12-1052140
City 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: FIELDS
Project Address: 31627 36TH AVE SW
iuilding - Single 'Family
Permit #: 12 -105214 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 873198 0830
Project Description: REP - Remove existing tile roofing and replace with composition shingles
Owner
A1212111cant
Contractor
Lender
RUSSELL M FIELD
EDCA INC
EDCA INC
OWNER IS LENDER
31627 36TH AVE SW
PO BOX 69114
EDCAI** 126RT (1/6/13)
FEDERAL WAY, WA 98023
SEATTLE WA 98168
PO BOX 69114
SEATTLE WA 98168
Census Category: 555 - Non-structural roofing permits
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 New / Additional Sq. Feet - Basement ................... 0
Mechanical to be Included?....................................No Plumbing to be Included? ....................................... No
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Tuesday, May 14, 2013
Permit Issued on Thursday, November 15, 2012
I hereby certify that the above information is correct and that the construction on the above described properly and
the occupancy and the will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: //_ /S_ /
FW*V,5bo 111Z911Zo
CITY OF '405&
Federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQU TS: (253) 835-3050
12 -105214 -00 -SF Address: 31627 36TH AVE SW
RUSSELL M FIELD FEDERAL WAY, WA 98023-2105
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
B= Date I (� "lBy /L Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
RECEIVE
Fed
Feeral Wa# OV 1:5 2012 PERMIT
COMMUNITY DEVEI.OPME�rI' 'M FEDERAL�c�r PLICATION
253-835-2607• FAX 25 --gg 2 0�./�
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SF MF CO ME PL DE EN FP
SITE ADDRESS
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SUITE/UNIT #
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PROJECT VALUATION DATION
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ZONING
ASSESSQR'S TAX/PARCEL # � � � -
8 b
TYPE OF PERMIT
(NAUIIAING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
0A O V e% St\ vN c ro 0
3:r t Ct New CO vn OS \00 1'\ \h
Ili
be included on this permit only
PROPERTY OWNER
NAME C n �\
PRIMARY PH NE 3$ ,1 44
MADdNG ADDRESS
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E-MAIL
CITY STATE
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ZIP
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NAME j— *J c
PHONE _KV
MAILING ADDRESS ,P , V Go)(6111 ,� 1
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CONTRACTOR
CITY
ZIP,,, bY
FAX 14
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WACONTRACTORS LICENSrrgERPIRATION DATE
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FEDERAL WAY BUSINESS LICENSE #
NAME V
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PHONE V 2.5
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MAILING ADDRESS /
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APPLICANT
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STL0ATE
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PROJECT CONTACT
(7he individual to receive and
respond to all correspondence
this application)
NAME GC
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9L(:9L(:)6FAX
PHONE b
MAILING ADDRESS//
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E-MAILconcerning
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FAx �2e6 5151 431
ALTERNATE CONTACT NAME: PHONE
Y,..k\ o e) ob 9]2i$/6
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5.000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY. STATE. ZIP
PHONE
I cert(fy 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 c ty as a part of this application.
ff C
SIGNATURE: DATE 1 r ✓ �'
PRINT NAME: EA ��� � b r C-0^ O
Bulletin #100 - January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application