14-105251City 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: ROUSSEAU
Project Address: 32800 29TH AVE SW
wilding - Single Family
Permit #: 14-105251-00-S F
Inspection Request Line: (253) 835-3050
Parcel Number: 894520 0680
Project Description: REP - Inspection only of fire damage. No construction work included on this permit.
Ownr
Applican
Contractor
Lende
MICHAEL ROUSSEAU
C R HARSHAW
KRISTIE ROUSSEAU
11345 39TH AVE NE
32800 29TH AVE SW
SEATTLE WA 98125
FEDERAL WAY WA 98023-2768
Census Category: 999 - Unknown
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Areas . ft. 0 0 0 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 II
PERMIT EXPIRES Tuesday, April 7, 2015
Permit Issued on Thursday, October 9, 2014
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. G�
Owner or agent: LDate: rb_-,
CITY OF `'
Federal Way
RW&
PERMIT • PPLICATION
OCT 0 9 2014
CITY OF FEDERAL WAY
PERMIT NUMBER
TARGET DATE
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SITE ADDRESS SUITE/UNIT #
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PROJECT VALUATION
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ASSESSOR'S TAX/PARCEL # —2,L2
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TY E OF PERMIT
*BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
ig
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
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EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
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E-MAIL
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PROJECT CONTACT
NAME CPRIMARY
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PHONE
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
(RCW 19.27.095)
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 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 rel"once of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci as a p of this plication.
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SIGNATURE: DATE
PRINT NAME: '
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Ri letin 4100—.ianuary L 2013 Paoe 1 ofd k WanAn„tc\Perm;t A„ Ii; t;n