16-104379City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
-0a,k 54.ilffd
Building - Single Family
Permit #: 16 -104379 -00 -SF
Inspection Request Line: (253) 835-3050
Project Name: PHILBRICK
Project Address: -1508 SW 321ST ST
Project Description: REP - Remove and replace composite roofing and underlying
010450 0850
Owner
A nlp icant
Contractor
Lender
MICHAEL PHILBRICK
MICHAEL PHILBRICK
OWNER IS CONTRACTOR
RUTH PHILBRICK
1508 SW 321ST ST
1508 SW 321ST ST
FEDERAL WAY WA
FEDERAL WAY WA
Census Category: 555 - Non-struct� \ai Do g permits
Includes:
#1 #2 #3 #4
Occupancy Class:
R-3
Construction T
Type V - B
Occupancy Load
Floor Areas . ft.
0 0 0
l Addit l P it Information
New / Additional Sq. Feet - 3rd Floor ................... New / Additional Sq. Feet - Basement ................... 0
Calculated Structure Valuation .............................. 0 Occupancy #1- Construction Type. ....................... Type V - B
Mechanical to be Included? .................................. Occupancy #I - Class............................................. R-3
Plumbing to be Included? ................................. Occupancy # 1- Use ............................................... Residence (1 or 2
family)
o F. res Iociated With This Permit 11
P R T EXPIRES Wednesday, March 1, 2017
ermit Issued on Friday, September 2, 2016
1 hereby certify that the above formation is correct and that the construction on the above described property and
the occupancy and the use ill be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. ,
Owner or agent: f ►1 Date:
THIS CARD IS TO REMAIN ON-SITE
coy of Construction Inspection Record
Federat- a; INSPECTION REQUESTS: (253) 835-3050
PERNIIT #: 16 -104379 -00 -SF Address: r 1508 SW 321 ST ST
Project: MICHAEL PHILBRICK FEDERAL WAY, WA 98023-5401
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
Approved to install
By n_\ Date Q
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
11
Right of Way
Approved
By
Date
By
Date
By
Date
41k
CITY OF
Federal Way
PERMIT NUMBER f v
it EIVEIJ
PERM I*APPLICATION
SEP 4 2 2016 PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcentel@cityoffederalway.com
CITY OF FEDERAL WAY
— TARGET DATE
SITE ADDRESS
115-0,3 Sl„� j� I s t- st Gj�,, gyU,j
SUITE/UNIT #
PROJECT
�VALUATION � r
-�
ZONING
ASSESSOR'S T � /PAR L # 4 5 0 - D S/ s T
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
900et c,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
C� �C
/
i 0� G�
NAME
PRIMARYPHONi���
PROPERTY OWNER
MAILING ADDRESS ^_ _, b��
E-MAIL
CITY ,ry /���
�'�/�/
SE
ZIP
NAME
PHONE
MAILING ADDRESS
A
E-MAIL
CONTRACTOR
CITY
ZIP
FAX
WA STATE CONTRACTOR'S ENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME �r � w ^ ` �
C• TU K UR1,w1`�`t1
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
APPLICANT-
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME MIKE 1 th,lA t`CV-
�
PRIMARY PHONE q
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
concerning this application)
CITY IP
FAX
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $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 flied 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
irWformation supplied to the as apart of this application.
ditty
SIGNATURE- �^�--�_ DATE 2(7
PRINT NAME:
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Iiandouts\Permit Application