11-103312CITY OF I T
Federal wa EC *PERM
COM DEVELOPMENT SERVICES APPLICATION
253-833-83 5-2-2 607• FAX 253-835-2609
AUG Ip/ nc panr-DAI WAY
---�-g f 2 -
MF
MF CO ME PL DE EN FP
SITE ADDRESS
�C' � n w CD3
SUITE/UNIT #
yl
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
LD
—� —
TYPE OF PERMIT
❑ BUILDING OPLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
N� v
PROJECT DESCRIPTION
Detailed description of work to
e- �CJ L&t je::34
be included on this permit only
PROPERTY OWNER
NAME
�V,O u
PRIMARY PHONE
MAILING ADDRES
E-MAIL
CITY
STATEI
Lv
ZIP
NAME
��6 k7Q ffC4b
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY �jSTATE
/ ti
t.�a
ZIP
f� 51-/
FAX
WA STATE C NNTRACTOR'S LICEyNNSSSE #
EXPIRAAT}IyON DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY ST
FAX
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certtfy 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 apart of this application.
SIGNATURE: DATE 8
PRINT NAME:
Bulletin #100 — January 1, 2011 Q_1/ Pagel of 3 k:\Handouts\Permit Application
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing futures to remain.
7177
MECHANICAL Fixna'
LAVS (Hand sinks)
TOILETS
WATER PIPING
VALUE OF MECHANICAL WORK $
(a copy of bid or estimate must be provided)
URINALS
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 (commercial)
SINKS (Kitchen/Utility)
BOILERS
FURNACES HOT WATER TANKS (Gas)
HOSE BIBBS
COMPRESSORS
GAS LOG SETS REFRIGERATION SYST
POTi1L
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 futures 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/Utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
POTi1L
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
AREA DESCRIPTIONI Area Occupancy Groups) I Construction I # of Additional Information
in Square Feet Tvve Stories
ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet a Stories
TENANT AREA ONLY
PROJECT AREAONLY --
Bulletin #100 — January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application
City of Federal Way
Community Development Services
s
Yr...
Contractor
P.O. Box 9718
Federal Way, WA 98063-9718
t. -salt
ILE
Ph: (253) 835-2607 Fax: (253) 835-2609
PO BOX 389
PLUMBPS914RS (12/10/11)
Project Name: RUIS
Project Address: 2605 S 272ND ST Unit 41
Project Description: Replace electric hot water tank.
Plumbing
Permit #: 11 -103312 -00 -PL
Inspection Request Line: (253) 835-3050
Parcel Number: 757480 0410
Owner
Applicant
Contractor
GREGORY L RUIS
THE PLUMBING SHOP
THE PLUMBING SHOP
2605 S 272ND ST UNIT 41
PO BOX 389
PLUMBPS914RS (12/10/11)
KENT, WA 98032
MILTON WA 98354
PO BOX 389
MILTON WA 98354
're's
Plu!"nb
:....
Water Heaters ................................. 1
PERMIT EXPIRES Sunday, February 12, 2012
Permit Issued on Tuesday, August 16, 2011
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: Date:'"
t7(wLa> jP/J;g/11
• THIS CARD IS T REMAIN ON-SITE
Cl" of Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 535-3050
PERMIT #: 11 -103312 -00 -PL Address: 2605 S 272ND ST Unit 41
Project: GREGORY L RUIS FEDERAL WAY, WA 98003-8265
1 , .
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.
rl
Plumbing Groundwork (4190)
F1
Rough Plumbing (4230)
Final Electrical
Approved
Gas Piping (4125)
Approved to cover
By
Approved
Approved to release test
By
Date
By
Date
By
Date
rl Final - Plumbing (4075)
Approved
By Date- I�
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date