10-100592 .+"0 Mechanical
City f Federal Way n
Community Development Services Permit #: 10-100592-00-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: MAXIMO
Project Address: 2251 SW 331ST ST Parcel Number: 894500 0440
Project Description: Gas fuel line extension
Owner Applicant Contractor
MAXIMO ROMERO PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
2251 SW 331ST ST PO BOX 808 PILCHCI101MA(02/20/11)
FEDERAL WAY WA BOTHELL WA 98041-0808 PO BOX 808
98023-2831 BOTHELL WA 98041-0808
Mechanical Valuation 1000 Is this an Online or O.T.C.application? Yes
'(#1.1 Mechanical Fixtures
Gas Pipe Outlets 1
PERMIT EXPIRES Tuesday, August 10, 2010
Permit Issued on Thursday, February 11, 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
f % and o- Cit deraI Way.
Owner or agent: L'^=gam / Date: "(l—lG.
VThk1Lt, tZS j o
• THIS CARD IS TO AIN ON-SITE
CITY
°F Construction Ins tion Record •- -
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 10-100592-00-ME Address: 2251 SW 331ST ST
Owner: MAXIMO ROMERO FEDERAL WAY, WA 98023-2831
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) Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date 2.��< a
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
... l,.....,Way 4100,PERMIT mpurF CO(-3M EL1:1, ;
Federa
COMITIVITY DEVELOPMENT SERVI9le celAwLICATION : I.--------- --------------'-------i
253-835-2607.FAX 253-835-260t
Ewit.c.Atmaci_e_ahvatks_om
SITE ADDRESS
,
a Z cl.,5*iyagR14-*, -17 1--) 1-
‘,Ji Fe- ejeA / (icy/A-
SUITE/UNIT# 377.
- n
... R'S TAX/PARCEL#
ASE . Li
NAME OF PROJECT
(Tenant or Homeowner Name) i4C a': ryi A )CI rY C
0 BUILDING 0 PLUMBING ,,I21'MECHANICAL.
TYPE OF PERMIT
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
(451 A'- ck.:e- i L.:4:1\1C"; - c.r(Aff4 nic, /
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
ttott EIiiiiiiiiiiiiiMMENIRESIONMAROMPPROPR
NAME PRIMARY PHONE
PROPERTY OWNER 14 cS g m A,c-Tiv-1(-_ tO It14 .6 ( ) -
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
29.. 5. 1
. w 3.31 Sr 51-
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
NAME PRIMARY PHONE
(;''.::. ) k'er-' - '7CC. f(
CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP FAX
.5.-7c? A<T414A/0 LAZ.,‘ ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
I'; c Clic i 101 pi A / /
NAME PRIMARY PHONE
APPLICANT (Joy .4/ K-,4,,t 1) 12.-- (z53) 465 - 7i-', :
MAILING ADDRESS,CITY,STATE,ZIP FAX
i 'C'i L67 RI
2- 7 1 K.742-KILAt•16 t"( A- ( ) -
I
PROJECT CONTACT NA, •,. .. PRIMARY PHONE
(The individual to receive and ( --e/2ez" ,1--/re--). /.. .-‘26?,,e (253). .--.,-
respond to all correspondence MAILING ADD SS,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$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of thi,s application.
,
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SIGNATURE: ('''------_,.... ,-; ,e6,1z.. .-1- DATE ;i. , //' ,''
PRINT NAME: „..„a"-e7 /7"- -/L","1,"‘-74)6."'/C.:.
Bulletin#100-January 1,2010 Page 1 of 4 IcAllandouts\Pennit Application
Value of Mechanical Work$ Ii 6z-0, GC) (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(Commoxoi
BOILERS FURNACES HOT WATER TANKS(Ge)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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