12-100371r 114 _ wilding - Multi: Family
City of Federal Way Permit #. 12 100371 -00 -MF
Community& Econ. Dev. Services �-_,:a,ti
33325 8th Ave S
Federal Way, WA 98003'` Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609y p q
Project Name: ST CROIX APARTMENTS BUILDING 17 (Phase 1)
Project Address: 32130 19TH LN SW Bldg 17
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. 0 1 0 1 0 1 0
New / Additional Sq. Feet - 3rd Floor....................0
Mechanical to be Included?...................................No
Permit for Building Shell Only? .............................No
New / Additional Sq. Feet - Total .......................... 0
New / Additional Sq. Feet - Basement...................0
Number of Stories ................................................. 2
Plumbing to be Included?.......................................N.o
Zoning Designation................................................RM 1800
PERMIT EXPIRES Tuesday, July 24, 2012
Permit Issued on Thursday, January 26, 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
See ApapaclIbCiiv6E2deralamWay.
Owner or agent: Date:
AN 3 62017
plmqw. a#lm.
• THIS CARD IS TO MAIN ON-SITE
crc,roF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 12 -100371 -00 -MF Address: 32130 19TH LN SW Bldg 17
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 zh-�Date -r '-1 By / Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
AL C) o!5
Cffy
Fe d �3 ERMIT SF MF CO ME PL DE EN FP
Federal Way CPN 1� 0
COXIMUNI7Y DEVELOPMENT SERVICES < k Ftv p LI CAT I O N y�
2.53!3!-607'F2AX 253-635-2609 !�
mu:•. cituul!ederalwau.cum G
SITE ADDRESS
SUITE/UNIT #
3L t3 0 �Of ttj /_ w S L,._,
PROJECT VALUATION
ZONING _T
ASSESSOR'S TAR/PARCEL #
�t v`i ��
-
TYPE OF PERMIT
IS(BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
CTenant Name/Homeowner Last Namel
/
PROJECT DESCRIPTION
Detailed description of work to
lofi b' ` f T�
(n/ tit i✓
a
be included on this permit only
PROPERTY OWNER
NAME//"If,
%#�! 7/"I G
PRIMARY PHONE
MAILING ADDRESS � � �
E-MAIL
CITY
STATE
ZIP /
NAM
A
PHONE �S7 u p -3
I J�7 O
MAILING ADDRESS
c {�
E -MAIL -
CONTRACTOR
CI STAT
FAX
-'✓�
I� I
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
)WIass-o
PH
z�
MAILING DRESS L
E-MAIL
APPLICANT
C1 —`
STAT
ZIP
FAX
PROJECT CONTACT
(Me individual to receive and
NAME
e_ �41
PHONE
-� 5
MAILING DRESS 1 _ ''\\
3 ` S / AA -1- V
E-MAIL
respond to all correspondence
concerning this application)
C U /✓�_
ft
STATE,
(I/,//
ZIP „ _ ,
`Yi`!/i/vl
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5.000 or more
(RCW 19.27.0951
ZZ
MAILING ADDRESS. CITY. STATE. ZIP
PHONE
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 harml the of deral Way as to any claim (including costs, expenses. and attorneys' fees incurred in
the investigation and defense of u aim) ich may be made by any person, including the. undersigned. and filed against the city,
but only where such cL 'm ut o he reliance of the city. including its officers and employees. upon the accuracy of the
Wormation supplied to h a of this application.
SIGNATURE: DATE
% ,
PRINT NAME: 4�'l
Bulletin #100 -January 1, 2011 Page I of 3 k:\Handouts\Permit Application
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