14-104249City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax: (253) 835-2809
c I
Building - Single Family
Permit #: 14 -104249 -00 -SF
Inspection Request Line: (253) 835-3050
Project Name: E%1BR0 r— 11r00%000
Project Address: 1103 SW 350Th PL Parcel Number. 542243 0200
Project Description: REP - Remove existing shake roofing and replace with shingles.
Owner
NAN B I BRO
ARRIlicant
STATEWIDE ROOFING LLC
Contractor
STATEWIDE ROOFING LLC
lender
OWNER IS LENDER
1103 SW 350TH PL
PO BOX 964
STATER*004NP (9/13/14)
FEDERAL WAY WA 98023-8106
SUMNER WA 98390
PO BOX 964
SUMNER WA 98390
Census Category: 555 - Non-structural
Includes. I # 1 I #2 `f*0!!!j3 I.J4 I
Occupancy Class: & .
Occupancy Load I I / I or I I
Floor Area (sq. ft.) 1 0 1 - 0101 1 1 0
New / Additional Sq. Feet - 3rd Floor ...............
Mechanical to be Included? ..............................
iitional Sq. Feet - Basement...................0
tabe- Included? ...................................... No
64
lTqgx onday, February 16, 2015
ermit Wednesday, August 20, 2014
I her ertify a ve infor correct and that the construction on the above described property and
the an use will be in rdance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. 'J
Owner or ent: Date:
V;&� THIS CRD IS TO REMAIN ON-SITE
FedA
eral WayConstruction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 14 -104249 -00 -SF Address: 1103 SW 350TH PL
Project: NAN B IMBRO FEDERAL WAY, WA 98023-8106
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.
Pee- Apgroved to install roofing v Approved
By � s Date $- a� ,/ Y By Date
EJ
Rough Electrical
Approved
Final Electrical
Right of Way
Approved
Approved
By
Date
By
Date
By
Date
Cl" of `
PERMIT 91PPLI&"10N
Federal Way
AUG 19 2014 �,'��'�g
PERMIT NUMBER f —[ _ I O 4 2-4
\\ TARGET DATE CITY OF FEDERAL WAY
SITE ADDRESS
SUITE/UNIT #
$ PR ECT VALUATION
ZONING
ASSESS rlr�! # 02700
TYPE OF PERMIT
BUILDING El PLUMBING ❑MECHANICAL El DEMOLITION El ENGINEERING 13 FIRE PREVENTION
NAME OF PROJECT
P
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CSTATE ZIP
NAME l 1/�_`
MAIL O ADDRESS
E-MAIL
CONTRACTOR
r
1kh-
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
-f
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
^ g11_0 _
MAILING ADDRESS
__- -__ -__ -_-
E-MAIL
(-The- individual to receive-anr�
respond to all correspondence
R S461 a4Je/
CITY
I";L-S3_863_
STATE
ZIP
FAX
CIM
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 reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city apart this application.
SIGNATURE: DATE 1
PRINT NAME:
Bulletin # 100 —January 1, 2013 Page 1 of 3 k:\I3andouts\Permit Application
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