12-101116 IP
ty Federal y • Mechanical
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CommunCiityof&Econ.Dev.WaServices Permit #: 12-101116-00-ME
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 56
Project Address: 32820 20TH AVE S Unit 56 Parcel Number: 144170 0560
Project Description: Relocate meter and extend gas line
Owner Applicant Contractor
CHARLES D&BETTY PROWSE INFRASOURCE CONSTRUCTION LLC INFRASOURCE CONSTRUCTION LLC
32820 20TH AVE S UNIT 56 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.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
and the City of Federal Way.
Ft
Owner or agent: Date:
fNAW? 4/4/12
AL'• THIS CARD IS TO MAIN ON-SITE
CITY OF • Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-101116-00-ME Address: 32820 20TH AVE S Unit 56
Project: CHARLES D & BETTY PROWSE FEDERAL WAY, WA 98003-9432
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 3,00,v Approved
.By Date .By Date 4-y•- 1z .By r/ Date y_ %/ /Z—
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
Federal •PERMIT
s MF .00
°2 83 z° AX25 8 5-2609Es APPLICATION
www.rirgoffedero/wau_com MA 0 8 '.'0':7
SITE ADDRESS CITY `.'SC )ET/ g lip L WA
3a8a0 ' Q'fn4vc J ccus
PROJECT VALUATION v ZONING ASSESSOR'S TAR/PARCEL#
$ I ,0vo 14 LI I 7 0- 0 0 0 0
TYPE OF PERMIT 0 BUILDING ElPLUMBING • MECHANICAL
0 DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT / �'�� � / ��%/� f �✓J/ J/ ' l
(Tenant Name/Homeowner Last Name) C A��`1L...I—�V[i7/ C."I�/�V " 1 1 I V l V M
PROJECT DESCRIPTION & I ` eiT rove 5 uS rhe d'C a byh1 Q
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
- ... _ CITY
- - - — --- -- __ I STATE I ZIP
NAM PHONE---- -----
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MAILING ADDRESS
E-MAIL
CONTRACTOR laoo Rouseve 1+ R e i-e 403
TY
teat I ttiln STATE ZIP
It. (.0,OI.3'7FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
Nr► • GL.9' '1C3. -4/ IL /oaol3 100 rS.
NAME'," evc TO` n �� PHONE
MAILING ESS h -�-1-7 0--APPLICANT 8`0 1 CDRi-h ti "
st--rQ c A- E-MAIL
CITY 1 -en t w ITF ZI FAX
PROJECT CONTACT NAME„..-
PHONE-- YV ./T1 X03 a
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(The individual to receive and �QVC J n n ) 3'37Q a !a
respond to all correspondence MAILING AD RESS L E-MAIL l
concerning this application) OO . 50 k 7 9% a l a t' S G e
CIT'Yh.ti l T I STATE ZIP01 . FAX
ALTERNATE CONTACT NAME: W PHONE E-MAIL
PROJECT FINANCING N ` /
Required value of$5,000 or more (1f rq•Jcurce bans ink c.};dye f'G 0 OWNER-FINANCED
/RCW 19.27.095) MAILING ADDRESS,CITY, ATE,ZIP
1�1 00 (3 oo ckle'T 1 (`o sit. `'vo Glen Ellyn It. (,3( (13 A-18
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 ci • a part of this application. /
SIGNATURE: � V! .01 a
L DATE
PRINT NAME: S 4CNG y8h fl S,„,r1
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application