12-101087 • Mechanical
Cof Federal Way
Community&Econ.Dev.Services Permit #: 12-101087-00-ME
33325 8th Ave S
Federal Way,WA 98003 Request
Ph.(253)835-2607 Fax(253)835-2609Inspectionq st Line: (253)835-3050
Project Name: CEDAR CREEK CONDOMINIUM UNIT 19
Project Address: 32820 20TH AVE S Unit 19 Parcel Number: 144170 0190
Project Description: Relocate meter and extend gas line
Owner Applicant Contractor
RICHARD B&ESTELLE LASKO INFRASOURCE CONSTRUCTION LLC INFRASOURCE CONSTRUCTION LLC
32820 20TH AVE S UNIT 19 8001 S 212TH ST INFRACL899CZ(2/14/13)
FEDERAL WAY WA 98003 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.application9 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
and the City of Federal Way.
Owner or agent: FILE Date:
FINALU 3/11 1 12.
THIS CARD IS TO MAIN ON-SITE ,
CITY OF Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-101087-00-ME Address: 32820 20TH AVE S Unit 19
Project: RICHARD B & ESTELLE LASKO FEDERAL WAY, WA 98003-9429
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) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By /if Date 3-/`y-/ By f4 Date 3 79-/Z
El Rough Electrical El Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
QTY OF - - I 0 I 0 V
Federal.-, OPERMIT 4 -F ME PL DE EN FP
CCEIVE
COMMUNITY DEVELOPMENT SERVICES
253-835-2607•FAX 253-835-2609 APPLICATION
www c?yol'fed eral wau.corn
MAR' 0 8 2012
SITE ADDRESS
3-a g an av+n a ve S CITY OF FEC3ER`I�' 'I ►1(
CDS
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1,000 1 t LI I 7 0 - 0 0 0 0
TYPE OF PERMIT ❑BUILDING 0 PLUMBING • MECHANICAL
❑ DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT /• _DAV-C W n� �/
(Tenant Name/Homeowner Last Name) (�{� r 'Nl v/l C t.� �o ,
PROJECT DESCRIPTION
F4& ( role- elf- }a rh o uG 5 c4S rhe R r a Pi ho h1 Q _
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE T
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAM
�rt Pru So1.rde Coostrvief4on I G PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR Ia oo R oos eve 1+ R a •S i-e 400
��tC„ I,_ 111 STATE ZIP FAX
f n 1 It (.0137
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
— 1 Nr=R s3 GL 1' elC7.. IYX/ 19 /Rota 100 G}
NAMFtVc �.oh n SbYi PHONE
-as-3-1'70-- ATI)
APPLICANT MAILING ADDRESS E-MAIL
a 00 1 s) -P alai-~ SvreC4-
CITY 1 n STAT ZI FAX
w I+ ,6o3' .
PROJECT CONTACT NAME PHONE
(The individual to receive and ��SVG `, h"�n )173-37(x_a yf,,
respond to all correspondence LING AD KESS L E-MAIL /
concerning this application) u.44.1 a a�� 5�''ro C
CITY STATEZIP FAX
ttto i-- w ti., 0/803 a.
ALTERNATE CONTACT NAME: PHONE E-MAIL
•
PROJECT FINANCING NAM — W
qu �n is Sk.0rce Go ns .,r(4tet;;db., f t G ❑ OWNER-FINANCED
Required value of$5,000 or more �L �} Ste-
(RCW79.27.095) MAI1aLd°ADDRESS,osc , 1 fi R O S�1'fcoo Glen EJIyn , (;3o, GSTATE,ZIP IS- 3c18
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 arty 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: // / 7' ,ol a
DATE
PRINT NAME: S ftgel /Oh nson
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application