21-101530City of Federal Way
Community Development Dept.
33 325 Sth Ave S
Federal Way. WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: KILGORE
Project Address: 220 S 329TH LN
Building - Single Family
Permit #:21-101530-00-SF
Inspection Request Line: (253) 835-3050
Parcel Number: 926870 0260
Project Description: Tear off composition shingles and install composition shingle roofing system with some
sheathing replacement.
_Owner A_p lip cant Contractor Lender
CARL KILGORE ALISA BERKLANDNORTHW EST NORTHWEST ROOF SERVICE INC OWNER IS LENDER
220 S 329TH LN ROOF SERVICE INC 801 CENTRAL AVE N
801 CENTRAL AVE N KENT WA 98032
FEDERAL WAY WA 98003-6368 KENT WA 98032
Census Category: 555 - Non-structural roofing permits
Additional Permit Information
Mechanical to be Included? ......................... I ...... I... No
Plumbing to be Included? .............. .. No
Total Valuation: 9,000.00
Is this an Online or O.T.C. application? ................. Yes
No Fixtures Associated With This Permit !I
PERMIT EXPIRES Saturday, 16 October, 2021
Permit Issued on Monday, April 19, 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
n
tvn a City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON -SITE
CITY OF Construction Ins ection Record
Federal Way INSPECTION REQUEVTS: (253) 835-3050
PERMIT #: 21 101530 00 Address: 220 S 329TH LN
Project: CARL LEE KILGORE FEDERAL WAY WA 98003-6368
Scheduled inspections may be failed if this card is not on -site. nQ NOT LOSE TIiiS 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)
Approved to install roofing
By Date
❑ Final - Building (4050)
Approved , r
By VJ 5 Date 51��Z
❑ Final Electrical
❑
Right of Way
Approved
❑ Rough Electrical
Approved
Approved
l;y Date
!3y Date
By
Date
RECEIVED
4� �_'N.. PERMIT APPLICATION
07y W: APR 15 2021 Pt�prvia 3'3325 " )�jjj�jj + A �js"A3-6M5
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Federal Way 2_53-935-2f,60? #- PAX 253-8,35-26,,),9 + otrylit."'. -I
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
10- 1 -5 3 -0 -5 F TARc*.,r DATE
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PROJECT VALUATIO14
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ril S01V8 TAX/PARCEL A
TYPE OF PERMIT
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NAME OF PROJECT
PROJECT DESCRIPTION
Detade,d dc,scription qf t),)ork to
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6 i r 1 t,'l U d O'd 117 1, GIiIS p e r r,, z i t o n h I
NAME
I MAIMNI; ALP
PRIMARY PHONE
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PROPERTY OWNER
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CONTRACTOR Au
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PRIMARY PHONE
APPLICANT t'IATLING ADDRVS3
E-MAIL
CITY STATE 211P
FAX
IN` D
PROJECT CONTACTfr
PRTMARY NHONI' J
id ; t receI;ve on'd 10 A,))�
—
CiTy TA7-Imp
FAX
NAME
PROJECT FINANCING
OWNER, -FINANCED
10ic"t U,!Ixis $5,000 orawre MAILING ADDREISS, CITY, STATE, ZIP
ip" i V .19. L,' 7,0 95;
PHONE
I certify under penalty of perjury that I (trn the property owner or authorized agent of the property viviter,
I Certify that to the best
of my knowledge, the Information submitted in support qj'this permit application is true and corroct, I certify that I will comply with
all applicable City of Federal Way regulations portaininy to the work authorized by the issuance of " pel,mit, I understand that the
issuance of this permit does not remove the owner's respon4ibllity for cornpHarive with total, state,
construction or environmental laws.
or fe0cral lairs requlaUng
Ifurther agree to holrl 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 filerl against the cloy,
but only where such claim arises out of the relfunce of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
I
SIGNATURE :
--.---DATE
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