12-102901City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: TRELLIS AP
4ruilding'- Mfilti Family
Permit #: 12-102901-00-M F
Pxz� Inspection Request Line: (253) 835-3050
Project Address: 35210 25TH AVE SW
8
Parcel Number: 176150 0080
Project Description: ALT - Removing composition roofing and installing new composition roofing.
Owne
RRlicant
Contractor
Lender
MOSAIC USA FEDERAL WAY LP
3-D ROOF SYSTEMS LLC
3-1) ROOF SYSTEMS LLC
2505 3RD AVE SUITE 326
PO BOX 330
3DROOSL982CJ (2/11/14)
SEATTLE WA 98121
LYNNWOOD WA 98046-0330
PO BOX 330
LYNNWOOD WA 98046-0330
Census Category: 555 - Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Areas . R. 0 1 0 1 0 1 0
Additional Permit Information
Mechanical to be Included?....................................No Number of Stories ................................................. 2
Permit for Building Shell Only? .............................No Plumbing to be Included? ....................................... No
New / Additional Sq. Feet - Total .......................... 0
No Fixtures Associated With This Permit If
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Saturday, December 22, 2012
Permit Issued on Monday, June 25, 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 a in accordance with the laws, rules and regulations of the State of Washington
nd t e /City of Federal Way. l
Owner or agent: `'/ Date:
IINDS 9/* F/(L
` THIS CARD IS TO REMAIN ON-SITE
CITY OF THIS
Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 12 -102901 -00 -MF Address: 35210 25TH AVE SW
Project: MOSAIC USA FEDERAL WAY LP FEDERAL WAY, WA 98023-3191
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.
Rough
SWM Precon Site Mtg (4400)
E]
Initial Erosion Control (4365)
E]
Footings/Setback (4110)
By
Approved
To be done prior to breaking ground
Approved to place concrete
By
Date
By
Date
By
Date
Rough
Foundation Wall (4115)
E]
Drainage/Downspout (4040)
E]
Re -steel (4215)
By
Approved to place concrete
Approved to backfill
Approved to place concrete or grout
By
Date
By
Date
By
Date
E]
Slab/Concrete Floor (4255)
Underfloor Framing (4285)
Floor Sheathing (4105)
Approved to place concrete
Approved to sheath floor
Approved to install flooring
By
Date
By
Date
By
Date
Shear Walls (4245)
Roof Sheathing (4220)
Fire/Draft Stops (4095)
Approved to install siding
Approved to install roofing
Approved
By
Date
B
Date ——�
By
Date
E]
Interim Erosion Control (4370)
El
Framing 4120
g ( )
Prior to scheduling a Framing inspection;
Approved
Electrical, Plumbing & Mechanical Rough -in and
Approved to insulate
By
Date
Fire/Draft Stop inspections must be signed -off and
By
Date
approved IBC 109 3.4
Insulation (4150)
Gypsum Wallboard Nailing (4130)
❑
Suspended Ceiling Grid (4265)
Approved to install wallboard
Approved to install mud & tape
Approved to drop the
By
Date
By
Date
By
Date
E]
Final - Fire Department (4060)
Final Erosion Control (4375)
Final - Building (4050)
Approved
Approved
Approved
By
Date
By
Date
By
Date - Ze - 12—
L
Right of Way
Approved
Date
Rough Electrical
Approved
I
Final Elec
Approved
By ,
Date
By
Date
Right of Way
Approved
Date
-.1 of RECEIvE' —
Federal Way *PERMIT tFM
y
COMMUNITY 253 -D7 -FAX M1fE-835-RI7- 'V 2 5 "kPPLICATION
253-d35-2607• FAX 253-d35�260
u.,:•,:,.�;,,,6.:,,F,...,:,: C1N OF FEDERAL WAY
CDS
LD -� -Y-0L
CO ME PL DE EN FP
SITE ADDRESS
SUITE/UNIT #
�•�,
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
L 0,21 t a UU
—
TYPE OF PERMIT
-��
li�'BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
t
i
/e oc(" d
PROJECT DESCRIPTION
H �o !� C7. Cid SatrN ' q
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
10 ofd ' L
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
1
T�
CITY
STATE
ZIP
NAME r� �W(' ii vvi L t L
PHONE) ( 2. 0 2—
MAILING ADDRESS
! 2' 5,0
E-MAIL
CONTRACTOR
CITY
STATEZIP
FAX
w
it,4-
,
WA STATE ONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
I)t9 G-
02- 11
,¢
NAME
�G
PHONE
MAILING ADDRESS
E-MAIL
APPLICANT
CITY
STATE I
ZIP
FAX
PROJECT CONTACT
NAME_ ��
' CU
PHONE
-7
(The individual to receive and
Dti `-
MAILING ADDRESS �(
B-Ith t6
respond to all correspondence
concerning this application)
• 6 -
CITY
FSTATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
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 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 fled 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 a of this application.
SIGNATURE: / DATE
PRINT NAME:
Bulletin #1100 - Janua 1, 2011 Page] of 3 k:\Handouts\Permit Application