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12-102458r City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835 -2607 Fax: (253) 835 -2609 Project Name: CAMELOT SQUARE MJIIP - SPACE 331 Project Address: 3001 S 288TH ST Space 331 Project Description: Relocate meter and extend gas line • Metharnical Permit #: 12- 102458 -00 -ME Inspection Request Line: (253) 835 -3050 Parcel Number: 042104 9155 Owner ARRIican Contractor CAMELOT SQUARE INC INFRASOURCE CONSTRUCTION LLC INFRASOURCE CONSTRUCTION LLC 3001 S 288TH ST 1200 ROOSEVELT RD SUITE 400 INFRACL899CZ (2/14/13) FEDERAL WAY WA 98003 -8019 KENT WA 98032 1200 ROOSEVELT RD SUITE 400 KENT WA 98032 Mechanical Valuation .................... ........................1000.00 GasPiping ....... ............................... 1 Is this an Online or O.T.C. application ? .................Yes PERMIT EXPIRES Tuesday, November 27, 2012 Permit Issued on Thursday, May 31, 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: F I HA U4V */11/1 V& CITY OF Federal Way PERMIT #: 12- 102458 -00 -ME THIS CARD IS TO MAIN ON -SITE Construction In ection Record INSPECTION REQUE TS: (253) 835 -3050 Address: 3001 S 288TH ST Space 331 Project: CAMELOT SQUARE INC FEDERAL WAY, WA 98003 -8019 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 /4.f5/ Approved By Date By Date -7- 1�_ /,Z By IZf- Date -7-1,P-12 Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date CITY OF Federal Z,EIVED PERMIT COMMUNITY DEVELOPMENT SERVICES 2012 253u- 8�u35 w- X chua �� APPLICATION em OF FEDERAL WAY z - i c). SWMF CO ME 2Jt5� PL DE EN FP SITE ADDRESS CDs SUITE /UNIT # 3 00 t 5 01 Soo 3 3 3 PROJECT VALUATION ZONING ASSESSOR'S TAR /PARCEL # $/000 - TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING A MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT (Tenant Name /Homeowner Last Name) ��► �e— Lo T S 6W n,-r_ PAP– PROJECT DESCRIPTION (9--i °C-o Detailed description of work to Al be included on this permit only N PRIMARY PHONE PROPERTY OWNERq. m�L -o T MAILING ADDRESS 3001 S 8 s 6f-s-r E-MAIL CITY Fea t✓'q-L STATE we, F ZIP I of e003 NAME PHONE X03003 34-18 ADDRESS MAILING 1 ZDU4oDSe-Ve-C.?- eo ST6: 4-00 CONTRACTOR Imo ' • C n G I ( ^/ STATE I to ZIP to o /.3 -7 FAX WA STATE CONTRACTOR'S LICENSE # 'rA( J=i2 A C t_ 8 4 01 C Z EXPIRATION DATE z, i +, , FEDERAL WAY BUSINESS LICENSE # NAME SA-tn f_ pGLOuJ PHONE APPLICANT MAILING ADDRESS EMAIL - CITY STATE ZIP FAX PROJECT CONTACT `, /s NAME6 C Y C� d2� V N PHONE Zs3 4q s -7 0 / .3 t0 (The individual to receive and MAkLING ADDRESS Oo 1 5 2-1 Z- #-5 r- E-MAIL Evc -a-t OrQ r C. 20 MY respond to all correspondence concerning this application) CITY K4-,-)T lto'jo'- STATE ZIP 0. Z FAX ALTERNATE CONTACT NAME- PHONE E -MAIL PROJECT FINANCING NAME OWNER - FINANCED Required value of $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 undersigne4 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. DATE S -3 /—/Z PRINT NAME: �V 02�© N Bulletin #100 - January 1, 2011 Pagel of 3 k:\Handouts\Pennit Application a GENERAL ".11ti'FE}i2IATIQI�'_ CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING /PREVIOUS USE 1 LOT SIZE (In Squa a Feet) EXISTING FIRE SPRINKLER SYSTEM? I PROPOSED FIRE SUPPRESSION SYSTEM? []Yes o No o Yes o No AREA DESCRIPTION MEACIIANICXL.. FIXTURES VALUE OF MECHANICAL WORK $ d�U (a copy of bid or estimate must be provided) Indicate how many of each type of re 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 po -ciai) BOILERS FURNACES HOT WATER TANKS )G-) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES GENERAL ".11ti'FE}i2IATIQI�'_ CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING /PREVIOUS USE 1 LOT SIZE (In Squa a Feet) EXISTING FIRE SPRINKLER SYSTEM? I PROPOSED FIRE SUPPRESSION SYSTEM? []Yes o No o Yes o No AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information in S uare Feet a Stories NEW BUILDINCr ADDITION , E `T1IERI�L- Rt )D I 'Co T IIIR�`' AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information in S uare Feet a Stories TOTAD.BUILDING< TENANT AREA ONLY PROJECT AREA 6NLY Bulletin #100— January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application