10-101662 Mechanical
clanical
City of Federal Way • Permit #: 10-101662-00-ME
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: HOLMES
Project Address: 32719 40TH AVE SW Parcel Number: 873195 0160
Project Description: Gas fuel line extension for meter relocate on house
,
Owner Applicant Contractor
BRIAN HOLMES PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
32719 40TH AVE SW PO BOX 808 PILCHCI101MA(02/20/11)
FEDERAL WAY WA 98023-2660 BOTHELL WA 98041-0808 PO BOX 808
BOTHELL WA 98041-0808
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Mechanical Valuation 1000 Is this an Online or O.T.C.applications Yes
Gas Piping 1
PERMIT EXPIRES Saturday, October 23, 2010
Permit Issued on Monday, April 26, 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
nd the City of Federal Way.
Owner or agent:c-���� (-11)(4, Date:
4-z6 `v
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THIS CARD IS TO IN ON-SITE - r
CITY°F . • Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-101662-00-ME Address: 32719 40TH AVE SW
Owner: BRIAN HOLMES FEDERAL WAY, WA 98023-2660
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 Approved�,
By Date By A ate 4/1/40 By,✓/�,-- Date"// Z7/0
C
❑ Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
_
DE 1\101 jzaFp
0 P E R M I T # PLEN
.. Federal Way
APPLICATION RE Mb
COMMINITY DEVELOPMENT SERVICES
253-835-2607.FAX 25,3-835-2609
.,,,vv,,itvrilcrf,74.4:11'41ij CP ri 944. '' ,....'
Lts APR 2 6 7.07.i
SITE ADDRESS CITY OF FEDERAL WAI/UNIT#
3 z 7 17 4c m A-tk. s L-L) . CDS
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ ) , 0 0 °
TYPE OF PERMIT
0 BUILDING 0 PLUMBING ) MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
, )1.--
c-74-6 (...- u -ee--476-r 1 S 16/1/4.)
PROJECT DESCRIPTION , .--
Detailed description of work to P---e A O C P-oet- 0 gg'S eh Q-41CP— -/ 'e-L ti,L., o-", otAP-cs"to -•(
be included on this permit only c) eLV
NAME PRIMARY PHONE
PROPERTY OWNER
- 1.-4 COi" t-6 )rnt$
MAILING ADDRESS E-MAIL
2-7 i g 4,,te- 4.4.e...„s i...0
CITY STATE ZIP
Fe'rjeiat-- LA/al LAJC",-
NAME PHONE
P.1 1-04-fite_ (8 n4-v'ta-C—ior-S 2,S3 4 03—'6,5-6 g
DIMING AD HESS E-MAIL
P 0 6 Olt OS"7 1
CONTRACTOR
CITY I} STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
e 1LGH• C 1 0 1A 4 a
NAME PHONE
APPLICANT MAILING ADDRESS E-MAIL
. CITY STATE ZIP FAX
PROJECT CONTACT NAMF/36.. PHONE
V 67 Oe -1-1 . 2.5-3 40s- 6,5-6 g
(The individual to receive and
respond to all correspondence MALANG ADDRESS E-MAIL
concerning this application) ' 0 430)( _LS-- 141
IPFAX
STATE „Z _
CPI t 1 80 8
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
El OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 regulationspertainingto the work authorized by the issuance of a permit. I u
ththe
isa eofthispeit does not remove theomner,srespoibilityforeon;ianeemithloealstate 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 city as a part of this application.
SIGNATURE:-....Z(e4-.1 -7326***-Vc------" DATE 4 -
PRINT NAME: g&V 6 ViC)0 i'n
Bulletin#100-April 14,2010 Page 1 of 3 k:\Handouts\Perrnit Application
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VALUE OF MECHANICAL WORE' $ 1. 0 0 0 (a copy of bid or estimate must be provided)
Indicate how many 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 GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commcroie!)
BOILERS FURNACES HOT WATER TANKS(G.)
COMPRESSORS GAS LOG SETS .REFRIGERATION SYST
DUCTING I GAS PIPING WOODSTOVES
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include
existing fixtures to remain.
BATHTUBS(or Thb/show r Combo) LAVS(Bond ) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(&kchic)
SUMPS WASHING MACHINES 'iiii:}•i_.;«. iiiiii:: >?%.%?'z.>
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0311 BRIME ENE 81 in IN MBRE "NV." 11N.1.0..ANA Sallataill Mtn 1111111 1111.1:31 Rai
CRITICAL AREAS ON PROPERTY- 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
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
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FIRST FLOOR(or Mobile Home)
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COVERED ENTRY
GARAGE 0 CARPORT 0
Area Totals EXIST/NG c PROPOSED TOTAL
ESTIMATED SELLING PRICE$ # OF BEDROOMS
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Area
Construction
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AREA DESCRIPTION OccupancyGrou s Additional Information
in Scpuaze Feet Type Stories
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ADDITION
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Area Construction #of
AREA DESCRIPTION in Square Feet Occupancy Group(s) Type Stories Additional Information
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TENANT AREA ONLY
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Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application