21-100862City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: LONE
Project Address: 425 SW 295TH PL
Building - Single Family
Permit #:21-100862-00-SF
Inspection Request Line: (253) 835-3050
Parcel Number: 119600 4063
Project Description: Tear off shake roofing. Install new 1/2" CDX sheathing and a composition shingle roofing
system.
Owner
Applicant
Contractor
Len -der
KRISTIN M LONE
VALENTINE ROOFING INC
VALENTINE ROOFING INC
425 SW 295TH PL
400 INDUSTRY DR SUITE 130
400INDUSTRY DR SUITE 130
FEDERAL WAY WA 98023-3555
TUKWILA WA 98188
TUKWILA WA 98188
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? ............ I ...... :............ :.... . No
Plumbing to be Included?............ ... Yes
Total Valuation: 54,955.00
Is this an Online or O.T.C. application? .................. Yes
No Fixtures Associated With This Permit H
PERMIT EXPIRES Tuesday, 31 August, 2021
Permit Issued on Thursday, March 4, 2021
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: Date:
THIS CARD IS TO REMAIN ON -SITE
"TM OF
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 21 100862 00 Address: 425 SW 295TH PL
Project: KRISTIN M LONE FEDERAL WAY WA 98023-3530
Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE T111S 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.
EJ Roof Sheathing (4220)
Approved to install roofing
By Date
Final - Building (4050)
Approved
By 'L L-J.5 Date 41I / 3
Rough Electrical
❑
Final Electrical
L1Right
of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
Ai��
Federal Way
MAR 03 2021 PERMIT APPLICATION
P$RMIT CENTER + 33325 31 Avenue South + Federal Way, WA 98003-5325
�' M N FEMMFV11-W11Y MIT C NTER + FAX 253-835-2609 + perrllitcentelfgcityoffederal��ay.coal
COMMUNfTY q�L�PME�IT
PERMIT NUMBER 2 1 _ ®/2 _Q h A _ :5
TARGET DATE
4Z 5 S W 2q5"', Pt ficde_raA Via , WA
PROJECT VALUATION
ZONING
ASSESSOR'S TAXIPARCEL #
$ 54,955.00
1_ _1 k lyn Ja-
TYPE OF PERMIT
BUILDING ❑ PLUNIBIIvG ❑ MECHAMCAL ❑ DEmou'rION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
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PROJECT DESCRIPTION
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Detailed description of work to
be included on this permit only
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NAME K-M
PRIMARY PHONE
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PROPERTY OWNER
MAILING ADDRESS
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STATE
ZIP
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NAME VV4AVl ll (1 t IV+�J� i iV
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CONTRACTOR
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STATE
ZIP
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FAX
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WA STATE CONTRACTOR'S LICENSE 8 EXPIRATION DATE
UBI A
NAME ^ pp , /" m (Zal(�{
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
APPLICANT
CITY STATE I ZIP
FAX -
NAME 1_ �/� �(,yJ7
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PMAMRY PHONE
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PROJECT CONTACT
MAILING ADDRESS
E-MAtt
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The individual to receive and
respond to all correspondence
Q me
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CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING NAME aA•t_l Crcd 4 Un ld(} ❑ OWNER -FINANCED
When value is $5,000 or more /MAiLIN4 Ae213RE S, CITY, STATE, ZIP ,, �jPHHONE
(RCW 19.27.09,5) (01 4 J {( � Avdar \V . tWj kA Z010 - 2_ 1 {y -
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 enutronmental 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 citty, Including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
r
DATE II
SIGNATURE: _
IIf
PRINT NAME:Gf G iar [`�iG P P
14 11
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Bulletin 9100 — February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application