11-101020 • wilding - Single Family
City of Federal Way
Community Development Services FILEPermit #: 11-101020-00-SF
PO.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line:
Ph:(253)835-2607 Fax (253)835-2609 p q (253)835-3050
Project Name: WEBSTER/FALCO
Project Address: 28221 15TH AVE S Parcel Number: 025130 0320
Project Description: ALT-Tearing off shakes,installing new sheathing and using 10d nails. Installing new
asphalt shingles.
Owner Applicant Contractor Lender
COLLEEN WEBSTER JORNADA ROOFING JORNADA ROOFING COLLEEN WEBSTER
ALFONSO FALCO PO BOX 1992 PO BOX 1992 28221 15TH AVE S
28221 15TH AVE S AUBURN WA'98071 AUBURN WA 98071 FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Census Category: 555-Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0 0 0 0
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0
Mechanical to be Included? No Plumbing to be Included? No
Zoning Designation RS 7.2
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.
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PERMIT EXPIRES Tuesday, September 13, 2011
Permit Issued on Thursday, March 17, 2011
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.
Owner or agent: #9. — Date: 3//41!/
FIN \LED 3/Z5//1
• THIS CARD IS TO EMAIN ON-SITE
CITYOFConstruction I ection Record .
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT#: 11-101020-00-SF Address: 28221 15TH AVE S
Project: COLLEEN WEBSTER FEDERAL WAY, WA 98003-6183
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.
0 Roof Sheathing(4220) 0 Fi i , !- ing(4050)
- .proved to install roofing Approved /
(111:„.„...? Dat ..../ By Da L j/
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OfRMI T
Federal Way CO ME PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES APPLICATION
253-835-2607•FAX 253-835-2609 RECEIVED
u u u rayoffrievhrau con, � (1a 7
SITE ADDRESS C! MAR 1S?IT MIT r
544-- rVi
S 1.410-1-y
szo
PR I V `ION ONIN ` AS O�S AR 1 OF
CITY F DERAL WAY
o00 - CDS
TYPE OF PERMIT 14 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) C./One-eh" GO sic)s
Tom.- -C Q i stJ iin-cA4M '/Z` 514.`4 ,0:41 usi /0ci
PROJECT DESCRIPTION
Detailed description of work to til04l s. Zvis ,4" A4t I A_agUI
be included on this permit only
NAME _ PRIMARY PHONE
PROPERTY OWNER e.,01kur^ 20(0- (ob 1 - 2-9 0$
MAILING ADDRESS E-MAIL
12.1l1 vi?e .3 A '• S
CITY STATE ZIP
ptA�i un Wh diiiP 14 CP
NAME PHONE
So-u c to 1.450A"o, I t' e.— 253-!o y 3-
MAILING ADDRESS C�n E-MAIL
CONTRACTOR P•o. x 14112..l2. mi va Io h4coal..c .ca.."
CITY STATE ZIP FAX •!
AWjLk/vv 1 - 4iQ071 2-5-3 - 735--(03 ((
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
lbR -)Ae_ 1°i�t 3�C. _ 2- / I t / i 2.
NAME PHONE
06•A^ �''�- (Tau.-4•.c& 1c 2S3-40V-V tot
APPLICANT MAILING ADDRESS E-MAIL
Q•U, i3etX 1`tqZ �7i7WiG ►tea-v.�a � . C
CITY STATE ZIP FAX
PROJECT CONTACT NAME � PHONE
(The individual to receive and 'raw N. A ,#
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME PHONE E-MAIL
PROJECT FINANCING NAME D
OWNER-FINANCED
Required ualue 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 as a part
of this application.
SIGNATURE: /a4444A0 /. v"`4I "-_ DATE 3//t4v/)
PRINT NAME: t2AWI pvl 1eiwi ii,i41 80414.
Bulletin#100-January I,2011 Page 1 of 3 k:\Handouts\Permit Application