20-102015 f t ji
Building - Single Family
City ofFederal ay Permit #:20-102015-00-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: SAM
Project Address: 419 SW 327TH PL Parcel Number:926491 0940
Project Description: Tear off existing tile roofing.Install 1/2" CDX plywood sheathing.Install asphalt roofing
shingles and all necessary components.
Owner Applicant Contractor Lender
MITCHELL SAM PLATINUM HOME LLC. PLATINUM HOME LLC OWNER IS LENDER
419 SW 327TH PL 11921 SE 212TH PL 11921 SE 212TH PL
FEDERAL WAY WA 98023 KENT WA 98034 KENT WA 98031
USA
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: 16,240.00
PERMIT EXPIRES Tuesday, 17 November,2020
Permit Issued on Thursday,May 21,2020
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
on a City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON-SITE
Federal Way Construction Inspection Record
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 20 102015 00 Address: 419 SW 327TH PL
Project: MITCHELL SAM FEDERAL WAY WA 98023-5643
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 0Final-Building(4050)
Approved to install roofing Approved
4By Date .•By LAS Date Ocp let ktao.
Rough Electrical 0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
DECEIVED
PERMIT APPLICATION
2 0 2020 PERMIT CENTER+33325 8th Avenue South + Federal Way.WA 980031 6325
< e a MAY 253-835-2607+ FAX 253-835-2609 + t r-i=i iso erf .0 cityoffcdczalway.co,n
OF
COMMUNITY FEDERAL
DEVELOPMENT
PERMIT NUMBER F
0 _ / D A o / a _ 5- TARGET DATE
SITE ADDRESS
SUITE/UNIT#
L//1
5&
�0 7
PROJECT VALUATION I ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT n BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detaileddescription of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
I
NAME _- .. PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE.: ZIP FAX
?0,1101, y N WA STATE CONTRACTOR'S LICENSE#, EXPIRATION DATE UBI#
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE„ ZIP - FAX
NAME N • PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP , FAX
s--
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), whichmay be made by any person, including the undersigned,and filed against the city,
but only where such claim arises put of the/reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE: DATE t
� j
PRINT NAME:
Bulletin#100—February 19,2020 Page 1 of 2 k:\Handouts\Permit Application