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12-104592_ K ARRIiican City of Federal Way KW CLUB PALISADES LLC Community & Econ. Dev. Services VOGNYK 33325 8th Ave S Federal Way, WA 98003 29211 58TH PL S Ph: (253) 835-2607 Fax: (253) 835-2609 FOLSOM CA 95630 AUBURN WA 98011 29211 58TH PL S Project Name: CLUB PALISADES APARTMENTS -BLDG 11 Project Address: 2211 S STAR LAKE RD Project Description: Install gas water heater Methdnlical Permit #: 12 -104592 -00 -ME Inspection Request Line: (253) 835-3050 Parcel Number: 720480 0095 Owne ARRIiican Contractor KW CLUB PALISADES LLC VOGNYK VOGNYK 800 IRON POINT PKWY RD SUITE 726 29211 58TH PL S VOGNY**951PJ (10/12/13) FOLSOM CA 95630 AUBURN WA 98011 29211 58TH PL S AUBURN WA 98011 Additional Permit Information Mechanical Valuation............................................150 Is this an Online or O.T.C. application?.................Yes Mechanical Filxtures Hot Water Tanks ............................ 1 PERMIT EXPIRES Sunday, April 7, 2013 Permit Issued on Tuesday, October 9, 2012 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: Date: l ® !% 9 // ?, 5 CLUB PALISADES Q Scale: 2211 S STAR LAKE RD - Units: 750 N 1 1 160 Feet CL U ca , f£R£RAt, N CL r MY CW Federal Way PERMIT #: Project: THIS' CARD IS TO REMAIN ON-SITE Construction Inspection Record INSPECTION REQUESTS: (253) 835-3050 12 -104592 -00 -ME Address: 2211 S STAR LAKE RD KW CLUB PALISADES LLC FEDERAL WAY, WA 98003-3406 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 /4 'Psi Approved By Date By Date /d 1a - /Z By Date Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date Federal EIVED COMMUNITY DEVELOFME 1 S9 2012 253-835-2607• FAX 25320 uirtna. n?yyj(eriemjual._ro:rs • PERMIT APPLICATION (2-,- I d -4 5 92_ 0 MF COG) O ME PL DE EN FP CITY OF FE12& V�AY PA & f a d& 3 CL D CL 4 V►A F vl � -C SITE ADDRESS S Ds a,- 1_1 A, l/I/' n 0 0 3 SUITE/UNIT # PROJECT VALUATION $ IS0, ©© ZONING ASSESSOR'S TAX/PARCEL # 7 2 O 4 9 D_ 00 �S TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT (Tenant Name/Homeowner Last Name) i �h)D(� \\l J PROJECT DESCRIPTION Detailed description of work to 1 f (� be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER MAILING ADDRESS E-MAIL CITY STATE ZIP NAME ` /' ,/� CAI `/ ` / / PHONE CONTRACTOR MAILING� ADDRESS O l �+ 6L rl E-MAIL CITY w /f $TATET;PIR ��©®/ FAX WA STATE CONTRACTOR'S LICENSE # ATIONDATE w6wy�r'-�Js Di 21113 FEDERAL WAY BUSINESS LICENSE # NAME / o � C -L� C? %D2 Cc -%2 (i^� PHONE2--s-3 r 3 - � 3 S- - S- 6 APPLICANT MAILING ADDRESS 9'a2ff -��' E-MAIL ct1w� ra CITY S�TTAfTE ZIP (��! 11 FAX PROJECT CONTACT NAME PHONE (The individual to receive and respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E-MAIL PROJECT FINANCING NAME 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 1 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 apart of this application. SIGNATURE: DATE ,, �( PRINT NAME: R/' is `- A © _ /O .'►�.'a-� +��r 3 Bulletin #100 - January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application VALUE OF MECHAMCAL WORK I (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 (Commercial( BOILERS FURNACES HOT.WATER TANKS (Gal) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING �_ GAS PIPING WOODSTOVES Bulletin #100 — January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application