12-101081 • Mechanical
City of FederalWay Permit #: 12-101081-00-M E
Community&Econ.n.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (2
53)835-3050
Project Name: CEDAR CREEK CONDOMINIUM UNIT 6
Project Address: 32820 20TH AVE S Unit 6 Parcel Number: 144170 0060
Project Description: Relocate meter and extend gas line
Owner Applicant Contractor
LAVON GOODMAN INFRASOURCE CONSTRUCTION LLC INFRASOURCE CONSTRUCTION LLC
32820 20TH AVE S UNIT 6 8001 S 212TH ST INFRACL899CZ(2/14/13)
FEDERAL WAY WA 98003-9428 KENT WA 98032 8001 S 212TH ST
KENT WA 98032
•
Additional Permit Information
Mechanical Valuation 1000.00 Is this an Online or O.T.C.application Yes
Mechanical Fixtures
Gas Piping 1
PERMIT EXPIRES Saturday, September 8, 2012
Permit Issued on Monday, March 12, 2012
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
Owner or agent: F ' nd t ty of Federal Way.
Date:
rt3 1141 (2.
THIS CARD IS TO MAIN ON-SITE ,
CITY OF :11111 . 110 Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-101081-00-ME Address: 32820 20TH AVE S Unit 6
Project: LAVON GOODMAN FEDERAL WAY, WA 98003-9428
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) El Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test �� Approved /�
By Date By •-Date 5 /' -( By ��lam" Date �(_/ -/z.
El Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By. Date By Date
t2 _ rO ( Oef
Cry OF
Federal Way E R M I i 51�'MF CO G PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES APPLICATION RECEIVED
253-835-2607.FAX 253-835-2609
WIMP cifuoffederahuati cm
SITE ADDRESS MAR 08 414E/UNIT#
3- 8a0 a.0+.1`M-vc 5
CITY OF FEDE WAY
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1 ,000 1 4 1 7 0 Chu O O O
TYPE OF PERMIT 0 BUILISING 0 PLUMBING pp MECHANICAL
❑ DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT /
('Tenant Name/Homeowner Last Name) ( /C,J\12-CE(g1/ / 01\)1)0 iii
N( 1 )I' (GOO j��^"
PROJECT DESCRIPTION F�c l (l a a ci.1- -�o�( rho ue- c cc S lhe it rr I a n` �/ho rn c
!'1'V )
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAM /� {(^� Coel
/'
�i I Fru c)-tNree. vile 5i-rviGHOrt i I V PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR 1400 RooseVe1+ R a :si-e 400
cITY
l{`II r /i k STATE 2IP FAX
/n 1I' W13"")
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NJa• GL?• 6IG7"• tyX/ II" /a0l3 WO rS:
NAMFa VC TOh n or1 -- --._.. - --- PHONE-as-3-1-7(9-
HONE
LING DRESS v C MAIL �^ ���
APPLICANT MAILING
1OO- I 60,41-11
f �fh 'a l a fti J��e c A- E-MAIL
_. _ W -- oITY 1♦-e I --- _ j sT LTi I I ZIP 803,, ... FAX
PROJECT CONTACT NAME,,, Y V J PHONE
(The individual to receive and ��'VL J h"�n
')173-170-a�q,
MAILING AD RESS
respond to alt correspondence L E-MAIL
concerning this application) 0 00 50 k►7 i) a l t�" StrC e
CITYY tI`i— STATE ZIP 0- FAX
a.
ALTERNATE CONTACT NAME: w PHONE pr q IV•l E-MAIL
PROJECT FINANCING NAM —
5f 1 fra 5t rce Gan �{v 1 t^Gh G 1 /- 0 OWNER-FINANCED
Required value of$5,000 or more S
(RCW]9.27.095) MAILING oosc ,4 �STATE,ESS,CITY, o sty '-loo Glen Ellyn j G30- 613 ZIP
35-18
I certify under penalty of perjury that I ami the property owner ori authorized agent ofthe property owner.I certify that t the best
of my knowledge,the information submitted in supportof this permit application is true and correct.1 certify that certify
comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci - a part of this application.
SIGNATURE: DATE 8!mol a
PRINT NAME: S 7 C'C /Oh f$fin
Bulletin#100—January I,2011 Page I of 3 k:\Handouts\Permit Application