11-104025City of Federal Way •. rVi�chanical
Community Development Services Permit #: - 104025 -00 -ME
P.O. Box 9718
Federal Way, WA 98063 -9718 Inspection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 835 -2609 p Q
Project Name: KUCIEMBA (o
Project Address: 2219 S 304TH ST Parcel Number: 053700 0115
Project Description: Install gas furnace
caner
Asmlicant
Contractor
MARK & TONI KUCIEMBA
ASHLEY BOUCK
GREENWOOD HEATING AND A/C
2219 S 304TH ST
GREENWOOD HEATING AND A/C
GREENHA922137 (3/ 27/12)
FEDERAL WAY WA 98003 -4807
825 S STACY ST
825 S STACY ST
SEATTLE WA 98134
SEATTLE WA 98134
Mechanical Valuation ................. ...........................1000
Furnaces .......... ............................... 1
Is this an Online or O.T.C. application ? .................Yes
PERMIT EXPIRES Sunday, April 1, 2012
Permit Issued on Tuesday, October 4, 2011
1 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: ^LAI ILlIn Date:
�-., --%Z� Its/ I I
CITY OF
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON -SITE
®
Construction Inection Record
INSPECTION REQU TS: (253) 835 -3050
11- 104025 -00 -ME
Address: 2219 S 304TH ST
Project: MARK & TONI KUCIEMBA FEDERAL WAY, WA 98003 -4807
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.
FII �
Mechanical Rough -in (4165)
Gas Piping (4125)
Final Electrical
Approved
Final - Mechanical (4065)
Approved
By
Approved to release test
Approved
By
Date
By
Date
By
Date
FII �
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date