07-104613Y
City of Federal Way
Community Development Services Mechanical Permit #: 07- 104613 -00 -ME
P.O. Box 9718
federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835 -3050
Project Name: RECINOS
Project Address: 33415 28TH PL SW _. Parcel Number: 010060 0810
Project Description: Install gas piping for (4) outlets; no applicances installed with this permit.
Owner
Applicant
Contractor
SANTOS & KENDRA RECINOS
SANTOS & KENDRA RECINOS
SANTOS & KENDRA RECINOS
33415 28TH PL SW
33415 28TH PL SW
33415 28TH PL SW
FEDERAL WAY WA 98023 -2744
FEDERAL WAY WA 98023 -2744
FEDERAL WAY WA 98023 -2744
`Additional Permit inf6 r im Lion
Mechanical Valuation ................ ............................750 Over the Counter Permit? ...................................... Yes
Flo Fi), Ures As With "ttris Ret'mit !!
THIS CARD IS TO REMAIN ON -SITE
aTY OF Community Development Inspection Record.
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104613 -00 -ME
Owner: SANTOS & KENDRA RECINOS
Address: 33415 28TH PL SW
FEDERAL WAY, WA 98023 -2744
This card is part of your required inspection documents. 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 �L 0 By Date
For inspector reference only
O Rough Electrical O FINAL - Electrical
Approved Approved
By Date By Date
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COMAIUNUY DEVELOPMENT SERVICES
33345 8n AVENUE SOU77i • PO BOX 9718
FEDERAL WAY, WA 98063 -9718
453.8354607• PAX 453 - 835.2609
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PERMIT
RECEN9tA c
APPLICATION AUG 2
The following is required information - an incomplete application wijgM*
SITE ADDRESS
ASSESSOR'S TAX /PARCEL # O Q -ca d -
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
ME E PL DE EN ,F'P
print. legibly (in ink) or type.
#
LOT SIZE (s,)
(Attwh sq-a6w jbr krvfhy kgd d-aWaq
PROJECT •• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT NAME (Name of Business or Owner Last Name) PEOPLE %-
•• •
PROPERTY
NAME PRIMARY PHONE
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
COMPO NAME
APPLICANT NAME
OFFICE PHONE _
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
MAILING ADDRESS
E-MAIL ADDRESS
CITY, STATE, ZIP
E -MAIL ADDRESS
RELATIONSHIP TO PROJECT
h L ,
er -clL 6._ +46 t pia_
COMPO NAME
APPLICANT NAME
OFFICE PHONE _
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMB R XXPIRATION DATE
E-MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
CITY, STATE, ZIP
PHONE
AILING ADDRESS
CITY, STATE. ZIP
CELL PHONE
t���iU,C �c
l 03 -0-50
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect 13 Tenant ❑ Agent ❑ Other
NAME PRIMARY PHONE E-MAIL ADDRESS
6 -
NAME
Per RCW 19.2.7.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE
USE
VALUE OF PROPOSED WORK
SPRINKLERED BUILDING? ❑ YES O FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES
WATER SERVICE PROVIDER ❑ HAVEN ❑ HIGHLINE ❑TACOMA 13 PRIVATE (WELL)
SEWER SERVICE PROVIDER LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE ISEPTICI
❑ NO
PROJECT ••• AREAS
AREA DESCRIPTION EXISTING
$ : FT.
PROPOSED
S . FT.
TOTAL
8 . FT.
BASEMENT
13UMDING SHELL ONLY?
o YES r o NO
FIRST
o YES
o NO
ZONING DESIGNATION
SECOND
CHANGE OF USE?
a YES
THIRD
NEW ADDRESS REQUIRED?
o YES o NO
ADDITIONAL FLOORS (DESCRIBE)
o YES
a NO
PLATTED LOT?
DECK (❑ COVERED OR ❑ UNCOVERED ?)
DEMO PERMIT REQUIRED?
a YES
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
D INTM
•soro so
corer
rorsasaersasr
rorncrsaraesosr
rarAcar
• "NEW HOMES ONLI"'• NU OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of f cture to be
as part of this project. Do not include existing fixtures to remain.
MECIL4MCAL
Value of Mechanical Work $ (A P R ESTHAM MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS- EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS (cemmereino
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
PLUMBING
BATHTUBS )or Tub /show combo) LAVE
DISHWASHERS RAINY
DRINKING FOUNTAINS SHO`
ELECTRIC WATER HEATERS
HOSE BIBBS S I
a" URINALS
SYST VACUUM BREAKERS
WATER CLOSETS (roileq
WASHING MACHINES
MISC (Describe)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I cert(& that to the best of my
knowledge, the irVormation submitted in support of this permit application is true and correct I cwj jy that I will Comply with all applicable
City of Federal Way regulations pertaining to the work authorised 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:. r�1w.&,Gl,/ naTF OI O Vl l
a NEW o ADDITION
o ALTERATION
o REPAIR D TENANT IMPROVEMENT
13UMDING SHELL ONLY?
o YES r o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU?
o YES
a NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED?
a YES
a NO-
• Bulletin #100 "August 16, 2007
Page 2 of 4 .
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