCISO CA 94111
Census Category: 555 - Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Areas . ft.) 1 0 1 0 1 0 0
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
See �►p��������ederal Way.
Owner or agent: (, ' V Date:
:JAN IS 2012
171HAUX,"b 8:/1+11z
THIS CARD IS TO MAIN ON-SITE
CrrY OF Construction I ection Record
Federal Way INSPECTION REQU TS: (253) 835-3050
PERMIT #: 12 -100370 -00 -MF Address: 32114 20TH LN SW Bldg 14
Project: LEEWARD STRATEGIC PROPERTI FEDERAL WAY, WA 98023
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 SC <-> Date Z . I— I By G Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
0
0". RECEIVEDPERMIT
Federal Way JAN
COMMUNIY DEVELOPMENT SERVICES A I q 2 4AP p LI C AT I O N
253-835-2607• FAX 253-835-2609
WWII,. cituol!edemisau.rom
CITY OF FEDERAL WAY
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12-
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SITE ADDRESS
SUITE/UNIT #
3ztIK Zo TSI
LU'ATION
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
31 90Z)
-
TYPE OF PERMIT
'S(BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
4 A,
PROJECT DESCRIPTION
Detailed description of work to
Re `
tit >r�
be included on this permit only
PROPERTY OWNER
NAMEPRIMARY
P/,!5h'ic hLYi
PHONE
MAILING REBS 9-7 � ��
E-MAIL
CITY
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STATE
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ZIP '
NAM
PHONE
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MAILING ADDRESSl : \
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E-MAIL
CONTRACTOR
CSTATE
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FAX
7
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PHQNE4
MAILING DRESS
f -�/w Ste► i� l�
E-MAIL
APPLICANT
CITY w- _`
STAT
ZIP
FAX
PROJECT CONTACT
Mw individual to receive and
NAME44 ���
PHONE
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MAILING DRESS _
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E-MAIL
respond to all correspondence
concerning this application)
C u � 6CYe..
STATE
(J/I//
ZIP „ _ /
lY/`!/7Yvl
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5.000 or more
(RCW 19.27.095)
4 44
MAILING ADDRESS, CITY, STATE, ZIP I W pfPHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certtN that to the best
of my knowledge. the irtformation 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.
1 further agree to hold harml the of deral Way as to any claim (including costs. expenses. and attorneys' fees incurred in
the investigation and defense of aim) ich may be made by any person. including the undersigned, and filed against the city.
but only where such cl im ut o he reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to h a of this application.
SIGNATURE.- DATE
PRINT NAME: 14 t
Bulletin #100 -January 1, 2011 Page l of 3 k:\Handouts\Permit Application
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