11-101853 -
City of Federal Way Ill • Mechanical
Community Development Services Permit #: 11-101853-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: HETRICK(CRESTWOOD MHP SPACE 26)
Project Address: 1645 S 272ND ST Space 26 Parcel Number: 332204 9010
Project Description: Relocation of gas meter w/gas line extension.
Owner Applicant Contractor
CRESTWOOD MOBILE HOME PARK INFRASOURCE CONSTRUCTION LLCmINFRASOURCE CONSTRUCTION LLC
1645 S 272ND ST 3380 146TH PL SE#310 INFRACL899CZ(2/14/13)
FEDERAL WAY WA 98032 BELLEVUE WA 98007 3380 146TH PL SE#310
BELLEVUE WA 98007
Y=:(w .Adtionadi ,Per it I ormation r, 3 ,.s. ,,„
Mechanical Valuation 1000 Is this an Online or O.T.C.application? Yes
'' Mechanical Fixtures , •
Gas Pipe Outlets I
PERMIT EXPIRES Wednesday, November 9, 2011
Permit Issued on Friday, May 13, 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
c4 "� and the City of Federal Way.
")Owner or agent: c ) (-) ,--4Date: '3T /S--- 1/
Pi S. ao h1
THIS CARD IS TO EMAIN ON-SITE
CITY UP Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 11-101853-00-ME Address: 1645 S 272ND ST Space 26
Project: CRESTWOOD MOBILE HOME PAR FEDERAL WAY, WA 98032-6835
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) ElGas Piping(4125) Final-Mechanical (4065)
,
Approved Approved to release test /dip.* El Approved
By Date By '/ Date ,� // By ,- . Date 7;i
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
- ( v � � ,S.---,
CITY OF PERMIT
errs •i ED
Federal .,Way N FP
COMMUNITY DEVELOPMENT SERVICES APPLICATION
253-835-2607•FAX 253-835-2609
uq.v_',rtgc(lc derctu'al.core MAY ' 9 vt'�
&'..tJ
SITE ADDRESS CITY QF FEAY
/( 4S— E Z-7 z s r z U (p qC g Ze
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1000 3 3 Z- Z () y - ? o ( o
TYPE OF PERMIT ElBUILDING LI PLUMBING tMECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) �"4.1 jir `CIL elLe4)4rra /1 / / I IP
PROJECT DESCRIPTION `j f` S � K€_1 -Le..
Detailed description of work to 64 ;i ( 64-%-ems 6-se-re-/i S/o A.)
be included on this permit only
1
NAME PRIMARY PHONE
PROPERTY OWNER Je,41-1 /1e-rfe-J(/C 223 g¢(, a 34.S.
MAILING ADDRESS E-MAIL
/bits- 5 Z7Zt� s r z
ICITY STATE Z1 GLJ(,`� 3
�-.I/e,-/-4-L cAiri we.,
NAME PHONE
ThC-0/-4.-SO ci✓C.E'_ cin S-1-- L,.LLC b 30 6 i 3 5.3-7
MAILING ADDRESS
,/ E-MAIL
CONTRACTOR / Z6 V / _4>-AvZLA 2 ,s r E 4-c o
CITY, STATE ZIP FAX
C'II 1 e4-1 CLL.-1A) l C_ to O / 3 '?
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
_ anreAc..LsggCZ_ Z i l 4 //.3
NAME /� PHpNE ZS 3-so
V CSO/ C)rI 6920-6i-3 t^3 zq9 i
APPLICANT MAILING ADDRESS E-MAIL
5242, S7-
CIT72 STATE ZIP FAX
V 6-1-a---- z i/Jt 80,E z
PROJECT CONTACT NAME PHONE
(The individual to receive and 6 V 6e)4 D(1r, ZS -Cy 2_55- /
respond to all correspondence MAILINGILADDRESS E-MAIL
concerning this application) VJQO/� rs �/z . 1^{��
CITY SI/_' E ZIla-
�� FAX
2-
ALTERNATE
ALTERNATE CONTACT NAME, PHONE E-MAIL
PROJECT FINANCING NAME OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 as a part of this application.
SIGNATUF`�fs.=¢�s 'o"dti C DATE `� /•3 //
PRINT NAME: � V (1.0CJ/V
Bulletin#100—January 1,2011 /// Page 1 of 3 k:AHandouts\Permit Application
•
-,t!-a—
y'} ,i1�'f.
VALUE OF MECHANICAL WORK $ ! 00 C) (a copy of bid or estimate must be provided)
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(comroerriau
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING I GAS PIPING WOODSTOVES
., ea`a�#w�.,z•3 ,.�?0 �, ..,z.. ,.i .n .,f�.,,�`�,. ..� .,t� .. � � 8 ,. ��i'",:. �ce+m.a ra..?�.„ .. , + ,, ��e'c�'�• �..,.,a�'�+`� '�+•�'��s
Indicate how many of each type of fvdure to be installed or relocated as part of this project. Do not include existing fixtures 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(Eiertr )
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
�w. �. �n .„ ,.
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?
n 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 Li CARPORT [1
OTHER(describe)';
EtiI_STING PROPOSED TOTAL
Area Totals
*NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS)
CoMMFRCIAT,-NE't r`/ADI
AREA DESCRIPTION Area Construction # of
Occupancy Group(s) Additional Information
in Square Feet Type Stories
NEW BUILDING a
ADDITION
CO INIERCIAL-REMODEL/nNANTT IMPROVEMENTS----
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
r
TOTAL BUILDING
TENANT Ae V ONLY
PROJECT AREA ONLY -
Bulletin#11/0—January 1,2011 Page 2 of 3 k:AHandouts\Permit Application