18-103668City of Federal War
conn -m4 D-dopent Dep.
33325 8th Ave S
Federal way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Project Name: RATTERAY
Project Address: 32628 49TH PL SW
Project Description: Relocation of the gas meter.
Mechanical
Permit #:18 -103668 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 873219 0820
Owner
Applicant
Contractor
ROSE RATrERAY
COREY ALEXANDERU*TASOURCE
H*TASOURCE SERVICES LLC
32628 49TH PL SW
SERVICES LLC
INFRASL871C2 (7122!19)
FEDERAL WAY WA 98023-1927
13330 STONE AVE N
14103 STEWART RD
SEATTLE WA 98133
SUMIVER WA 98390
Additional Permit Infonnation
Mechanical Work Valuation? ................................. 1000 Is this an Online or O.T.C. application? ................. Yes
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Gas Piping 1
PERMIT EXPIRES Sunday, 10 February, 2019
Permit Issued on Tuesday, Auarust 14, 2018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and a use will be in accordance with the laws, rules and regulations of the State of
Wasfj and the City of F deral Way.
r-! g01
Owner or agent: Date:
V
-1%
CRY OF <A
Federal Way
PERNHT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
18103668 00 Address: 32628 49TH PL SW
ROSE RATTERAY FEDERAL WAY WA 98023-1927
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)
®
Gas Piping (4125)
® Final - Mechanical (4065)
Approved
Right of Way
Approved to release test
Amroved
By
Date
By
Date
Date di /
El
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
40k
CITY OF
Federal Way
PERMIT NUMBER ( S
RECEIVED PERMIT APPLICATION
AUG 14 2018 PERMIT CENTER + 33325 8- Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
CITY OF FEDERAL WAY
COMMUNFN DEVELO13AVAJEWT
05
TARGET DATE Plpr
SITE ADDRESS
Z 241 97 -Al- s
SUITE/UNIT #
PROJECT VALUATION
$lacr>oU
ZONING
ASSESSOR'S TAX/PARCEL #
a ?
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
7 Me r ��
be included on this permit only
1 Ar—JVPAV E
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
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WA
STA
ZIP 2 ✓
MAILINGADD
E-MAIL
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CONTRACTORK
C �4�STATE
f.
ZIP
FAX
WA ATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
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PRnffMT Z PHONE r/c.
APPLICANT
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CITY
STATE
ZIP
FAX
PROJECT CONTACT
G- GGA C
P
ZPHONE
s"7'�-
MAH.nVG ADD �
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $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 Iocal, 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 flied 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 ty as a part of t app on.
3IGNA DATE �
�
PRINT NAME:
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Pcrmit Application