11-104261 •uilding - Single Family
City of Federal Way
Community Development Services Permit #: 11-104261-00-SF
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: PHAN
Project Address: 34826 11TH AVE SW Parcel Number: 542242 0720
Project Description: ALT-Reroofing,tearing off existing cedar shakes and installing new comp shingles.
Owner Applicant Contractor Lender
THINH PHAN MM CONSTRUCTION MM CONSTRUCTION
NHI PHAN 12626 RENTON AVE S MMCONC*894PC (10/3/13)
34826 11TH AVE SW SEATTLE WA 98178-3711 12626 RENTON AVE S
FEDERAL WAY,WA 98023 SEATTLE WA 98178-3711
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
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PERMIT EXPIRES Monday, April 16,.2012
Permit Issued on Wednesday, October 19, 2011
I hereby certify that the abov- information is correct and that the construction on the above described property and
the occupancy and the u`-� ill be in accordance with the laws, rules and regulations of the State of Washington
/ d t.e City of Federal Way.
Owner or agent:
Date:i Date: /0 /
Int iofii,,
'' THIS CARD IS TO REMAIN ON-SITE
CITY OF 0Construction Injection Record #.
Federal Way INSPECTION RE UESTS: 253 O 835-3050
Q
PERMIT#: 11-104261-00-SF Address: 34826 11TH AVE SW
Project: THINH PHAN FEDERAL WAY, WA 98023-7014
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) ❑ Final-Building(4050)
Approved to install roofing Approved
By -L� Date �0,2o_// By Date /4,..—zj—1
.
0 Rough ElectricalCI Final Electrical ID Right of Way
Approved Approved Approved
By Date By Date By Date
LL - LO4 L
FeCITY ,..w.. 0 PERMIT •MF CO ME PL DE EN FP
I Federal '- . �� /�D /y /�
COMMUNITY DE T V AP P LIC A `" N I
253-835-260 253-835-2609 v i i.
wwul ati rriPruluvll!arE �, � koe
PCT 19 LI:'1 CYS f`t
SITE ADDRESSy (IFFEDERAL Y SUITE/UNIT#
d
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ (-7/5Li(f -
TYPE OF PERMIT do tsUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) /)/1 01
PROJECT DESCRIPTION /`���y j' o,?�'�� ���:2,1z...-‹.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE y—
PROPERTY OWNER rru�lSrnrG'r s 01,4_
1-1-1 �S3– `1.� �T
E-MAIL
3yi3„26v /i / -vc_ 3,/).
CITY STATE ZIP
�_-.c,a 1. LA./4'7 ),,,0 T 2570 2 3
NAME PHONE
/31 in e.... .7 NS; j2L 7 .J 0 ',--.?".?--Z.---4)I l.?
MAILING ADDRESS E-MAIL- L
CONTRACTOR /2-6 .)17 2e-e.,711-.) /4"(�k.-- 5
CITY STATE ZIP FAX
Sr i GM y r/. i-
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
M 01
NAME./.'G(1--/L ti g,4*/ 11.-
APPLICANT MAILING ADDRESS E-MAIL/ 2(i e).4, ) .4-t/zs
CITY ...... STATE ZIP FAX
664- 641-:- It?1 9f'/2S
PROJECT CONTACT NAME PHONE
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME El OWNER-FINANCED
Required value of$5,000 or more ),1 •
(RCW 19.27.095) MAILING AbDRESS,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 city as a part of this application.
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SIGNATURE: 1 4,7 /,r„"" - DATE /2 / ----e="2‘"/"/
PRINT NAME:
Bulletin#100–January 1,2011 Page 1 of 3 k:\Handouts\Permit Application