14-105423 c s
• Mechanical
City of Federal Way Permit #• 14-105423-00-ME
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p a
Project Name: DISSMEYER
Project Address: 29003 22ND AVE S Parcel Number: 422270 0030
Project Description: Relocation of gas meter.
Owner Applicant Contractor
CARL M DISSMEYER INFRASOURCE SERVICES LLC INFRASOURCE SERVICES LLC
CARLY R DISSMEYER 14103 STEWART RD INFRASL871C2(2/22/15)
29003 22ND AVE S SUMNER WA 98390 14103 STEWART RD
FEDERAL WAY WA 98003 SUMNER WA 98390
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Mechanical Fixtures
Gas Piping 1
•
PERMIT EXPIRES Wednesday, April 15, 2015
Permit Issued on Friday, October 17, 2014
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:
FIL Date:
Pfk:‘°.1C4°'
THIS CARD IS TO MAIN ON-SITE
CITY
OF • Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 14-105423-00-ME Address: 29003 22ND AVE S
Project: CARL M DISSMEYER FEDERAL WAY, WA 98003-3846
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) El Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By IMj Date I0 ( 7._3 f tt.
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
LL.....‘ l_ - ( ME z
Federal Way •PERMIT MF CO PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES A P P L I C A T I O N
253-835-2607•FAX 253-835-2609 �eceivE
www.dtrjofferieralwaucorn �d4irWi'..l V �
x9 0 0 3 1r- 0g1�p} ,�'�j
SITE ADDRESS 1 , 0" I1PIT#
IGOZ 22/db 4v E CITY OF FEDERAL WAY
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ a a a _7O - CDS) 30
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL
❑ DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT ..---_
(Tenant Name/Homeowner Last Name)
1SSVV` €,V'
PROJECT c DESCRIPTION
t I R � ", / �S VI • i r ,._ _
Detailed description ofwork to V`4 ,_-\(�j , Cj
be included on this permit only
('I,2AI b� (R.1'Il./ , Jl.CC/2c jei
PRIMARY PHONE
PROPERTY OWNER :1 v I _-1:14�
MAIM
RESS 3 11/..l b • )��../ s E-MAIL
vory
�. ✓f 52 Ces LGA P �=5'/e-V ' p'
I�- MAILING ADDRESS C ,�/ E-MAIL
\:I CONTRACTOR /3336 Sn ' , s,A/
\O0/1n—k— S AT A A3 FAX
WA STATE CONTRACTOR'S LICENSE# f/,( 2I L IOEXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/
it
/ C'//L�,jX/'/�
• "Ty / 1iI./il "T( PH�.37 .. G/U�( 1APPLICANTMAILIs C1dwl 1 E-MAIL U
CITY STATE ZIP FAX
PROJECT CONTACT NAM ' � ,G/ / `/� -- _ P �Z ie�
The individual to receive and �lC?rE L
respond to all correspondence MAILING AD RESS E-MAIL
concerning this application)
CITY I STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME0 OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE —
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 taws.
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 o e reliance of the city, includin• its officers and employees, upon the accuracy of the
information supplied to the city as a p this appli•-••do.
SIGNATURE: DATE i/C/0 -/ C7
PRINT NAME: C O/'
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
1`V�I/ECH i 1C L F+ XTT:IRES
• •
VALUE OP-MECHANICAL WORK $ �/6 116ee((-> (a copy of bid or estimate must be provided)
Indicate how many 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(commerc at)
BOILERS FURNACES HOT WATER TANKS(Gas)
•
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many 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/ShowerCombo) 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
GE;�TE1w I�ti'FORMA.TIO f.n=,
CRITICAL AREAS ON PROPERTY? 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
• R S/ EN, AL. E OR ADI311if Nk� F e
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
t'THER.(desenbe)
EXISTING PROPOSED TOTAL
Area Totals
*NEW HOA=ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
... .... .. -. .. - ., x_ ._._. ..�..,. .. _ .3x.>-..t�.� z ..-�-..,,,. t. .. ,.. ..,,'fir ? ..,_.. ., „'�',_.,. .?'a•t
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square FeetType Stories
NEW BUILDINGr
"f f
ADDITION
C6MMERCIi3iL RE •
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
In Square Feet Type Stories
TOTAL-B
TENANT AREA ONLY
PROJECT AREA.ONLY
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application