10-100974 Mechanical
City of Way Permit #: 10-100974-00-M E
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: NGUYEN
Project Address: 28434 MILITARY RD S Parcel Number: 332204 9086
Project Description: Gas piping and relocate meter.
Owner Aoolicant Contractor
TU NGUYEN PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
28434 MILITARY RD S PO BOX 808 PILCHCI101MA(02/20/11)
FEDERAL WAY WA 98003-3328 BOTHELL WA 98041-0808 PO BOX 808
BOTHELL WA 98041-0808
Mechanical Valuation 1000 Is this an Online or O.T.C.application9 Yes
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Gas Piping 1
PERMIT EXPIRES Tuesday, September 7, 2010
Permit Issued on Thursday, March 11, 2010
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: 2f ��� 'C----- Date: 3 ~/ _
0
THIS CARD IS TO REMAIN ON-SITE
CITY OF
Construction Inspection Record
Federal Way INSPECTION REQUESTS : (253)835-3050
PERMIT#: 10-100974-00-ME Address: 28434 MILITARY RD S
Owner: TU NGUYEN FEDERAL WAY, WA 98003-3328
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.
0 Mechanical Rough-in(4165) 0 Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date
•
El Rough ElectricalEl Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
Federal PERMIT spiwiF CO (ME)EL PL DE EN FP
253-8352607•FAX 253-835-2609 • APPLICATION ' EE . / �:E:E
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SITE ADD /
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NAME OF PROJECT r /' ie,(T enant or Homeowner Name) r v WIT `'❑BUILDING) UMBING aiL MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION
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PROJECT DESCRIPTION //� �• C
Detailed description of work to
be included on this permit only
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NAME PRIMARY PHONE
PROPERTY OWNER u t _q - ( )
MAILING AD N,CITY '
E-MAIL
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
NAME PRLf♦ARY PHONE
PICCii-La 1L ( (zs3)4cs-- Lore F
CONTRACTOR MAILING ADDREas.CITT.STAYS,ZIP FAX
PC) x Z 79 Kvti,a-7,4 96063 ( ) -
WA STATE CONTRACTOR'S IM—S=5 i EIDIIATYON DAYS FEDERAL WAY BUSINESS LICENSE t
PI LC.ki:- /e/ M.a i i
NAME
PRIMARY PHONE
APPLICANT ( ) -
MAILING ADDRESS,CITY,STATE,ZIP FAX
( ) -
PROJECT CONTACT NAME �I
{' PRIMARY PHONE
(The individual to receive and I t!,C[n.. t( (.0k1,T rle-./t,'. , (ZS3 )40$' ,s(�
respond to all correspondence MAILING ADDRESS,C=YY,STATE, FAR
concerning this application)
AL TE F�`ACT NARK PRIMARY PHONE E-MAIL
V nck-GCs-1 (253) 4)&5—_4,..5-6c. f:. . ;=;�5e.G.
PROJECT FINANCING NAME
Required for projects with
El OWNER-FINANCED
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27 095) ( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the thee ettt�pa apart of this application.
SIGNATURE: .°_�!�/ c'.f DATE r-`I/`/L'
PRINT NAME: "fir✓ t [0-V/e'Q✓)
Bulletin#100-January 1,2010 Page 1 of 4 k:\Handouts\Pennit Application
I )l V
Value of Mechanical Work$ l (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
IV
Indicate number of each type of fixture to be i,stailed 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(commereas
BOILERS FURNACES HOT WATER TANKS(oe.)
COMPRESSORS T GAS LOG SETS REFRIGERATION SYST
DUCTING 1 GAS PIPING WOODSTOVES
PI,,[JMR1N FI TUR S
Indicate number of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
BATHTUBS tor Tub/shower Combo) LAVS mom sminl TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS Ixrtmee/vettyl WATER HEATERS(saecmd
HOSE BIBBS SUMPS WASHING MACHINES TOTALF... ... S _,.
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR _..SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ /' C CSC $
EXISTNIO/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes❑ No ❑ Yes ❑ No
� IIkEN 'lL
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE DSE
BASSM>31VT
FIRST FLOOR(or Mobile Home)
SI~:COlID FWQ#
-COVERED ENTRY
EC..
GARAGE ❑ CARPORT ❑
4THEi (desdrxe)
roeruo reoaosro TOTAL —
Area Totals
==raw ffotdES Oiler*
ESTIMATED SELLING PRICE$ #OF BEDROOMS
C MMER+ I.AL -NE IADDITIQN . .
AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information
in Square Feet Type Stories
NEWBUILDIEG _,:
ADDITION _. .
COMME CI R MO LITE ANT I F 'E ENT•
AREA DESCRIPTION Area Occupancy Groups( Construction #of Additional Information
in Square Feet Type Stories
'FC}'fA 11UtLDINQ : ... '
TENANT AREA ONLY
P9,.$f .AREA ONLY ' -[ is >'t ..
Bulletin#100—January 1,2010 Page 2 of 4 k\Handouts\Pemiit Application