11-102197 ° ily
City of Federal Way &lilding - Single Fam
Community Development Services F ILEPermit #: 11-102197-00-SF
PO.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line:
Ph:(253)835-2607 Fax (253)835-2609 p a (253)835-3050
Project Name: SCHULTZ
Project Address: 33606 7TH PL SW Parcel Number: 729804 0410
Project Description: REP-Tear off shake roofing;Install CDX Plywood and Presidential Composition Shingles
Owner Applicant Contractor Lender
TIMOTHY G&PAULA M MOSS MASTERS ROOFING LLC MOSS MASTERS ROOFING LLC
SCHULTZ 12626 RENTON AVE S MOSSMMR9110W(9/16/11)
33606 7TH PL SW SEATTLE WA 98178 12626 RENTON AVE S
FEDERAL WAY WA 98023-5004 SEATTLE WA 98178
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
5. t"Y ». ,,No Fixtures < .. ,� ,',,a�� ; s Permit i!,., ., a
43.)\ -;0 / I VI 1
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 10)and must comply with FWRC
Chapter 19.185 and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES Wednesday, November 30, 2011
Permit Issued on Friday, June 3, 2011
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u will be in accordance with the laws, rules and regulations of the State of Washington
a the City of Federal Way.
Owner or agent: Date: 3 _ �/
THIS CARD IS TOREMAIN ON-SITE
airy 11;11: ' 1°F Construction I ection Record
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 11-102197-00-SF Address: 33606 7TH PL SW
Project: TIMOTHY G & PAULA M SCHULTZ FEDERAL WAY, WA 98023-5004
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.
O SWM Precon Site Mtg(4400) 0 Initial Erosion Control(4365) 0 Underfloor Framing(4285)
Approved To be done prior to breaking ground Approved to sheath floor
By Date By Date By Date
El Floor Sheathing(4105) ❑ Shear Walls(4245) El Roof Sheathing(4220)
Approved to install flooring Approved to install siding 'if-
to install roofing
By Date By Date By // "f- Date G //
O Fire/Draft Stops(4095) 0 Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in and
Fire/Draft Stop inspections must be signed-off and
By Date By Date approved. IBC 109.3.4 .
Framing(4120) 0 Insulation(4150) '0 Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date By Date By Date
▪ Final Erosion Control(4375) Final-Building(4050)
Approved Approved
By Date By .,1 Date to 1 l3.-\ ,
o Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
.
CITY OFCA
1 �
Federal Way7---
( OZ I 4/1)ERM F CO ME PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES A.P P LI CATION RECEIVED
253-835-2607•FAX 253-835-2609
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6z5•41'-...iii JUN. 0 ;i 'i a$°1
SITE ADDRESS
CMI UPWO E RA L WAY
�.3&•4 ?- S �� t 1,..,, (-L/a CDS
PROJECT
TION ZONING ASSESSOR'STAX/PARC4#
3- 0
O O
TYPE OF PERMIT -IIBUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) �C/ j L -T� �(
PROJECT DESCRIPTION l''"'D v� (� '�� r _
Detailed description of work to ..."--045-7---)0 1....1., C:_./�C Q L y j t/par/)
be included on this permit only
�-j— r
_ice 4N)s tz— /2, e_ -7/e- i4 :7--;,),) SI I '. ,s5Lef
NAME J - PRIMARY PHONE
PROPERTY OWNER SL'-A, L L , ,.2_5-3 _6 - 9�6
MAILING ADDRESS - E-MAIL
'3�3� .?--n-o 6 .. L )
CITY STATE ZIP
CITY__----,
�� 1147 L4 `,`P z 3
NAME _ PHONE '7
a 5'5 �Y) S 7-e.tiS'' i124,01--;" E � , -7122-�J/lI
0, MAILING ADDRESS �J
ONTRACTOR I Z`t' o?4:, /�� � .¢i/C1 S
( CITY�7, %7 STATE ZIP` ` � FAX
1\ (//L'1'/!� EKY/ _
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE k
MOS 5 /fit mg g!1 e /V 9 //‘. iii z
NAME PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME PHONE
(The individual to receive and �i'la ���MAILING ADDRESS / E-MAILespond to all correspondence
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
_ 0 OWNER-FINANCED
Required value of$5,000 or more
(RCW 19 27 095) MAILING DRESS,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 t ity as a part of this application.
SIGNATURE: DATE ` //
7
PRINT NAME:
Bulletin#100—January 1,2011 Page I of 3 k:\Handouts\Permit Application