09-104929 •
Mechanical
City of Federal Way •
Community Development Services Permit #: 09-104929-00-ME
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: SANBORN
Project Address: 4902 SW 324TH PL Parcel Number: 873219 0170
Project Description: Gas fuel line extention
Owner Applicant Contractor
EVERETT SANBORN III PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
4902 SW 324TH PL PO BOX 808 PILCHCI101MA(02/20/11)
FEDERAL WAY WA 98023-1909 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.application? Yes
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Gas Pipe. 1
PERMIT EXPIRES Tuesday, June 15, 201
Permit Issued onThursday,� ►'t r' ''c ,20
I hereby cel fy that t#a above information is correct and that the construction Ott the above;�crike property and
the occupancy:shd the use willbe in accordance with the laws, rules and regulations of the State of.Washil ton
a the City of ederal Way.
Owner or agent: Date: / 2 "/7-op
FC OALLO . l 2-11 g.- oq
THIS CARD IS TO AIN ON-SITE
crr,roF WayI •
Construction In ction Record
Feier INSPECTION RE UE TS: (253)835-3050
PERMIT#: 09-104929-00-ME Address: 4902 SW 324TH PL
Owner: EVERETT SANBORN III FEDERAL WAY, WA 98023-1909
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) 0 Final-Mechanical(4065)
Approved Approved to release test A proved
By Date By Date By r' Date / 47O1
0 Rough Electrical El Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
Z - 7Z‘ 11Z.2.y
I,
F,„„"ederal W�� PERMIT CO L PL DE EN FP
COMMUARTYDEVELOPMENT SERVICES 1 we LI CATI O N / /
253-835-2607•FAX 253-835-2609
www.atuolrederalwaucom DEC
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SITE ADDRESS U'
4 l0 E a i s VI( ,c� tp L re-r -p 1 £tJ 4
SUITE UNIT# CCJy
/ ZONING ASSESSOR'S TAX/PARCEL#
/
7 :.w : e Fv .. , d _Z,` S ;ire& •. �..
NAME OF PROJECT �..
(Tenant or Homeowner Name) E V 'jT ., A ryi toil
0 BUILDING 0 PLUMBING MECHANICAL
TYPE OF PERMIT
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
0 A-S I:76c_I 6,Sri6 £)c Ten!T-z-ati
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER E ye.2L-r-1 S,f't bo(2-/`( ( ) -
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
441o( SW 3 2,Ci PL
OWNER IS ALSO: o CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
N PRIMARY PHONE
f LC.� l-} u CiL c_4›.1TIZAC.TDa S ( 23"3)'OS' - '79 5)-c
CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP FAX
V O ?,00 K Z-5-1 q MKT k A,.(b vv4 ( ) -
WA STATE CONTRACTOR'S LICENSE# IRA ON DA FED AY I E M
P=.1... ,14 c-r t d I NI A / /7/ �
N n r, PRIMARY PHONE
APPLICANT leA y `^-�� ell_ (z4- ) 4'OS- 791:r
ykILING ADDRASS,CITY,STATE,ZIP FAX
o Rox' 2,s7 9 Ki-e D w4 9& , ,3 ( ) -
PROJECT CONTACT NW PRIMARY PHONE
(The individual to receive and -AC)gel.A'Le-)6A/� e�- (.24-3)'/c 5 - 78 7S"
respond to all correspondence MAILING ADD ,CITY,STATE,ZIP FAX
concerning this application) pc) tg a x 2.f7 a /�T[Z��t 0 v7/4 9cf093 ( ) -
ALTERNATE CONTACT NAME: ! PRIMARY PHONE E-MAIL
( ) -
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the
best of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to t ty as a part of tst application.
SIGNATURE: _ ---4-, �!t - DATE / 2-- /7 0-/
PRINT NAME: -05f / -,1,'v!,''L
Bulletin#100-4/17/2009 Page 1 of 4 k:\Handouts\Permit Application
MI
al, MECIIANICAL FIXTURE*
Value of Mechanical Work$ ?,00e/.GO (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 V OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commerciai) ( iA F.tie I
BOILERS FURNACES HOT WATER TANKS(cas) - "I'4 e *JCTCiI1 x
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING, FIXTif
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/Sbosvercombo) LAVS((toed Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
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
'' ` RES ENT L"
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
BASEMENT _::....---.�.-------------__-----
FIRST FLOOR(or Mobile Home)
SECOND FLOOR - — -- - -.—COVERED ENTRY ._.._-_..-
DECK
GARAGE 0 CARPORT 0
-
OTHER:(describe} _ ___ —_.--
ESIsrIIO PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEWfADDITION
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION
'COAIMEIZCIAL—REM( DEL!i'ENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square FeetType Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-4/17/2009 Page 2 of 4 k:\Handouts\Permit Application