12-101984City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Plumbing
` Permit #; 12- 101984 -00 -PL
Inspection Request Line: (253) 835 -3050
Project Name: COVE EAST APARTMENTS UNIT 109
Project Address: 111 S 331ST PL Bldg 01
Project Description: Replace electric water heater in unit 109
Parcel Number: 172104 9121
Owner
ARI21ican t
Contractor
KC HOUSING AUTHORITY
COVE EAST APARTMENTS
OWNER IS CONTRACTOR
600 ANDOVER PARK W
33030 1ST AVE S
TUKWILA WA 98188
FEDERAL WAY WA
98003
Plumbing Fbdures
Water Heaters .. ............................... 1
PERMIT EXPIRES Wednesday, October 31, 2012
Permit Issued on Friday, May 4, 2012
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: y-
r
CITY OF
Federal Way
• THIS CARD IS TO MAIN ON -SITE I
Construction In ection Record
INSPECTION REQU TS: (253) 835 -3050
PERMIT #: 12- 101984 -00 -PL Address: 111 S 331 ST PL Bldg 01
Project: KC HOUSING AUTHORITY FEDERAL WAY, WA 98003
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.
Final - Plumbing (4075)
Approved
By Date 15 _c; - `
Plumbing Groundwork (4190)
Rough Plumbing (4230)
0
Gas Piping (4125)
Approved to cover
By
Approved
Approved to release test
By
Date
By
Date
By
Date
Final - Plumbing (4075)
Approved
By Date 15 _c; - `
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
cm w A
Federal Way
COMMUNITY DEVELOPMENT SERVICES
253- 835 -2607- FAX 253- 835 -2609
www. a[uoffederalwau. com
PERMIT RE E PL DE EN FP
o
APPLICATION
CITY
MAY 0 4
OF FEpE
SITE ADDRESS p
S
SUITE / UNIT r
S. -3.3 /f 10 F�vF�R& Jv� �vA: g g o 03
PROJECT VALUATION
ZONING
ASSESSOR'S TAX /PARCEL Y
$ �O,C) D
I -7 2- ! o Y- 9 l 2 t
TYPE OF PERMIT
❑ BUILDING 2-PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeowner Last Name)
G p V 104 'e 7-111 E w >— S
PROJECT DESCRIPTION
R E g —'e.. Wo 7- w g 7-;r /f T.4 n/ k< J .v �4i°% J o
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
f n�G c p u n�7 </o H S r.✓(, .'� �tTL R i7
PRIMARY PHONE
MAILING ADDRESS
J_V-1- G f-Ty/9 -C-. -r- 5.6 4771-1 ov 19- `� B /$ 8
E-MAIL
CITY
STATE I
ZIP
NAME
PHONE
AJ yo ct%sE tiI��NTe- ,-4--,'cc4
Lr.7
MAILING ADDRESS
.330 3 c, S r rE
F-MAIL
CONTRACTOR
CITY
/CED�2RL .vg
STATE
wrl
ZIP
oo3
FAX
z,"- 838 -656
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
NAME
PHONE
APPLICANT
MAILING ADDRESS
E -MAIL
CITY STATE ZIP
FAX
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
MAILING ADDRESS
E -MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E -NAIL
PROJECT FINANCING
Required value of $5,000 or more
NAME
OWNER- FINANCED
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorised 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 apart of this application.
SIGNATURE: ��t�'� -- - DATE - LI - I L
PRINT NAME: TR rt f /Z. 14 TK r.✓t o .✓
Bulletin #100 -April 14, 2010 Pagel of 3 k:\Handouts \Permit Application
•
VALUE OF MECHAMCAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type qffixture 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 (aas(
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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 (Handsinka( 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 _L TOTAL FIXTURES
GENERAL INVOWWON .
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
.
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/ PREVIOUS USE
L A; ,k E f/grB AJ
LOT SIZE IIn Square Feet)
L,g kB yArG.v
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
rykt7 /- FqM /cr 11o6451Nb
❑ Yes 9'No
❑ Yes W-'No
(}Mlt'iERCA: = ELD
ARE A DESCRIPTION Area Occu anc Grou s Construction # of
in S uare Feet Occupancy Group( s) e Stories Additional Information
NEW BUILDINQ
ADDITION
ft0JWt AREA ONLY,
Bulletin #100 -April 14, 2010 Page 2 of 3 k: \Handouts \Permit Application