17-103224 . i
Mechanical
City of Federal Way Permit #:17-103224-00-ME
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: TIMBER GROVE CONDOMINIUMS BLDG 1 UNIT A
Project Address: 31738 49TH LN SW Parcel Number:864800 0010
Project Description: Gas water heater replacement
Owner Applicant Contractor
JANE DOLL JEROME GIBSON CONSTRUCTION JEROME GIBSON CONSTRUCTION
4920 SW 318TH ST UNIT 1-A 11207 1ST AVENUE CT E APT A203 JEROMG*884NN(8/15/18)
FEDERAL WAY WA 98023 TACOMA WA 98445 11207 1ST AVENUE CT E APT A203
USA
TACOMA WA 98445
Additional Permit Information
Mechanical Work Valuation? 1400 Is this an Online or O.T.C.application? Yes
Hot Water Tanks 1
PERMIT EXPIRES Monday, 1 January,2018
Permit Issued on Wednesday,July 5,2017
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 and the City of Federal Way.
/
Owner or agent: i /, � ,� Date:
D:\TI: INSPI-w(TOId kRE ANI) •nPE 3r I\SPI:( I i n'\ •
THIS CARD IS TO REMAIN ON-SITE
Federat Way Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103224 00 Address: 31738 49TH LN SW Unit I-A
Project: JANE DOLL FEDERAL WAY WA 98023
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) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
.By Date •• ••Date ..By Ad Date ViXti ]
El Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
A..1,,,,,,..._ _A. PERMIT
CITY OF APPLICATION
MIT CENTER+33325 8th Avenue South+Fe�' y •.1;!3-6325
Federal Way PER253-835-2607 + FAX 253-835-2609 +permite'ei'i _ ay.com
PERMIT NUMBER 17- I 0 ✓ ?2 4 - ME- JUL 052017
— — TARGET DATE CITY OF FFDERAL WAY
COMMUNITY DEVELOPMENT
SITE ADDRESS Fj,c "9 SUITE/UNIT#
J / ZP L/ 779 L,r: 5i/' Feoeeg< A/ I A
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
)4/06/1 43' & k g 0 0 - 0° 1 0
/
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING %MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT Ti- -2 GlOuti cVN1M,'N 07-4s
PROJECT DESCRIPTION ��^^ �//
Detailed description of work to V-A i v,47-- -E N 'A 7e,e, 4) .?/..057 e---
be included on this permit only
NAME PRIMARYY PHONE
PROPERTY OWNER g 1 v A�e 0 o 7 43 3 P7-
MAILING ADDRESS E-MAIL
?773 ' W7-61 t. '
ITYSTATE ZIP
4. /�7�/ Ar/fir 2Vg 3
_
NAME r PHONE. .
0-64 c4 ((?5c',✓
MAILLING ADDRESS / /� E-MAIL
CONTRACTOR /4®Z 9 ` fT 7-we < �,'4 /�O FAX CITY STATE
' t '^' b P/4 Z LPG FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
7
NAME PRIMARY PHONE
APPLICANT- MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT _579i
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME ..
PROJECT FINANCING ✓ //► ❑ OWNER-FINANCED
When value is$5,000 or more MAILING ADDSIE S,CITY,STATE,ZIP 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 this • -.licatio
SIGNATURE: �' � .r DATE 7r-- c. .- ,267
77
PRINT NAME: (Tete 6_l c169"/
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
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(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
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 Tub/shower Combo) LAVS(Hand 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
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 ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
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