09-101929 City of Federal Way
• Mechanical
Community.O. elopmenntServices ^ ��,1 Permit #: 09-101929-00—ME
Federal Way,WA 98063-9718 d Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 p Q
Project Name: ALI
Project Address: 29254 12TH PL S Parcel Number: 516200 0080
Project Description: Adding gas piping to install gas kitchen range
Owner Applicant Contractor
EJAZ ALI RABIA E ALI RABIA E ALI
RABIA E ALI RABIA E ALI 29254 12TH PL S
RABIA E ALI 29254 12TH PL S FEDERAL WAY WA 98003-3770
29254 12TH PL S FEDERAL WAY WA 98003-3770
FEDERAL WAY WA 98003-3770
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Mechanical Valuation 350.00 Is this an Online or O.T.C.application' Yes
Gas Piping...., I
PERMIT EXPIRES Monday* November 23, 2009
Permit,Issued onvvedaeaday
, may 27, 2009
I hereby certify that•the above information is correct and that the construction on the,above describedproperty 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: 4 S 027 - q
VIN (4fcrfcq
J
• THIS CARD IS TIOEMAIN ON-SITE ,
a •
rt OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-101929-00-ME
Owner: EJAZ ALI
Address: 29254 12TH PL S •
FEDERAL WAY, WA 98003-3770
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. p0 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) El Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved d
By Date By Date By % Date///27
•
•
For inspector reference only _
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
4ARA,,f
E - ° / q q
Federal PER I I SF MF COM�L PL DE EN FP
Gmlunfa YDEv"PAf6Kf� 2 7 2009 -
3332FEDERABNUBSt A 98063-9718
80 a _ APPLICATION
FEDERAL WAY,WA 53-8 3 460 / /
253-835.26x'!•PAX 253-8354609ffeirrittiglOFED�yeRAL}�i WAY
yry
The following is reguiree n-an incomplete application will not be accepted. Please print legibly(in ink)or type.
MMI PROPERTY INFORMATION
ADDRESS ' . I "L (`5riA) 9 06 3 SUffE/UNIT#
ASSESSOR'S TAX/PARCEL# I _CL0 _- -0 __ LOT SIZE(sfl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
reach WaratoPeldbrisitater*id ameiPtion!
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING )Z ECILAIRCAL
0 DEMOLITION 0 ELECTRICAL 0 ENGIIIEERRIG 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work iru3uded on ' '
. f- pitr�
po I ,P .� 'fit 5 AlP •
A PROJECT NAME(Name of Business or Owner�y_Y . •.uL A i i - • i ,I a
M PEOPLE INFORMATION
OPRWONERPERTY --/1 NAME E-3-az.
3-a( . 1` / RA\� F .
}} I t' PRIMARY( )PHONE o - O -i
MAILINSTATE, P E-MAIL ADDRESS
a-514 I� L 5, fRESS ee a% LIJR
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
0 (...) vNR r ( ) -
l°,01(.
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE _
C/ CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
® vn(,cs, ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
CI Architect o Tenant 0 Agent o Other ( )
PROJECTTNAME PRIMARY PHONE -MAIL ADDRESS
CONTACT ( ) - � I -
E
LENDER NAME Aar RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED ETJILDING INFORMATION
EXISTING USE , PROPOSED USE .
EXISTING ASSESSED/APPRAISED VA VAL •F PROPOSED WORK $
SPRINELERED BUILDING? o YES 0 NO FIRE SUPPRESSION SYSTEM • -,- -• - ,„/REQUIRED? O YES o NO
WATER SERVICE PROVIDER o LAKEHAVEN O IIGHLINE ❑TACOMA o . - . - (WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN a HIGELINE a PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
BASEMENT _ SQ.FT. SQ.FT. SQ.FT.
FIRST —
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 17 CARPORT 0
NUMBER OF FLOORS suemo memo, 1 . same r Tom MOICINoSF TOMS:
"'NEWHOMES ONLY" NUMBSR 6 BEDROOMS ESTIMATED SELLING PRICE $
® FIXTURES
htdloate number of each../, offixture to >. installed or relocated as part of this project. Do not include existingfxtures to remain.
MECIVARICAL
Value of Mechanical Work '• �_�0 B� or...- OF BID OR ESTIMATE MUST BE INCLUDED N WPlHAPPLICATIONJ
AIR HANDLING UNITS EVAPORATIVE COOLERS / GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(D )
BOILERS FIREPLACE INSERTS HOODS
•
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLS
BATHTUBS(:nab/Shaw Combo) IAVS ressowswop URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS crows
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that I am the property owner or authorised of the property
knowledge,the y permitapplicationagent to ithlicable ,
City f notrethe owner's pertaining regulations to the work authorised by the issuance of a permit.I understandy that tthat the issuance of this permit
onsibility for compliance with local,state,orJIderal laws regulating mon or environmental laws.
I farther 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 supplied to
the city as a part of this application.
SIGNATURE: TCLL DATE d5—_a 7—ao q
/CI Property Owner and/or Authorized Agent
a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
: 1 / 'NG SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? a YES a NO
•Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application