10-100260 *
Mechanical
City of Federal Way .
Community Development Services ID
Permit #: 10-1 00260-00-M E
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 p Q
Project Name: HAVEN F ILE
Project Address: 31343 31ST AVE SW Parcel Number: 438801 0360
Project Description: Gas fuel line extension
Owner Applicant Contractor
CAROLYN G HAVEN PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
31343 31ST AVE SW PO BOX 808 PILCHCI101MA(02/20/11)
FEDERAL WAY WA BOTHELL WA 98041-0808 PO BOX 808
98023-7867 BOTHELL WA 98041-0808
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Mechanical Valuation 1000 Is this an Online or 0.T.C.applications Yes
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Gas Pipe Outlets 1
PERMIT EXPIRES Monday, July 19, 2010
Permit Issued on Wednesday, January 20, 2010
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use4will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Buz Date: /� -70
FIwku6D t rt IO
THIS CARD IS TO REMAIN ON-SITE
c,r,;MW ' Construction Insction Record
Federal Way • INSPECTION REQUE TS: (253)835-3050
PERMIT #: 10-100260-00-ME Address: 31343 31ST AVE SW
Owner: CAROLYN G HAVEN FEDERAL WAY, WA 98023-7867
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) El Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test f 5-/-75/ Approved
.By Date Bypz,r Date i zer pip By Date i 'lw
0 Rough Electrical CI Final Electrical ® Right of Way
Approved Approved Approved
By Date By Date By Date
. A 0 _ / 002
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Federal C E `/I0 / PERMITMF CO vIE7EL PL DE EN FP
COAMAJNI7YDEVELORIEENT SERVICES C APPLICATION / /
253-8352607•FAX 253-835-2609
wew.cituotTederaluay.com JAN 2 (L,r'�`'J
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NAML OF PROJECT
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(Tenant or Homeowner Name) �(��/
0 BUILDING 0 PLUMBING )2'MECHANICAL.
TYPE OF PERMIT
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
di AS Fe,e/ Li" b.- )crev,/rroiv.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
31. 3 -I.3 3( A ve Sv✓ Ft gAt way
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
PRIMARY PHONE
NAMIPPXLCI-1 COc-- C c 11- C VO s S (2s3) (ICS- - 78ri
J CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP Fax
POX(3c -.057 9 Kr_12-te._cA 6 v(A ( ) -
WA STATE CONTRACTOR'S LICENSE 0 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 9
P1 LL'N Cz I 0 t yvi A / /
NAME A PRIMARY PHONE
APPLICANT ` cc.Jl i&�X A-/•`t 1 J C IZ_... ('-i-3) s- 79 5,...S-
MAILING
-sMAILING ADDICkSS,CITY,STATE,ZIP FAX
P 8 P.. cs>C 2 S'7! I6-z(LV-6.A . V\(#4 ( ) -
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and y e 1be R- ( ) -
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) pc) Z.S- ) 9 t.-"rc-K....CAt.q( (01,4 ( ) -
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
( )
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
/RCW 1927.095) ( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
/further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred
in the investigation and defense of such claim),which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of application.
SIGNATURE '-e- / -'< = 2 DATE if-2C/ -/
do'PRINT NAME: _e/2-.-e y' ie/,%°"C/4
Bulletin#100-January 1,2010 Page 1 of 4 k:\i-iandouts\Pennit Application
Value of Mechanical Work$ //ZX U 0 (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS Z., GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(comme.ciii4
BOILERS FURNACES HOT WATER TANKS(Ger)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
• DUCTING GAS PIPING WOODSTOVES
..............................................................................................................................................�...t..�.........................................................................................................................................
•
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
emain.BATHTUBS or rub/shower Combo) LAVS(11.3d sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Koehen/its WATER HEATERS(Elecnc)
HOSE BIBBS SUMPS WASHING MACHINES TO AL'PIZTURES
•
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes❑ No- • ❑Yes 0 No
..............................................................................................................................................................................................................................................................................................
.............................................................................................................................................................................................................................................................................................
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
BA�I3NT
FIRST FLOOR(or Mobile Home)
• COVERED ENTRY
..........................................................................................................................................................................................
GARAGE 0 CARPORT 0
...........................................................................................................................................................................................
•..........................................................................................................................................................................................
: PROPOSED
Area Totals TOTAL
'xlEWfiIO,AS<OlKI.F"'
ESTIMATED SELLING PRICE$ #OF BEDROOMS
AREA DESCRIPTION Area Construction #of
Square Occupancy Groups) Type Stories Additional Information
inuare Feet .._...._..._........................._.............._....._............. ........_...........•..St.._ie........._...__..............._........._._.............
NEW BUILDEIHQ
ADDITION
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AREADESCRIPTION::::.............:::::Area:::..._._..........._............................._._....................::..Construction.:::...:::..#:of:::::......._...................................................
in Square Feet Occupancy Groups) Type Stories Additional Information
TENANT AREA ONLY
Bulletin#100—January 1,2010 Page 2 of 4 k:\Handouts\Petmit Application