10-100008 j ` -
• • Mechanical .
City of Federal Way
Community Development Services Permit #: 10-100008-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718 FIL,,„..,„ Inspection Request Line: (2
53} 835-3050Ph:(253)835-2607 Fax (253)835-2609
Project Name: MORENO
Project Address: 33243 36TH AVE SW Parcel Number: 109961 1290
Project Description: Gas fuel line extension
Owner Applicant Contractor
AUGUSTIN MORENO PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
33243 36TH AVE SW PO BOX 808 PILCHCII0IMA(02/20/11)
FEDERAL WAY WA 98023 BOTHELL WA 98041-0808 PO BOX$08
BOTHELL WA 98041-0808
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AdditionalAdditioWarmit Information ' ly ).-1:..41:0
Mechanical Valuation 1000 Is this an Online or O.T.C.application' Yes
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4 .4frz4 MechanicixtureS 1'3g@8o
.. rF.
Gas Piping 1
PERMIT EXPIRES Saturday, July 3, 2010
Permit Issued on Monday, January 4, 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 Ci of Federal Way.
Owner or agent: Date: / V—/C)
1tiAUR> '/
••
• THIS CARD IS TO> AIN ON-SITE i
CITY°F Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 10-100008-00-ME Address: 33243 36TH AVE SW
Owner: AUGUSTIN MORENO FEDERAL WAY, WA 98023-2903
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) ❑ Gas Piping(4125) D Final-Mechanical(4065)
Approved Approved to release test Approved
if,Si
By Date By /i Date 0 a//0 By Date //z/4,
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
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cmoc`: ::':::::::.:,.;:: � RMIT / L PL DE EN FP
Federal Way ' FCO..
COMMfDV1TYDEVELOPMENT SERVICES JAN O 'APPLICATION __ _
253-835-2607•FAX 253-835-2609
www.cituoffedera �_�
-- �"1( OF FEDERAL WAYe +
:.........:.................. . .. . ..................................................................................
SITE ADDRESS
33 N- 3 c:c2 Aye Sjam/
SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL i
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;; . . . ........................... ... . .. :PR.........J........
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NAME OF PROJECT
.....................................................................................................................................
C(Tenant or Homeowner Name) ()-S � jZ CNC)
❑ BUILDING 0 PLUMBING 'MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only ! !
PE•�i:i! #.fi'i MENS 2� �s�' ? %`•?%2`•''•`:.< i i f iiiii 3 iii%•'•.:%. `•i`•2'•.ifi•'•.•'•.iiii ili' ':z:::-
...........................................
................................................................................................ ::::::::::::::
NAME ,� PRIMARY PHONE
PROPERTY OWNER 6 t,r. 1 , 1 L (Z�` -I 0 (,? 3)2// - 2Qcd
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
33, Ct3 3(e avt- S\Ai +-r 1)-e(2A( Lt.-) A
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT ❑ PROJECT CONTACT
PRIMARY PHONE
.Z1,f 1 UGIC- Cr R.4,C-T4R_3 (:)s- ) vcs - 7 , ,:-
CONTRACTOR ' °MIG ADDRESS,CITY,STATE,ZIP FAX
1' v ; .S'7 ci 14S2.kLAv•c vd4 ( ) -
WA STATE CONTRACTOR'S LICENSE� # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
1.�..0 4 C z IC.`t vP"/` / /
NAAM.?E,� PRIMARY PHONE
APPLICANT (..-- \( k- K.A,- 0.e It- ( 0-53) Yc. - 78 f ;
MAILING ADDRESS,CITY,STATE,ZIP FAX
6�x as 7' K ,) tLA , (6 (A/A ( ) -
PROJECT CONTACT NAM', PRIMARY PHONE
(The individual to receive and CJ2 (o,,/ -e_K--- (a-C3)4 s - 71?.1
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) Ci ='Z LA -( ;/ ( ) _
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
( )
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27 095) ( )
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of his application.
SIGNATURE: ��7 , / DATE
/- 6%—lc;
PRINT NAME:
Bulletin#100—January 1,2010 Page 1 of 4 k:\Handouts\Pelmit Application
Value of Mechanical Work$ 1 OCe5/CCi (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 GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commeniay
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORSGAS LOG SETS REFRIGERATION SYST
DUCTING V GAS PIPING WOODSTOVES
•
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(or Tub/Showercombo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(K+*ce.n/Utiity) WATER HEATERS(necmc)
HOSE BIBBS SUMPS WASHING MACHINES _.... MAL FIBS
�T nn ��TT INF
1\Ei�L
INFORMA ON
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 ❑ No
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
:::BASE11&ENT>
FIRST FLOOR(or Mobile Home) — —
COVERED ENTRY — ----------------_�_.—___—_
•
:I}ECK
GARAGE 0 CARPORT 0
OTHERuisscribe)
EED3TDI6 PROPOSED TOW.
Area Totals
..NEW HOMES ONLY
ESTIMATED SELLING PRICE$, #OF BEDROOMS
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
1�t� LIHc;
ADDITIOIf
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
lf1t I�FIxfIt3
TSIIAInT AREA ONLY
�I ARBA ONLY
Bulletin#100-January 1,2010 Page 2 of 4 k:\I-landouts\Permit Application