11-101854 City of Way Permit #: 11 -101854-00-M E
Community • Mechanical
Development Services
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: JONES (CRESTWOOD MHP SPACE 173)
Project Address: 1645 S 272ND ST Space 173 Parcel Number: 332204 9010
Project Description: Relocation of gas meter w/gas line extension.
Owner Applicant Contractor
CRESTWOOD MOBILE HOME PARK INFRASOURCE CONSTRUCTION LLC INFRASOURCE 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
i y Additio•n ler formation
Mechanical Valuation 1000 Is this an Online or O.T.C.application? Yes
Gas Pipe Outlets 1
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
. and the City of Federal Way.
Owner or agent: ���/ Date: r_5' //
pwA4 T/to /1
THIS CARD IS TO EMAIN ON-SITE
CITY OF `'` Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 11-101854-00-ME Address: 1645 S 272ND ST Space 173
Project: CRESTWOOD MOBILE HOME PAR FEDERAL WAY, WA 98003
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.
El Mechanical Rough-in (4165) fl Gas Piping(4125) El Final-Mechanical (4065)
Approved Approved to release test Approved
By Date By i �- Date 676 By Date
•
0 Rough Electrical El Final Electrical ® Right of Way
Approved Approved Approved
By Date By Date By Date
l0 / BS� y
CITY OF '= °PERMITc MØIE4FPeWay
COMMUNITY-DEVELOPMENT SERVICES A P P L I C A T I O N
253-835-2607•FAX 253-835-2609
MAY 1 3 2011
SITE ADDRESS
o1 I #L WAY
, --, 6,t1CI37 -z
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
/(>0�1 3 0 y- _ a 4�
TYPE OF PERMIT ElBUILDING ElPLUMBING [MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
�e /er j:0 e-
PROJECT DESCRIPTION
I / e- e ' / l0!'6 c eA(re4
-11,( f� C x-reex_c_o/lJ
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER f / L- 7°'1.1 e- 2/_ e3
MAIL''ING ADDRESS E-MAIL
Gr
i5•- S 27Zr-es / 73
C TY STATE ZIP
♦' �C_ !v 0063
NAME / PHONE
Sn-Fskg S wrl� C.�s t LLC 30h/ 3 3,S-/
MAILING
ADDRESS E-MAIL
1 UO n-00 ''V e-1_4- r-e) -57-6 Td 0CONTRACTOR
CITY 7 i � CLL! S/AE ZI�6 / 3 FAX
WA STATE/ CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 8
�N L121q t-.e q' C Z Z / � I _
--- N // PHONE
1 y L-7 ae-00 El Z 3 .S 76 Z 9` J
APPLICANT MAILING ADDRESS E-MAIL
8( o// ' Z-/Z �- L!TATE Ty�
_ CI/C l..-r "•7' SVL�^1.� eD,2 Z.ip FAX
PROJECT CONTACT NAME /�jI P ON_E
(The individual to receive and ✓ 0-",00-) $ 5 27 2,em r
M��ING ADDRESS E-MAIL
respond to all correspondence
concerning this application) tr) I S Z I Z,,,�
CITY STATE P FAX
00 2 2-
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME — --
OWNER-FINANCED
Required value of$5,000 or more
(RCN/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 city as a part of this application.
SIGNATURES�►"C _ __ DATE
PRINT NAME: 4I/ o -J - —
Bulletin#100—January 1,2011 Page 1 of 3 k:vllandoutsO ermit Application
• •
, Hi IC�L #I .TI
VALUE OF MECHANICAL WORK $/000 (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SE!b REFRIGERATION SYST
DUCTING } GAS PIPING WOODSTOVES
gg
Indicate how many of each type offLrture to be installed or relocated as part of this project. Do not include existing factures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS iiotrhen/utility) WATER HEATERS(Etertrio)
HOSE BIBBS SUMPS WASHING MACHINES `>Et7T g �'
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Yes n No ❑Yes C No
1114'ESID `dTIAL NE v {)R A ION
O
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR(or Mobile Home)
fs lay O ,
-------'-'-'----------
COVERED ENTRY
DECK r ��
GARAGE ❑ CARPORT LI
OTHER(describe)
-_ — — —
7 Eti1S'I'INO PROPOSED TOT AL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ _ _ # OF BEDROOMS
COMMERCIAL— ENViAI)I)IT EON
AREA DESCRIPTION Area Construction # of
Occupancy Group(s) i Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL--REM011.F L/TENAN 1`IMPROVEMENTS
AREA DESCRIPTION Area Construction # of
Occupancy Group(s) Additional Information
in Square Feet Type Stories
TOTAL IKs F ��� U
TENANT AREA ONLY
PROJECT AREA ONLY ° rr
Bulletin#100—January I,2011 Page 2 of 3 k:\Handouts\Permit Application