19-104091 _ w
r+ A
Building - Multi Family
City of Federal Way Permit #:19-104091-00-MF
Community Development Dept
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: MIRO AT DASH POINT APARTMENTS BLDG 30808
Project Address: 30808 17TH PL SW Parcel Number: 122103 9142
Project Description: Complete tear off and reroof of this building.
Owner Applicant Contractor Lender
ROC II FOREST COVE LLC BLUE PINE CONSTRUCTION BLUE PINE CONSTRUCTION
5295 S COMMERCE DR SUITE IOC CORP CORP
MURRAY UT 84107 4857 W 147TH ST SUITED 4857 W 147TH ST SUITE D
HAWTHORNE CA 90250 HAWTHORNE CA 90250
Census Category: 555-Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0.00 0.00 0.00 0.00
Additional Permit Information
Mechanical to be Included" No Number of Stories 2
Is this an Online or O.T.C.application? Yes Permit for Building Shell Only" No
Plumbing to be Included" No
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•i�,;; $ l:; d .E .t �V.: Rim •�j_-�i - .< 9
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PERMIT EXPIRES Wednesday, 19 February,2020
Permit Issued on Friday,August 23,2019
I hereby certify tha,the above information is correct and that the construction on the above described property
and the occupa and the use will • in accordance with the laws, rules and regulations of the State of
.- in'ton and the City of Federal Way.
Owner or agent: 14 d A A�/ Date:
..._.t...\(.14.A_
A I
44,14 THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19104091 00 Address: 30808 17TH PL SW
Project: ROC II FOREST COVE LLC FEDERAL WAY WA 98023
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.
Roof Sheathing(4220) 1 0 Final-Building(4050)
Approved to install roofing Approved
,ByLQ Date F/27/9 ..BY/(,(,s Date 3 /
0 Rough Electrical 0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
PERMIT APPLICATION
CITY OF �..�
PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835-2609 +permitcentertcityoffederalway.com
PERMIT NUMBER lq _
/ O--/ A�-
- 111-111 TARGET DATE
SITE ADDRESS ( (� SUITE/UNIT M
3C'c�'c ' 7�� �'Ctc�c_ -_�`` F-akf't14C\ 4,-)e.�
C. \vieC cl 02:3
PROJECT VALUATION ZONING ' ASSESSOR'S TAX/PARCEL 0 '
$ :2)c (,t= I - 2- r C -S - `i I ck -z---
TYPE
z_TYPE OF PERMIT ,]$UILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT 0\_1 it U GK-.\- -.. -...5‘k
-..5‘k -1 ,%\-\--
PROJECT DESCRIPTION
(1-C,.11-r1)\-Qz-'c-c? .\ e.. c .0 C_)Sr �-tivAck. 0 z----cz.S--
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
RW?:› tOk1(' (-51/4--,;41 e.r i L.Lam_ S.3 231. C.)S-4_,L)
MAILING ADDRESS E-MAIL
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CITY STATE ZIP
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NAME--, . - PHONE
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MAILING ADDRESS � E-MAIL
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CONTRACTOR "I i-.)-1- , v`1 l �� , 5��- rvi., :,VAu,,�';Rc I.'C ,el-134
CST{ STATE ZIP FAX
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WA
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
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E PRIMARY PHONE
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APPLICANT MAILING DRESS E-MAIL ' •
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT W ct.ec7' ,'., Zap h Lv-11.--i
(The individual to receive and /MAILING ADDRESS E-MAIL
respond to all correspondence YS(6 % N a1 (11-21: ` 1+ .31 i;‘,1, S.!kt..C'_c iA
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING F-,01-'a Wk-t c U .1-A,,%(1 rt..^ l IL-C- OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP we/� .� L PHONE
(RCW 19.27.095) J)1 • :-A„\ `"t� �)t
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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 suppli thWcits as a part f his application.
SIGNATURE: Wer ' t DATE il 2 Z-,I L'1 I
PRINT NAME: i\64-01k,,:. (. ktc t d c;-jt-y
Bulletin#100-January 29.2016 Page 1 of 2 k:\Handouts\Permit Application