10-101079 Mechanical
City of FederPermit #: 10-101079-00-ME
Community DevelopmmennttServices
S
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: THOMAS
Project Address: 4004 SW 328TH ST Parcel Number: 873195 0170
Project Description: Relocating gas meter from backyard to outright 4>4
Owner Applicant Contractor
THOMAS V ASHBROOK PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
4004 SW 328TH ST PO BOX 808 PILCHCI101MA(02/20/11)
FEDERAL WAY WA 98023-2657 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
Gas Pipe Outlets 1
PERMIT EXPIRES Monday, September 13, 2010
Permit Issued on Wednesday, March 17, 2010
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
0 and the City of Federal Way.
Owner or age `-- Date: 3 / - 10
fINN•i•O) 3/2a 40
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Ii. ction Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 10-101079-00-ME Address: 4004 SW 328TH ST
Owner: THOMAS V ASHBROOK FEDERAL WAY, WA 98023-2657
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 it
IA Approved
By Date By Date 3/23/7"
/2 / 2Jt By ,2p Date 343/z
c
0 Rough ElectricalCl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
a - / o / 0 ?
tom of ERMIT �� CO ME EL PL DE EN FP
Federal Way '��e T
COMMUNITY DEVELOPMENT X23S2 ICES APPLICATION :.
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www.cituo ifederahuaq.com
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SITE ADDRESS
4004.. Sw 3 Zr34 Ste• CITY OF FEDERAL WAY
SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL# C D S
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NAME OF PROJECT ' ' �
(Tenant or Homeowner Name)
❑BUILDING 0 PLUMBING , MECHANICAL.
TYPE OF PERMIT
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
/&/0C4-01111tai' Armee t� �, 44 y -4O
PROJECT DESCRIPTION 40 0 , 4.1-
Detailed description of work to
be included on this permit only
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NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS,CITY,STATE,ZIP • E-MAIL
4-O0¢ SLS ,32-em- ST—
OWNER IS ALSO: o CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
NAME /.
PRIMARY PHONE
(\\U /CONTRACTOR
PiL.0=i-tie- l p�Ar '/CSKS (1,r3 ) 4os 6 6-6 6
..qifil' MAILING ADDRESS,CITY,STATE,ZIP Ail'1060'4�I+^ w�9(J�/�+3 FAX
LI
WA STATE CONTRACTOR'S LICENSE 8 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE!
/a/404 a.r /O/ M.a- / /
lua /1 PRIMARY PHONE
APPLICANT V 46/49o-ti (z.53)405-4.5-6 4,
MAILING ADDRESS,CITY,STATE,ZIP FAX
( ) -
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and ( ) -
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$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city asart of this application.
SIGNATURE: DATE 3-17` !D
PRINT NAME: 66 V 4o69414.1
Bulletin#100-January 1,2010 Page 1 of 4 k:\Handouts\Permit Application
Value of Mechanical Work$ / ' 42 .' (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 .1 GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commenc4
BOILERS FURNACES HOT WATER TANKS(Geo
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING 4 lie GAS PIPING WOODSTOVES
B/ a EES?i'=S 3 Eiggi=iiia"'is i4i `:i i ''?iiiiES.>i' i 'E`?' v iii`
Indicate number of each type of fixture to be installed or relocated as part of this project. Da 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/ons WATER HEATERS(nedac)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
1ENE. I F R YI ' `IQN
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
•
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT::
FIRST FLOOR(or Mobile Home)
St� ONp FhQL}R —
• COVERED ENTRY
DEQ
GARAGE 0 CARPORT 0
OTHER{descrGbe ....
.. .. F=ISTING PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
....._. ..
AREA DESCRIPTION Area Construction #of
Occupaacy Group(s) Additional Information
in Square Feet Type Stories
IiEW BUILDIsr . ..
ADDITION
...:� �
AREA DESCRIPTION Area Construction #of
Occupancy Groups) Additional Information
in Square Feet Type Stories
TO AL �UILEIIHG
TENANT AREA ONLY
E... :F t>EIMr.AREA ox1.x:,
Bulletin#100—January 1,an Page 2 of 4 k:\Handouts\Permit Application