19-104561 Building - Single Family
City of Federal Way Permit #:19-104561-00-SF
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: BUTZERIN
Project Address: 28831 14TH CT S Parcel Number: 516210 0550
Project Description: REP-Remove cedar shakes and install 1/2" CDX plywood and composition shingles.
Owner Applicant Contractor Lender
ROBERT BUTZERIN PETE GIEREHORIZON ROOFING HORIZON ROOFING LLC OWNER IS LENDER
28831 14TH CT S LLC PO BOX 24449
FEDERAL WAY WA PO BOX 24449 FEDERAL WAY WA 98093
98003 FEDERAL WAY WA 98093
Census Category: 555-Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.)
Additional Permit Information
Mechanical to be Included? No Is this an Online or O.T.C.application? No
Plumbing to be Included? No
Total Valuation:8,100.00
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PERMIT EXPIRES Saturday,21 March,2020
Permit Issued on Monday,September 23,2019
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: geel°11". Date: fl23))/
/,
` THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104561 00 Address: 28831 14TH CT S
Project: JODI BUTZERIN FEDERAL WAY WA 98003-3774
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.
Cl Roof Sheathing(4220) ® Final-Building(4050)
Approved to install roofin Approved
, ens Date, 2V/� ..By �..vt4 Date ra 7/4 .
f/
❑ Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date ` By Date By Date
RECEIVEDAPPLICATION
CITYOF ice,- PERMIT
SEP 2 J 2019 PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
of
Federal Way 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
CITY OF COM UNITY p ERAL W,�Y
EVELOpME
PERMIT NUMBER I 9 _, ( 0 41 5 Co N1 _ s r-- P ( pc--
-
TARGET DATE
SITE ADDRESS SUITE/UNIT#
z f 8 3) )401 e4- 5 i-dcrAi Iii'-) LI 4 'N(40.3
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ el . �d 5 1G Z i o _ 0 5 S— 0
TYPE OF PERMIT BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT t „ ).2 Gr a/l
PROJECT DESCRIPTION .‘'�.01f4t t C!J v s K(f f'-J 1,.*) , 111 I. c lox (I-2 w D Gt)
Detailed description of work to
be included on this permit only (MP'S 1 41 SL1n�fil
`NAME , PRIMARY PHONE
700f 4- 134 6,p1- e '►n
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
.
.. . NAME PHONE
_
.n Oil zee) f2F;,,j 25) -84- 5833
MAILING ADDRESS �!�`X Q E-MAIL
CONTRACTOR V t/_ _7
�
CITY V \ (n t , (F� STATE ZIP #7 /3 FAX
WA STATE CONTRACTOR'S LICENSE# ICY EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
HiR 2 ZR7 L46� � G i iz►
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS � � E-MAIL
CITY STATE ZIP FAX
NAME 0 1 , PRIMARY PHONE
��
PROJECT CONTACT ((� t 2#c- 231-2181
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP - PHONE
(RCW 19.27.095)
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: / , DATE
ti1/j2 )/6.n
PRINT NAME: L 6,r tre
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application