12-103258City 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: KIM
Project Address: 33007 11TH AVE SW
Project Description: Extend gas piping for Idtchen gas range
M NfechLical,
Permit #: 12 -103258 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 926495 0180
Owner
AR lip cant
Contractor
JOHN H KIM
ROBISON & SONS
ROBISON & SONS
3300711TH AVE SW
PO BOX 323
ROBISS* 152QW (1/6/14)
FEDERAL WAY WA
PORT ORCHARD WA 98366
PO BOX 323
PORT ORCHARD WA 98366
Additional Permit Information
Mechanical Valuation............................................500 Is this an Online or O.T.C. application? ................. Yes
Mechanical Fixtures
Gas Piping ...................................... 1
PERMIT EXPIRES Saturday, January 12, 2013
Permit Issued on Monday, July 16, 2012
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy an will in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. ) /
Owner or agent Date:
nmAaso
S'�Ib/IL
oR �. THIS CARD IS TO MAIl�T ON-SITE
Construction In ection Record
federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 12 -103258 -00 -ME Address: 33007 11TH AVE SW
Project: JOHN H KIM FEDERAL WAY, WA 98023-5335
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
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Wn~tw �:A
Federal Way OPERMIT
FtECEIV
COMWMN DEVELOPMEKF SERVICES
253-835.2607• FAX 253-$35.2609 WPLICATION
u.•u�u� riluoifederolu�nit.rn(tt J U L 16 2012
MF CO ME PL DE EN FP
SITE ADDRESS
�r CDS f n 9
/ (ZONING
SUITE/L7xIT i
PROJECT VALUATIQ
ASSESSOR'S TAI[/PARCEL i
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
�.
PROJECT DESCRIPTION
Q S to U
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
t
PRIHART PHONE
aYfn i
MAIU NG ADDRESS
E MAII
CITY
STATE
ZIP
t
PHONE
/ %tK"W
5-17
CONTRACTOR
i t9 ✓�
C
p
STATE
Lc57
ZIP
8-36 6
FAX
W STA E CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY EIISmxEm LICENSE /
® 15
/16
,b
APPLICANT
MAILING DRESs
E MAII.
STATIC
JT /1�17a k
C72 ZIP- 3 6;
RAX
PROJECT CONTACT
PHONE
(The individual to receive and
c N
IKAILmG An REss
E ixAu
respond to all correspondence
concerning this application)
(91 J
/ O ! J 0, v t
" V
ZIP
! �-3(O
FAX
A.LT�ERNATE CONTACT NAME:
PHONIC'
E-MAIL
PROJECT FINANCING
NAME
Required value of $5;000 or more
OWNER -FINANCED
(RCW 19.2ZO95)
KAHdNG ADDRESS, CITY, STATIC, 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 1 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 hum
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 Itt o city a part of this application.
BIGNA \TUBE:/ r DATE
_
PRINT NAME-
Bulletin tt 100 — January 1, 2011 Page 1 of 3 UHandoutsNPermit Application
0
9
I
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.
BATHTUBS (. Tub/sh"- comb.)
— LAYS (Hand Sir**
TOILETS
WATER PIPING
DISHWASHERS
VAMM OF MECIrAWCAL WORIC
(a copy of bid or estimate must be proifided)
OTHER (Describe)
Indicate how many project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS
HOODS (c.—a4
WATER HEATERS (m-uic)
BOILERS FURNACES
HOT WATER TANKS (cad)
SUMPS
COMPRESSORS GAS LOG SETS
REFRIGERATION SYST
DUCTING GAS PIPING
WOODSTOVES
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.
BATHTUBS (. Tub/sh"- comb.)
— LAYS (Hand Sir**
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
Ei Yes o No
DRINKING FOUNTAINS
SINKS (Kitch./utmy)
WATER HEATERS (m-uic)
in
OSE BIBBS
SUMPS
WASHING MACHINES
-, —,")r
4
MX
CRITICAL AREAS ON PROPS `1%,\"\ WATER PURVEYOR
SEWER PURVEYOR
VALUE OF ZZISTING 1"ROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE (In Sq—e Feet)
FMSTING FIRE SPPJXIUXR SYSTEM?
pRoposxD Fntz SUPPRESSION SYSTEM?
STING
Ei Yes o No
o Yes ci No
T
AREA DESCRIPTION (in square feet)
STING
PROPOSED
TOTAL
FOR OFFICE E
in
care F t
p
�A
FIRST FLOOR (or Mobile Home)
W-4
ADDMON
4,
COVERED ENTRY
A
W, IN
Md. M3,
GARAGE 0 CARPORT 0
AREA DESCRIPTION
Area
'i
CIOastruction
Stories
P
Feet
wasma
TOTAL
Area Totals
y
ESTIMATED SELLING PRICE
# OF BEDROOMS
TENANT RFAONLY
T
Additio 0 flon
-tion # of
AREA DESCRIPTION Area Occupancy Groups) Stories
in
care F t
�A
ADDMON
A
W, IN
AREA DESCRIPTION
Area
Occupancy Group(s)
CIOastruction
Stories
in ftcare
Feet
y
TENANT RFAONLY
N
Bulletin #100 - January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application