06-105150 Comrn niity Deve opmenof Federal t Serviceay s Buil�n m#: 06-105150-00-SF
P.O.Box 9718 Y
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: BLACK
Project Address: 33117 10TH PL SW Parcel Number: 926495 0350
Project Description: REP-Reroof to include removal of shakes and installation of plywood
Owner Applicant Contractor Lender
TERRY BLACK HORIZON CONTRACTORS INC HORIZON CONTRACTORS INC
33117 10TH PL SW 32705 5TH AVE SW HORIZCI11OKR 05/14/07
FEDERAL WAY WA FEDERAL WAY WA 98023 32705 5T1I AVE SW
98023-5204 FEDERAL WAY WA 98023
Census Category: 555 -Non-structural roofing permits
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load: r
Fir Area(sq.ft.) 0 0 0 0
.E ti info tion
New/Additional Sq Feet-3rd Floor 0 'f New/Additional Sq.Feet-Basement 0
Mechanical to be Included9 N fi Plumbing
to be Ineluded No
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Friday, October 10, 2008
Permit Issued on Tuesday, October 10, 2006
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 accor nc,€with the laws, rules and regulations of the State of Washington
d-he City of Federal Way.
Owner or agent: � Ate. Date: I 0 (° `J
• • THIS CARD IS TO .MAIN ON-SITE " ,
CITY OF tommunitY pnt Develo m Inspection Record
P
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-105150-00-SF
Owner: TERRY BLACK
Address: 33117 10TH PL SW
FEDERAL WAY, WA 98023-5204
This card is part of your required inspection documents. 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 Temp.Erosion Control(4365) ❑ Underfloor Framing(4285) 0 Floor Sheathing(4105)
To be done prior to breaking ground Approved to sheath floor Approved to install flooring
By Date By Date By Date
❑ Shear Walls(4245) ,❑ Roof Sheathing(4220) 0 Fire/Draft Stops(4095)
Approved to install siding Approved to install roofing Approved
By Date By Aft Date /0/0/4 By Date
z.,NOTE: Prior to scheduling a Framing(4120) -❑ Framing(4120) ❑ Insulation (4150)
inspection;Electrical,Plumbing&Mechanical Approved to insulate Approved to install wallboard
Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 109.3.4/UBC 10854
By Date By Date
❑Gypsum Wallboard Nailing(4130) ❑ Final- SWM(4375) ❑ Final-Building(4050)
Approved to install mud&tape Approved Approved
By Date By Date By Pti Date /74/496
['Temp.Erosion Maintenance(4370)
Approved
By Date
III • 1132 )
RECEIVED _0 - 1 0 5 15 C�
QTY K
•
Federal Way PERMIT
COMMUNITYDEVELOPMSM'SERVICES 0 CT 1 O 2006 MF CO ME EL PL DE EN FP
33323 EN AVENUE solmr•PO BOX 9718 L I C AT I O N Ta
PBDSRAL WAY,WA 98-83:71 / /
a3a9saeo7•FAXa59835aITY OF FEDEAgg
www.dtuoliedemhvau.com BUILDING DEPT,
The oilowing is • fired i ormation-an(rico •lete a••lication will not be acce•ted. Please •rint •ibl n or , .
■ PROPERTY INFORMATION
SITE ADDRESS 3 31 I-7 JO ,r 1 . S.vV• SUITE/UNIT 0
ASSESSOR'S TAX/PARCEL I `I - _ LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach aoparatapr4.J4 Ienpttry legal dooaipNanl
■' PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provid detailed description`of work included T this it onl 1
SYN0IN.-4 (n-S g :)c
V V
PROJECT NAME(Name of Business or Owner Last Name) LA-c%_
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER -- of f" e tt. ( ) -
MAILINO C2S-9
CITY T ,ZIP
33`)"1 (DO5, t7
CONTRACTOR COMPANY NAME APPU AMEEsOFFICE PHONE
kikS
( Lcs .t, 1'�-' "� ( )
MAI 2710 A CITY, ATE,ZIP CELL PPI ONE '
ja7ox-- _f S.k jvJ ( 1113� o - Nh-
CITY FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
•- - -B L ' / I ( ) -
CONTRACTOR'S REGISTRATION NUMBER)copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT ' COMPArytrIlp APPLICANT NAME OFFICE PHONE
MAILING ADD>6 CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect ❑::Tenant 0 Agent ❑ Other(Describe) ( )
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( .) -
LENDER
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
•
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 7-200.
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
•
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
sasrua rsorasso mrN. �`-i 1?;
NUMBER OF FLOORS
**NEW HOMES ONLY"' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commerdu WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(orThb/Shower Combo) SHOWERS WATER CLOSETS(roan) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
IAAVS permroom since VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorised by the owner of the above premises to perform the work for which the permit application is made. 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 tiny person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance oft city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME TITLE cj'Iv ) t `t m ,r —Q DATE IO'o
(Signature) (ntie)
RELATIONSHIP TO PROJECT I] Owner o Agent 'Contractor t7 Architect o Other •
Ridletin#1 i111—Ianunry 1 20116 Pace 2 of 4 Wiandouts\Permit AnDlication