09-104594 •
•
Mecliani al
City of Federal Way �.J/.
Community Development Services Permit #: 09-104594-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name:,pAv CI .
Project Address: 505 S 330TH PL Parcel Number: 132140 0010
Project Description: Remove/replace gas water
•
Owner Applicant Contractor
DAVID B JACK WASHINGTON CORROSION SRVC INC WASHINGTON CORROSION SRVC INC
505 S 330TH PL 1425 BLAINE AVE NE WASHICS055KC(5/4/10)
FEDERAL WAY WA 98003-5900 RENTON WA 98056-2774 1425 BLAINE AVE NE
RENTON WA 98056-2774
Addivtekeiv, tional Permit Information y s.
•
Mechanical Valuation 1460 Is this an Online or O.T.C.application" Yes
Mechanical Fixture�4'
Hot Water Tanks 1
PERMIT EXPIRES Saturday, May 22, 2010
Permit Issued on Monday, November 23, 2009
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: r� Date: I 2� O
F9J*UPI ► u Z4lc
THIS CARD IS T€MAIN ON-SITE • .
CITY OF -'�'',','„� 0 Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 09-104594-00-ME Address: 505 S 330TH PL
Owner: DAVID B JACK FEDERAL WAY, WA 98003-5900
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.
E Mechanical Rough-in (4165) 0 Gas Piping (4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By C Date 11,-2,3/44_
0 Rough Electrical Final ElectricalCI Right of Way
Approved Approved Approved
By Date By Date By Date
r ,,. o Joos- g
CITY OF
Federal Way
EIVE TERM T smpg, CO CVIE L PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES 0 APPLICATION / /
253-835-2607•FAX 253-835-26q�V 2 3 2 u
www.atuoffederalwau.com
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SITE ADDRESS I t
c -, C J / kin°D -- . d4(kl_k„ ; ,
SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL#
.� _ 0 o / O
PROJECT
NAME OF PROJECT •
(Tenant or Homeowner Name) S-C; _ DA-111.pA
0 BUILDING 0 PLUMBING a MECHANICAL
TYPE OF PERMIT ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
• . r 6 l,, - If kto rte 71-k
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER �, ; I ,i,�%' • ( ! )_�)C7 -1 - 6
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
t'51.'7 S 32,r,tilt P 14u.
OWNER IS ALSO: ❑ CONTRACTOR 0 APPLICANT ❑ PROJECT CONTACT
NAME PRIMARY PHONE
f., '' `AVil il` �l} l �Y .A.)01
( ) '1 -
i4):
CONTRACTOR MAILING ADD S,CITY,STATE,ZIP FAX
7' .1 A, - f ` ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION`yDATE FEDERAL WAY BUSINESS LICENSE#
.�'t`. r i..i,./ �l jtj �.L. L- �/v Ci / •\'
NAMEff PRIMARY PHONE
\r'• 'i. ,_ 1I.. '� ' '� ,VV`t ( ) r2t✓1- ( 1
APPLICANT
MAILING ADDRESS,CITY,STATE,ZIP FAX
I`(`- .. i 0.1 t- ,. k c' .` 12._2 t'...- lam (.-`*. h-- ( )
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and ,l'\...t Vti ' ( )
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) ( )
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
( )
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095) ( )
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses,and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application. /�
SIGNATURE: DATE 1 Z G C‘
PRINT NAME:
Bulletin#100 -4/17/2009 Page 1 of 4 k:\Handouts\Permit Application
-
- '-_ MECHANICAL FIXTURE
Value of Mechanical Work$ (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(Commercial(
BOILERS FURNACES I HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
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/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 _
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
RESIDENTIAL
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECONDFLOOR — _..__.----_.....____._._..__....-.---._.....__....._.._..._........_.__...._-.-.-.-.--__-.
COVEREDENTRY _.............__..........—.__._._..._.__.______.__�..__....__.__.._.._._.__._._..
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Construction # of
in Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION
COMMERCIAL REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Construction # of
- in S uare Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-4/17/2009 Page 2 of 4 k:\Handouts\Permit Application