15-100134n
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: WILHELME
Project Address: 29717 4TH AVE SW
Project Description: Install 201 fe$t of gas piping for n
Owner
CAROL L WILHELME INF N
ED ,gOK717 4THWILHELME 91
J SW
SW
FEDERAL WWA
Is thi On1in T.JVappfication?...............Yes
t
GasPiping ............................. .......
A entl installed generator is not al.
#150 for place ent details.
Mechanical
Permit #: 15 -100134 -00 -ME
Inspection Request Line: (253) 835-3050
r
720510 0030
yards
Bulletin
PMIT EXPIRES Saturd
Permit Issued on Monday, an ry 1 2015
er y certify tha mation is r a th construction on the above described property and
the occup and S-... a nc aws, rules and regulations of the State of Washington
e City of F deral Way.
Owner or agent: & I I
(00
CITY OF
Federal Way
PERMIT #:
15 -100134 -00 -ME
THIS CARD IS TO*MAIN ON-SITE
F"
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 29717 4TH AVE SW
Project: CAROL L WILHELME FEDERAL WAY, WA 98023-3512
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.
E] Mechanical Rough -in (4165)
El Gas Piping (4125)
0 Final - Mechanical (4065)
Approved
Approved to release test
Approved
By Date
By P A— Date 3 .— Li —15--
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
PERMIT NUMBER S_ 10 0 [-3 4 _ I'tE
RECEIVED ty V �
JAN 12 2015
TARGET DATE OTY OF FEDERAL WAY
SITE ADDRESS
SUITE/UNI
POJECVALUATON
ZONING
ASSESSOR! TAX/PARC� 0 — Q O 55 � O
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING XMECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
1
'1 IR C3
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
t
PRIMARY PHONE
MAILING ADDRESS _
r
E-MAIL
CITY
C-Ze-'NA
STATE I
ZIP
NAME
—tet
PHONE
S3 - Q
MAILING ADDRESS
� � r-,
E-MAIL
CONTRACTOR
CITY %1
VIV—t Pf
1STATE
ZIP
5
FAX r�
G�
WA STATE CONTRACTOR'S LICENSE # j
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE —#
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
Required value of $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
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 . s out of the reliance of the .ty, including its officers and employees, upon the accuracy of the
information su o the city apart of this application.
DATE 1
SIGNATURE:/ZL /-S
PRINT NAME:
Bulletin #100 - January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application
0 19
MECHANICAL PERMIT
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
$ ----7v
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 t ` t
1 GA4 PIPS OUTLETS
pTHER (Describe)
AIR CONDITIONER
•
FIREPLACE INSERTyS
H0(3)0S (commercial)
part o this project. Do not include e)dstir�g fixtures to remain.
BOILERS
FURNACES
HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
URINALS
DUCTING
GAS PIPING
WOODSTOVES
VACUUM BREAKERS
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING - PERMIT
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EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
Indicate how many o each type offxture
to be installed or relocated as
part o this project. Do not include e)dstir�g fixtures to remain.
BATHTUBS (or Tub/shower combo)
LAVS (ii—dsinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS Z } i 7
SHOWERS
VACUUM BREAKERS
1 ON
DRINKING FOUNTAINS` 4
ii 1 1 SINKS (Kitchen/Utility)
WATER HEATERS (Electric)
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SUMPS
WASHING MACHINES
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GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
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PROPOSED FIRE SUPPRESSION SYSTEM?
FIRST FLOOR (or Mobile Home)
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TOTAL
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Bulletin # 100 —January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application