17-100456 Mechanical
City of Federal Way Permit #:17-100456-00-ME
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: FEDERAL WAY PUBLIC HEALTH
Project Address: 33431 13TH PL S Parcel Number:768190 0070
Project Description: Replace existing gas water heater with new 55 gallon tank
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Owner Applicant Contractor
KC-PUBLIC HEALTH KC-PUBLIC HEALTH KC-PUBLIC HEALTH
500 4TH AVE 500 4TH AVE 500 4TH AVE
SEATTLE,WA 98004 SEATTLE,WA 98004
SEATTLE,WA 98004
Additional Permit Information
Mechanical Work Valuation? 2000.00 Is this an Online or O.T.C.application? Yes
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• �f" .,41,7.; McC�lanical1�E411 fs1 ✓j 3
Hot Water Tanks 1
PERMIT EXPIRES Sunday,30 July,2017
Permit Issued on Tuesday,January 31,2017
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: /(..e."---4.
.c '4t/ /Y _-��-�GQ�/�— Date: / 1 7
•
` THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record
y INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 100456 00 Address: 33431 13TH PL S
Project: KC-PUBLIC HEALTH FEDERAL WAY WA 98003-6357
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.
® Mechanical Rough-in(4165) ® Gas Piping(4125) ® Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By e Date a— ,IA )ti
Rough Electrical
0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
,.,,A16,
• PERMI'PAPPLICATION
CITY OF
PERMIT CENTER + 33325 8th Avenue South + Federal Way,WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835-2609 + permirVetige0offederalway.com
PERMIT NUMBER 7- - 10 0 45-6, _ M JAN 31 `. `
TARGET DATE �� y
MI rif-, CE ii,W
SITE ADDRESS Fed*riot- t.0 Al f b 1;c he I'H. surslopyr#
334/ .3f 13A- L. S. Feder-AL L,47 9$003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARC# - CO$ & CJ
7-0
2, 000. 00
TYPE OF PERMIT ❑ BUILDING rif PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT Fr4le'of L W Pot pu& /k h e.-1'L
PROJECT DESCRIPTION Re P(c4cc. 14 W T' — (.0.„-k-1,_ ),„c u S$ 4 A( C.A-5 hof ou wi--.-�
Detailed description of work to 'y'4 M k
be included on this permit only
NAME RIMARY PHONE
k we CVIA#44. 1 00) 79 j- 7 919
PROPERTY OWNER MAILING ADDRESS E-MAIL
1-101 4 t2 A Ve. 560•04+ksve—
CITY STATE ZIP
1401- Gv14 q f/o y fee lly . Sulk>wto+J *VI Atccv4y.6,
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT 16 ft., 5"W l4NS c A.) \2 04) -7f4,- -)Ii 7
(The individual to receive and MAILING AD RESS E-MAIL
respond to all correspondence L-101 L Ate''- N. 1411 if'Swail/sari#.1 Cam?"4o.'
concerning this application) CITY STATE ZIP FAX
K.11/4+ wn- 98101
NAME
PROJECT FINANCING ❑ 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 the city as a part of this application.
SIGNATURE: //)JJ I, 41(442-1**-- / 1.-7/'' DATE � `/7
PRINT NAME: /tC I I 1 g 5w 41'W 6r/
Bulletin#100—January 29,2016 Page 1 of 2 k:AHandouts\Permit Application
• •
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATF.R SYSTEMS URINALS OTHRR(Tlnar)rihn)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet( EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No : ❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED ( TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR �
COVERED ENTRY
DECK
GARAGE 0 CARPORT ❑
OTHER(describe)
Area Totals EXISTING PROPOSED TOTAL
**.NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ j # OF BEDROOMS
COMMERCIAL-NEW/ADDITION
Area in Construction # of
AREA DESCRIPTION Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area In Occupancy Groups) Construction # of Additional Information
Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-January 29,2016 Page 2 of 2 k:\Handouts\Permit Application