19-104373 Building - Single Family'
City of Federal Way Permit #:19-104373-00-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: BERFIELD
Project Address: 633 SW 294TH ST Parcel Number: 119600 2937
Project Description: REP-Replace/patch GWB,replace insulation as needed for water damage repair. No
plumbing or mechanical.
Owner Applicant Contractor Lender
JEFFREY BERFIELD INTERSTATE RESTORATION WA INTERSTATE RESTORATION WA OWNER IS LENDER
633 SW 294TH ST LLC LLC
FEDERAL WAY WA 98023-3541 3401 QUORUM DR SUITE 300 3401 QUORUM DR SUITE 300
FORT WORTH TX 76137 FORT WORTH TX 76137
Census Category: 434-Residential alt/add-no change in number of units
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.application9 Yes
Plumbing to be Included9 No
Total Valuation: 10,000.00
4g z a re1°
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PERMIT EXPIRES Tuesday, 10 March,2020
Permit Issued on Thursday,September 12,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy a d 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: Date: 9— ,'
[eCf6 b6x 1 c(9 f
04 THIS CARD IS TO REMAIN ON-SITE f ,
OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104373 00 Address: 633 SW 294TH ST
Project: JEFFREY BERFIELD FEDERAL WAY WA 98023-3541
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 Insulation(4150) ; ® Gypsum Wallboard Nailing(4130) Q Final-Building(4050)
Approved to install wallboard / Approved to install mud&to Approved
.By �S Date [l / ! By'`CVS' Date /73/ By r.,44 Date 3-137406,
Polc
-137401.
olc A 0 rx.0-v4
Rough Electrical 0 Final ElectricalElRight of Way
Approved Approved Approved
By Date By Date By Date
,„..„ .A, RECEIVED PERMIT APPLICATION
CITY OF
Federal Way
SEP 12 2019 PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER 49 _ i a C/ 3 73 _ ,S. TARGET DATE C
SITE ADDRESS 1 SUITE/UNIT#
C33 5kV 21e(44 5.7z 41,-1-41 0az t/A 61Z-6, 3PROJECT VVALUI� ON ZONING ASSESSOR'S TAR/PAR L#
TYPE OF PERMIT BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT 8�,.r eik,/ c,k( .
W4- o(f.A. e /moo( ,la Chti 1 -J 6 '1O
PROJECT DESCRIPTIONpon 1�76/a4 b� P pot;c\ Q / /]N e�
Detailed description ofwork to A� PC ''�{ �i+1�1 `{�- "C1j
be included on this permit only J
NAME ,...1 ,,_ - PRIMARY PHONE.. s
PROPERTY OWNERd R,�' �'( 25-5' f yi_ 951
MAILING��K V 94 y 461 5) 4 E-MAIL
V 3
ITSTA ZIP
��I WA w, 1623 ___
NAME
IW
IP
NISL7o I RES Glc,+M ....,0c,, 443616 l '14113-0 a(�
CI �kS Y / ZI'i l?7 FAR 1 j>\ l,t
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# a
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/ /� (Y C
NAME/-,� �
�/NIA,A PJ1�V,Y 7 5
MAILING ADDRESS E-MAIL
APPLICANT- Q c-0 K4.10 M]T0-c.5 I5 ,Go kil
CITY 67`7 7 5./41C1,71- $.4' 1r t ►ATEZIP WA V TcI k FAX
PROJECT CONTACT N/ t:-RIS�ltil,t. R M a Y P - SSI
(The individual to receive and 31e/ADDRESS, C J 9r/ E-MAIL (k it
respond to all correspondence 1j `ry 7 C^f- T!/ C "` ,49S
concerning this application) NAI I k WA. Z�MI
n FAX �10„L (ted vVt
PROJECT FINANCING �/�/ v,( l O` 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 t;city as a part of this application.
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SIGNATURE: ,fri DATE 61422/..)/q
PRINT NAME: ' - �� 614441
Bulletin#100-January 29,2016 Page I of 2 k:\Handouts\Permit Application