16-1055290 • ,.
Mechanical
City of Federal way Permit #:16- 105529 -00 -ME
Community Development Dept.
33325 8th Ave S
FedaW Way, WA 98003 Inspection Request Line: (253) 835 -3050
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: WARDEN
Project Address: 1950 S 299TH PL Parcel Number: 367430 0030
Project Description: Install new gas line to range
Owner
Applicant
Contractor
PATRICIA L WARDEN
JENNY SHAWPAT'S PLUMBING INC
PAT'S PLUMBING INC
1950 S 299TH PL
30459 MILITARY RD S
PATSPI.083N5 (4/8/18)
FEDERAL WAY WA 98003
FEDERAL WAY WA
30459 MILITARY RD S
USA
FEDERAL WAY WA 98003
Additional Permit Information
Mechanical Work Valuation ? .................................. 2000 Is this an Online or O.T.C. application ?.................. Yes
Gas Piping
I Ranges
1
PERMIT EXPIRES Wednesday, 17 May, 2017
Permit Issued on Friday, November 18, 2016
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy
and use will be in accordance with the laws, rules and regulations of the State of
I 17IV,�ishington and the City of Federal Way.
Owner or agent:
Date: / l r
clw cur
Federal way
PERMIT #:
Project:
• THIS CARD IS TO REIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835 -3050
16105529 00 Address: 1950 S 299TH PL
PATRICIA L WARDEN FEDERAL WAY WA 98003 -4257
r i
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.
El
Mechanical Rough -in (4165)
ID
Gas Piping (4125)
0
Final - Mechanical (4065)
Right of Way
Approved
Approved to release test
Approved
By
Date
By
Date 1 -1
By
0 Date _
Right of Way
Final Electrical
Rough Electrical
Approved
Approved
1BY
Approved
By
Date
By
Date
-
- Date
*RECEIVED 0
CITY OF NOV 18 2016
PERMIT APPLICATION
Federal � Way PERMIT CENTER + 33325 8u Avenue South + Federal Way, WA 98003 -6325
j� Y(� 0� OF FEDERAL WAY 253- 835 -2607 + FAX 253 - 835 -2609 + permitcenter6o' cityoffederalway .com
PERMIT NUMBER _ _ TARGET DATE
SITE ADDRESS (7f� icp`2
SUITE /UNIT N
PROJECT VALUATION
$
ZONING
SSESSOR'S TAX /PARCEL #
�' 36
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING X MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of ulork to
be included on this permit only
N /y (1,
0� �C AO, Waf'
MARY PH NE
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PROPERTY OWNER
MAILING ADDRESS
50 ` 'YA 1
E-MAIL
ley U
STATE I TZV�
G ADDRESS �
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E -MAD.
CONTRACTOR
I ��a
STATE
1`./✓1'� -k`
2I� ��
FAX
ATE CO TOR'S LIC S
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EXPIRATION DATE
DERAL WAY BUSINESS LICENSE •
ZZ APPLICANT t,
i
NAME
PRIMARY PRONE
MARLING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
N
LJ f�W
MARYnPHONE ,[(� �j ry,
3 ' t % l vt
ADD ,� `��, l/l J
(The individual to receive and
respond to all correspondence
ATY
STATE
ZI ^` J
l /OSo
FAX L.
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER - FINANCED
When value is $5,000 or more
(RCW 19.27095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. 1 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 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 supplie he ci as a part of this application.
j
SIGNATURE: DATE l I
PRINT NAME:
Bulletin #100 —Janu4 2016 Page 1 of 2 k:\Handouts\Permit Application
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