09-103726 •
Plumbing
City of Federal Way FiatQ
Community Development Services Permit #: 09-103726-00-P L
3
PO. Box 9718
Federal Way,WA 98063-9718
Ph (253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: FERGUSON
Project Address: 920 S 315TH ST Parcel Number: 787540 0255
Project Description: Plumbing fixtures for associated remodel
Owner Applicant Contractor
DIANE&KENNETH FERGUSON DIANE&KENNETH FERGUSON DIANE&KENNETH FERGUSON
920 S 315TH ST 920 S 315TH ST 920 S 315TH ST
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-5354 98003-5354 98003-5354
Plumbing Fixtures
Bathtubs 1 Dishwashers 1 Laundry Washer Outlets 1
Lavatories 1 Showers 1 Sinks 4
Water Closets 1
PERMIT EXPIRES Wednesday, March 24, 2010
Permit Issued on Friday, September 25, 2009
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy an. the use will be in accordance with the laws. rules and regulations of the State of Washington
a d the City of Federal Way ry
Owner or agent: , __. 015 C�
Ce� q2-90 190
THIS CARD IS TO REMAIN ON-SITE
CITY or Construction Inspection Record
Federal INSPECTION REQUESTS: (253)835-3050
PERMIT #: 09-103726-00-PL Address: 920 S 315TH ST
Owner: DIANE & KENNETH FERGUSON FEDERAL WAY, WA 98003-5354
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 Plumbing Groundwork(4190) 0 Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
DI Final-Plumbing(4075)
Approved
By Date
El Rough Electrical Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
09 . 1 0 ? 7 2G
Federal Wa PERMIT S CO ME EL 'Pt E EN FP
EI�1
;OMMUNITY DEVELOPMENT SERVICES APPLICATION - /
253-835-2607•FAX 253-835-260
www.atuoffederalwaa.com,}cP 2j 5 /;,
SITE ADD-4---
fiSUIWOR c4 35 —1--
SUITE/UNIT
TE/UNIT# ZONING ASSESSOR'S TAR/PARCEL M
M t �# re- - t ys1:4*Ire : - t „ i �3 ssi
NAME OF PROJECT
(Tenant or Homeowner Name) lid.V\Y\-e.
i ~f M
�[
❑ BUILDING )(PLUMBING I 1 MECHANICAL
TYPE OF PERMIT `
0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
K.V L\e_ii.. )b rn 1Nv\ 1 L -4-� P.v►tr.. - 1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
—,,,,,,t,,,� ... � � :, ,tea e� ;:: �' a�> a� � t�,' `'fi � - r' &Y yew
NAMEr''-- PRIMARY PHONE
PROPERTY OWNER 115(l\,\ `l.xl��JuV _ ( ) -
MAILING ADD 3,CITY,STATE,ZIP E-MAIL
OWNER IS ALSO: 0 CONTRACTOR i APPLICANT 0 PROJECT CONTACT
NAME j\ — /T PRIMARY PHONE
\p
C 1 J� \'A AB Y c,,\uc5ak ( )
. ( l C• 'TRACTOR MAILING DRESS,CITY,STATE,ZIP L FAX
V . (4(40 5 , Oln ( ) -
4P WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
/ /
�/ PHONE
NAME T....)
�'n i `� ,'� PRIMARY S��
APPLICANT �x U�V��_ r � lv — Q ) 16"7-1
MAILING ADDRESS CITY,STATE,ZIP l , r - FAX
q‘ C)
' ( )
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and ( ) -
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) ( )
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
PROJECT FINANCING NAME
0
OWNER-FINANCED
Required for projects with ,
value of$5,000 or more MAILING ADDRESS,CITY,STA E, PRIMARY PHONE
(RCW 19.27.095)
( )
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
SIGNATURE: DATE
PRINT NAME:
Bulletin 4 100—4/17/2009 Page 1 of 4 k:\l-Iandouts\Permit Application
MECHANICAL FIXTITR 'a
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number 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)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WO]ODDSTOVES
-IL
number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
.+IL BATHTUBS(or Tub/Shower Combo) -1 LAVS(Hand Sinks) I TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS , SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS .. SINKS(Kitchen/Utility) WATER HEATERS(EIectric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
- GENERAL INFORMATION
PROJECT VALUATION 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
RESIDENTIAL
AREA DESCRIPTION(in square feet) EXISTING PROPOSED ( TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY — -- ---
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
— -- -- —
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL —NEW/ADDITION
AREA DESCRIPTION Area Construction # of
in Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION
COMMERCIAL —REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Construction # of
in Square Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—4/17/2009 Page 2 of 4 k:\Handouts\Permit Application