10-102713-Al
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 ILE
Project Name: CAZIER
Project Address: 32241 24TH AVE SW
Project Description: Gas fuel line extension
Meehal'A*cal
Perm #: 10 -102713 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 873180 0230
Owner
Applicant
Contractor
ANDREW & JOCELYN CAZIER
PILCHUCK CONTRACTORS INC
PILCHUCK CONTRACTORS INC
32241 24TH AVE SW
PO BOX 808
PILCHCIl0lMA (02/20/11)
FEDERAL WAY WA 98023-2506
BOTHELL WA 98041-0808
PO BOX 808
BOTHELL WA 98041-0808
Mechanical Valuation............................................1000
Is this an Online or O.T.C. application?.................Yes
GasPiping ...................................... 1
PERMIT EXPIRES Saturday, December 25,2C
Permit Issued on Monday, June 28, 2010
1 hereby certify that the above information is correct and that the construction on the
the occupancy and the use will be in accordance with the laws, rules and regulation;
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an t e Ity o e era ay.
Owner or agent: vL:+l� Y�-�r/� Date: V — y ` " '6-'
THIS CARD IS TO REMAIN ON-SITE
CITY °� Construction Iftection Record a
!federal Way INSPECTION REQUE:.TS: (253) 835-3050
PERMIT #: 10 -102713 -00 -ME Address: 32241 24TH AVE SW
Owner: ANDREW & JOCELYN CAZIER FEDERAL WAY, WA 98023-2506
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 /�
By Date 5110111
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Federal Way
COMWILAITY DEtTIO M&W SERY7CES
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'OPERMIT
APPLICATION 3
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MF C M PL DE EN FP
SUN 9
SITE ADDRESS
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U jt3NIT #
PROJ%ECT VALUATION
ZONING
ASSESSOR'S TAX/PARC.E'L #
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING "ECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NADA�v e I 7 /� PRIMARY PHONE
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MAILING AD Z `► 1 1 4
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E-MAIL
CITY STATE ZIP
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E-MAIL
CONTRACTOR
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STATE
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WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
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FEDERAL WAY BUSDYESS LICENSE #
NAME
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PHONE
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APPLICANT
MAILING ADDRESS
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E-MAIL
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FAX
PROJECT CONTACT
(The individual to receive and
NAME
PHONE
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
Required value of $5, 000 or more
NAS
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 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 t the city as apart of this application.
i ,\
SIGNATURE• DATE
PRINT NAME:
Bulletin #100 — April 14, 2010 Page l of 3 k:\Handouts\Permit Application
g fixtures to remain.
OTHER (Describe)
Indicate horn many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (or9hb/shower combo)
LAVS (Hanasinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Mtchen/ut;hty)
WATER HEATERS (Ekcttic)
HOSE B]BBS
SUMPS
WASHING MACHINES
AREA DESCRIPTION Area I Occupancy Group(s) I Construction I # of Additional Information
in Square Feet Type Stories
ADDITION
AREA DESCRIPTIONI in Square Feet I Occupancy Group(s)
ea
TENANT AREA ONLY
ConstructionI # of I Additional Information
Type Stories
Bulletin #100 — April 14, 2010 Page 2 of 3 k:\Handouts\Permit Application