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11-102964 CITY OFA *PERMIT Federal WayMF CO ME PL DE EN FP COMMUNITY DEVELOPMENT SERVICES APPLICATION 1 E C E I ED 253-835-2607•FAX 253-835-2609 www.rthloffedemlu,�aJ.rom JUL 2 W 201 b`ITE ADDRESS stn . NAWAY - •\),P ,_ni/ P/ ii--e')/i.)- RICIIP riker PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL ail zo 4z � I - a1Yo TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING [12MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT - (Tenant Name/Homeowner Last Name) �/, / ri --.a/ , (4,702/ii (', wrI / / , 1ROJECT DESCRIPTION / a , [ Uo (�jQ,/1 ty� tf ->i 72 VQl�f) llTZ/67 Detailed description of work to I L J ri l-1� �JJ�](� D 1�IL?'�G� li/ l/�� ' be included on this permit only �. N - -_�a tea ' . ..� /(7epgfRIMARY PHONE • PROPERTY OWNER /0144j, "Micil / �/ SMAILI G D J� [ s Cir?Y-'/C/I^�//) /`/ S(/�� / ,v/( / 3T� ZIP C„---(C) NAME LlPHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / NAME PHONE -N APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX PROJECT CONTACT NAM( P oNE�-. 7 (The individual to receive and ' "��' �� fnl �f � 2 respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E-MAIL PROJECT FINANCING NAME fl OWNER-FINANCED Required value of$5,000 or more (RCW 1 9.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE 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 applicatigfC e -i SIGNATURE: /a Z. a V Il/ c �) �W'4'L 'vl (iii-i TE ?CPRINT NAME: t&7--t to I c NM (A r 014s Bulletin#l00-January 1,2011 Page 1 of 3 •! k:\Handouts\Permit Application • • MECIENNIC:AL FIXTURES . VALUE OF MECHANICAL WORK $ (a copy of bid or estirn ust be provided) Indicate how many of each type of fucture to be installed or relocated as partfthtproject. 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 pas) COMPRESSORS GAS LO S REFRIGERATION SYST DUCTING PIPING WOODSTOVES , • • PLUMBING 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 RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GF NAM;A:it 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 ET]Yes No 411' 7;1' RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFIC5VUSE BASEMENT , FIRST FLOOR(or Moble Home) SECOND FLOOR COVERED ENTRY .DECK GARAGE LI CARPORT LI OTHER(describe) EXISTING PROPOSED TOTAL Area Totals 1iOlt, **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ 4/'BEDROOMS CONI):IERCIAL-NEW/AD D I ON Area Construction # of AREA DESCRIPTION ,/". Occupancy Group(s) Stories Additional Information in Square Feet Type NEW BUILDING ADDITION '4C,5 cOENTERCI XI,- REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Construction # of Additional Information / Occupancy Group(s)in Square Feet Type Stories `44'4'NW1 TOTAL BUILDING / TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application �_ b � • City of Federal Way mPlumbing• Community Development Services ° r8 Permit #: 11-102964-00-P L P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-2607 Fax (253)835-2609 , iutelizzas Inspection Request Line: (253)835-3050 Project Name: WILLIAMS Project Address: 2004 S 282ND PL Parcel Number: 422231 0170 Project Description: Relocate laundry washer outlets and install new bathroom sink,toilet and shower Owner Applicant PATRICIA JEAN WILLIAMS PATRICIA JEAN WILLIAMS PATRICIA JEAN WILLIAMS 2004 S 282ND PL 2004 S 282ND PL 2004 S 282ND PL FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 lin Fixtures Laundry Washer Outlets 1 Showers 1 Sinks 1 Water Closets 1 PERMIT EXPIRES Wednesday, January 18, 2012 Permit Issued on Friday, July 22, 2011 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and t - --- will be in accordance with the laws, rules and regulations of the State of Washington and t e C%,o ederal Way. Owner or agen : 1 videix w l A Date: 9/9/ O (; I / ts/te r Plumbing City of Federal Way • 1110 Community Development Services Permit #: 1 1-102964-00-PL P.O.Box 9718 Federal Why,WA 98063-9718 Inspection Request Line: 25 Ph:(253)835-2607 Fax (253)835-2609 P q ( 3)835-3050 Project Name: WILLIAMS Project Address: 2004 S 282ND PL Parcel Number: 422231 0170 Project Description: REP-Relocate laundry washer outlets and install new bathroom sink,toilet and shower Owner Applicant Contractor PATRICIA JEAN WILLIAMS GRIFFIS HEATING INC(GENERAL) GRIFFIS HEATING INC(GENERAL) 2004 S 282ND PL 402 E MAIN ST SUITE 130 GRIFFHI088DZ(1/5/13) FEDERAL WAY WA 98003 AUBURN WA 98002 402 E MAIN ST SUITE 130 AUBURN WA 98002 • Laundry Washer Outlets 1 Showers 1 Sinks 1 Water Closets 1 PERMIT EXPIRES Wednesday, January 18, 2012 Permit Issued on Friday, July 22, 2011 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy an se will be in accordance with the laws, rules and regulations of the State of Washington e „„, (7and t - Cit ' f F eras Way. Owner or agent: /° I / teior t Date: Z `' THIS'CARD IS TO MAIN ON-SITE CITY OF , Construction In ection Record Federal Way INSPECTION REQUE TS: (253) 835-3050 PERMIT#: 11-102964-00-PL Address: 2004 S 282ND PL Project: PATRICIA JEAN WILLIAMS FEDERAL WAY, WA 98003-3241 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 Plumbing Groundwork(4190) El Rough Plumbing(4230) El Gas Piping(4125) Approved to cover Approved Approved to release test By Date By - ,- Date /11" n •By Date El Final-Plumbing(4075) Approved By Date ID Rough Electrical Final ElectricalEl Right of Way Approved Approved Approved By Date By Date By Date