09-104831r w.
Mech~Ag l"ica"l
City of Federal Way Per'�iit # -, 09 -104831 -00 -ME
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 9718 Inspection Request Line: i(253 835-3050
Ph: (253) $35-26Q7 Fax: {253) 835-2609 i0 �
Project Name: NGUYEN
Project Address: 202 S 330TH PL Parcel Number: 132140 0760
Project Description: Install gas piping for gas kitchen range
Owner
,Agmlican
Contractor
DUNG TIEN NGUYEN
DUNG TIEN NGUYEN
DUNG TIEN NGUYEN
202 S 330TH PL
202 S 330TH PL
202 S 330TH PL
FEDERAL WAY WA 98003-5907
FEDERAL WAY WA 98003-5907
FEDERAL WAY WA 98003-5907
AdditJcnat Permit lnfornliadptl
Mechanical Valuation............................................500 Is this an Online or O.T.C. application? ................. Yes
.Mechanical Fixtures'
Gas Piping ...................................... 1
PERMIT EXPIRES Tuesday, June 8, 2010
Permit Issued on Thursday, December 10, 2009
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 a6cordance with the laws, rules and regulations of the State, of Washington
and the City of Federal Way.
Owner or agent: Date:
Folwo 1q1q10q
THIS CARD IS TO ON-SITE }
Crn OFConstruction Ins ction Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #:
Owner:
09 -104831 -00 -ME Address: 202 S 330TH PL
DUNG TIEN NGUYEN FEDERAL WAY, WA 98003-5907
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.
Mechanical Rough -in (4165)
Gas Piping (4125)
Final - Mechanical (4065)
Approved
Approved to release test
Approved
By Date
By �%�� Date 11 ®q;
By _ Date
Rough Electrical
Approved
Final Electrical
Approved
1:1
Right of Way
Approved
By
Date
By
Date
By
Date
crff OFA
Federal Way
C0A0ffMM,QEV=PAWATSERVICES
253-83S-2607- FAX 253-835-2609
Z�
*PERMIT
APPLICATION
0q- / 0 te 1 /
SF& CO (jiE L PL DE EN IF?
, '" 11". �'T g
0
am ADDRESS
330Th P& muw WAY, WA qira 3
ZONING ASSESSOR'S TAX/PARCEL #
Z— /40 7—
Z -F- A
NAME OF PROJECT
(Tenant or Homeowner Name)
70
TYPE OF PERMIT
BUILDING 0 PLUMBING MECHANICAL
11 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
*-tRR- rmc- cq� UW fk&M -Eb"bCk m kiRCHUN -ZA) OAAO-T-D
PROJECT "ztK;KU-r1UX
Detailed description of work to
e_n VMT- 7116 frLFCWC. kA*0?7-0 6e 8AWC-r1-
be included on this permit only
V -TJ
PROPERTY OWNER
bUNG
PRIMARY PHONE
MAILING ADDRESS, =T, STATE, ZIP
-t0Z S. 330-1-h k fabKgt W!J Ael too
Z -MAIL
OWNER IS ALSO:
R CONTRACTOR APPLIdANT PROJECT CONTACT
CONTRACTOR
NAft PRIMARY PEONS
WAILING ADDRESS, CrTY, STATE, zir
rAX
-T
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
PIWERAL WAY BUSINESS LICENSE #
NAM
PRIMARY PHONE
APPLICANT
MAILING ADDRESS, CITY, STATE, ZIP
PAX
PROJECT CONTACT
NAM
PRIMARr PEONS
Mw individual to receive and
respond to all correspondence
concerning this application)
MAILING ADDRESS, CITY, STATE, ZIP
PAX
ALTERNATE CONTACT NAME:
PRIMARY PHONE
E-MAIL
PROJECT FINANCING
Required for projects with
NAME
OWNER-MANCED
value of$5,000 or more
(RCW 19.27.096) 1
MAA OG ADDRESS, CITY, STATE, ZIP
PRIMARY PEONS
Z certVg under penalty of perjury that Z am the property owner or authorised agent of the property owner. Z cwtVy that to the
best of my knowledge, the iqformation submitted in support of this permit application is true and correct Z cert(fy that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. Z 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.
Zjkwther 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 ckdnq, Which may be made by any person, including the undersigned, and filed against the
city, but oP4 whom such claim arises out of the reliance of the c1W, including its offleers and emphqpees, upon the accuracy of the
i4ormation supplied to the aft as a part of this application.
SIGNATURE- &)111 -14' T- DATE4411640f
PRINT NAME: C NCItJQFKJ
Bulletin #100 — 4/17t2009 Page 1 of 4 k-.\Handouts\PernIit Application
JPW,
I
Indicate number of each type c
BATHTUBS (orTub/swwwcomuo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
:xture to be installed or relocated as
LAVS (--sm.q
RAINWATER SYSTEMS
SHOWERS
SINKS )Ettcbe„nrtW
SUMPS
Do not include
TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES
r f dlures to remain.
WATER PIPING
OTHER (Descn'be)
TOTAL FIXTURES
GENERAL
N. CHANICAL FIXT
FROJ= VALIIATION
Value of Mechanical Work $
SOS A COPY OF RD OR ESTIMATE MUST BE PROVIDED
Indicate number of each type offixture to be instaU,ed or relocated as part of this 'e Do not include existing es to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS OTHER (Descn'be)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS )coameraq
BOILERS
FURNACES
HOT WATER TANKS lam)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING �_
GAS PIPING
WOODSTOVES
Indicate number of each type c
BATHTUBS (orTub/swwwcomuo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
:xture to be installed or relocated as
LAVS (--sm.q
RAINWATER SYSTEMS
SHOWERS
SINKS )Ettcbe„nrtW
SUMPS
Do not include
TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES
r f dlures to remain.
WATER PIPING
OTHER (Descn'be)
TOTAL FIXTURES
GENERAL
INFORMATION
FROJ= VALIIATION
'WATER PIIRVWOR
SEWER FIIRVETOR
VAL= OF XXUr nfG DMQVXNa M=
BASEMENT
Additional Information
BMDM
MUSMG/MUMOIIS IIS&
LOT SIZE (in Sgnare Feet)
EZ18TIIfG FM SPRUMER SYSTEM?
PROP01W FM SUPPRESSION SYSTEM?
ADDITION
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
Additional Information
BMDM
FIRST FLOOR (or Mobile Home
ADDITION
SEGOPTD �FLO4'1R
G iM w[ER fiAI. ,_ REI QDI /TENANT
COVERED ENTRY
AREA DESCRIPTION
Area
in oars Feet
Occupancy Groups)
Construction
Type
DECK
Additional Information
TOTAL BIIILDDFti=
GARAGE ❑ CARPORT ❑
TENANT AREA ONLY
OTMR (describe
aMAwA; oft?
Area Totals
Ran=*o
rzsorosm
rarar.
-
**xEwsoaNs
01&Y**
ESTIMATED SELLING PRICE $
1 # OF BEDROOMS
4JMAIER
L NEW/ADDMON
AREA DESCRIPTION
AreaAare Feet
in ftNNW
Occupancy Group(s)
Construction
Stories
Additional Information
BMDM
ADDITION
G iM w[ER fiAI. ,_ REI QDI /TENANT
NTS
AREA DESCRIPTION
Area
in oars Feet
Occupancy Groups)
Construction
Type
# of
Stories
Additional Information
TOTAL BIIILDDFti=
TENANT AREA ONLY
aMAwA; oft?
-
Bulletin #100 — 4/17/2009 Page 2 of 4 k:lHandouts\Pennit Application