16-102883t
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: WII.LS/STIEGLITZ
Project Address: 628 SW 295TH PL
Boilding Single Family
Permit #: 16 -102883 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 119600 4224
Project Description: REP - Tear off shake roofing; install CDX plywood sheathing and composition shingle
roofing system.
Owner
Auulicant
Contractor
Lender
VICKI WILLS
HORIZON ROOFING LLC
HORIZON ROOFING LLC
LAWRENCE STIEGLITZ
PO BOX 24449
HORIZRL867L7 (6/27/16)
628 SW 295TH PL
FEDERAL WAY WA 98093
PO BOX 24449
FEDERAL WAY WA 98023-3546
FEDERAL WAY WA 98093
Census Category: 555 - Non-structural roofing permits
Includes:
#1 #2 #3 #4
Occupancy Class:
R-3
Construction T
Type V - B
Occupancy Load-
oadFloor
FloorAreas . ft.
0 0 0 0
Additional Permit Information
New / Additional Sq. Feet - 3rd Floor....................0 New / Additional Sq. Feet - Basement ................... 0
Calculated Structure Valuation..............................6000.00 Occupancy # I -Construction Type. ....................... Type V - B
Mechanical to be Included?...................................No Occupancy # 1 - Class ............................................. R-3
Plumbing to be Included?......................................No Occupancy # 1 - Use............................................... Residence (1 or 2
family)
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Saturday, December 10, 2016
Permit Issued on Monday, June 13, 2016
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
oe nd the City a Way.
Owner or agent Date:
lf�-- 46k\I
T_11 Hell
MY of
Federal Way
PERMIT #:
THIS CARD IST MAIN ON-SITE
# Construction I ction Record
INSPECTION REQ TS: (253) 835-3050
16 -102883 -00 -SF
Address: 628 SW 295TH PL
Project: VICKI WILLS FEDERAL WAY, WA 98023-3546
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.
SWM
recon Site Mtg
i rosionontroFootings/Setback11
Final Electrical
Approved
Approved
Shear Walls (4245)
To be done prior to breaking ground
Approved to place concrete
By
Date
By
Date
By Date
❑ Underfloor Framing (4285)
Rough Electrical
Approved
13
Final Electrical
Approved
Floor Sheathing (4105)
Shear Walls (4245)
Approved to sheath floor
Date
Approved to install flooring
By
Date
Approved to install siding
By Date
By
Date
By
Date
0
13 Roof Sheathing (4220)
Fire/Draft Stops (4095)
Interim Erosion Control (4370)
Approved to install roofing
Approved
Approved
By -A iJ Date
By
Date
By
Date
1:3
Prior to scheduling a Framing inspection;
�
Framing
g ( 4120in )
Insulation (4150)
Electrical, Plumbing & Mechanical RougWn and
Approved to insulate
Approved to install wallboard
Fire/Draft Stop inspections rust be signed -oft and
approved IBC 1".14
By
Date
By
Date
0 Gypsum Wallboard Nailing (4130)
Final Erosion Control (4375)
Final - Building (4050)
Approved to install mud & tape
Approved
Approved
By Date
By
Date
By
0 Date tell,
Rough Electrical
Approved
0
Final Electrical
Approved
11
Right of Way11 --^
Approved
By
Date
By
Date
By
Date
RECEIVED
CITY OF JUA3 016
PERM ITQkPPLICATION
2.
Federal Way CITY OF FEDERAL WAY
CDS (�
PERMIT NUMBER _ TARGET DATE
SITE ADDRESS
62-0 sw Z154 e) r -ed �A) w�7 ��GG�
SUITE/UNIT M
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL 4
TYPE OF PERMIT
(_)$UILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
�
1 �� S �'� �'�� CPK ll uir
be included on this permit only
NAME ^
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME Hifi /_" ` '�5
PHONE
-V 3O -55;/D
CONTRACTOR
MAILING AD 'S I G ^ _ r
1 �j _ r
E -MAH,
CITY 1 t ' rF) I !��
1✓ V W
STATE
a
ZIP C�w�
js(v'I
FAX
WA STATE CONTRAOR'S LICE rt N
2•J(''+ /(� ll' V 'l/
EXPIRATION /�> � i
FEDERAL WAY BUSINESS LICENSE M
NAME
PRIMARY PHONE
W'
MAILING ADDRESS
E-MAIL
APPLICANT
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME , �e
��
PRIMARY PHONE7 /
ZGG
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
When value is $5,000 or more
IRCW 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 as rt of this application.
SIGNATURE: DATE
�/
PRINT NAME: 1 t k 6`Je
Bulletin #100 — February 22, 2016 Page 1 of 2 k:\Handouts\Permit Application