09-103411 Pl trm wing
City of Federal Way
Cornmumty Development Services Permit #: 09-103411 -00-PL
PO.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: WILSON
Project Address: 30840 8TH AVE SW Parcel Number: 555820 0140
Project Description: Remove/replace all iron pipe plumbing lines in kitchen area to plastic piping
Owner Applicant Contractor
KEITH WILSON KEITH WILSON KEITH WILSON
30840 8TH AVE SW 30840 8TH AVE SW 30840 8TH AVE SW
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
Plumbing Fixtures
Other Plumbing Fixtures 2 Sinks 1
PERMIT EXPIRES Monday, March 1, 2010
Permit Issued on Wednesday, September 2, 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: 1- AA, l %l
;., Date: 1'` ` &l
6i 5G3>>3
THIS CARD IS TO REMAIN ON-SITE
Calf°r Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 09-103411-00-PL Address: 30840 8TH AVE SW
Owner: KEITH WILSON FEDERAL WAY, WA 98023-4605
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 Plumbing Groundwork(4190) 0 Rough Plumbing(4230) El Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By c...,, t..,....) Date d. - l t .. 05 By Date
O Final-Plumbing(4075)
Approved
By Date
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
ill--
9 _ i 0 .3 efkii
Ai CITY Or PERMIT SF MF CO ME EL DE EN FP
Federal Way ,s...
COMMUNITY DEVELOPMENT SERVICES'1. V � iiiiii�• P P L I C A T I O N / /
253-835-2607•FAX 253-835-2609 -
www.cituoffederalwau.com
nr
k' z. fir..rt �atx � �€ ' � „��„` 11 � 'w,.r:,f ^'r �s W=
SITE ADDRESS t i u 1,.4,
ti6 1-.. . b leiz_I-- c (Ai Ai
SUITE/UNITY Cr' ZONING ASSESSOR'S Te[pARCEL I
NAME OF PROJECT
(Tenant or Homeowner Name) n
TYPE OF PERMIT ; i; DDING Cl.PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
r e:- .l'- e_L:, L ` ',ti /'-//"C 14- %%!'7!.J fI ' ,
PROJECT DESCRIPTION C�PrelP>< 1 047 7 r- .- . t 7-7e /tel'
Detailed description of work to I
be included on this permit only
dt
NAME 7 / i PRIMARY PHO, /
PROPERTY OWNER 17\ l l,� �� l �� � �� ` S �/7' ~� !
MAILING ADDRESS,CITY,STA ZIP E-MAIL
' S 412{ZU1 _ ) ?- . Af.-
OWNER IS ALSO: El CONTRACTOR re APPLICANT 0 PROJECT CONTACT
NAME - ( PRIMARY PHONE
l
CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP FAX
(
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT (
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$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
(
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to.the city as a partjof this applicatio
SIGNATURE: " f , 1��til6' DATE l (7 ('24 0
PRINT NAME: !!l
Bulletin#100-4/17/2009 Page 1 of 4 k:\Handouts\Permit Application
MECHANICAL FIXTURES
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type off Lure 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
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
d DISHWASHERS RAINWATER SYSTEMS URINALS f OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS g- -1'- l./R
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electr(c)
_ HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE IIn Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
0 Yes ❑ No ❑ Yes ❑ No
RESIDENTIAL
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT _—.—
FIRST FLOOR(or Mobile Home)
SECOND FLOOR --�
COVERED ENTRY ---
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 Square 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