12-101411w �
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Mechanical
City of Federal Way Permit #: 12 101411 -00 -ME
Community &Econ. Dev. Services _
33325 8th Ave St ',
Federal Way, WA 98003 -.-"
Ph: (253) 835-2607 Fax. (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: LADUKE
Project Address: 32802 13TH AVE SW Parcel Number: 926494 0700
Project Description: Replacing the gas water heater
Owne
Applican
Contractor
TETSUKO LADUKE
TETSUKO LADUKE
PUGET SOUND PLUMBING AND HEATING
PO BOX 3772
PO BOX 3772
PUGETSP929CF (2/25/14)
FEDERAL WAY WA 98063
FEDERAL WAY WA 98063
11803 DES MOINES MEMORIAL DR S
BURIEN WA 98168
Mechanical Valuation.......
Additional Permit Information
................................1084 Is this an Online or O.T.C. application? ................. Yes
Mechanical Fixtures
Hot Water Tanks ............................ 1
PERMIT EXPIRES Tuesday, September 25, 2012
Permit Issued on Thursday, March 29, 2012
1 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: -
FI VU9b 4 /S/12=
/f
® THIS CARD IS TO REMAIN dN-SIT1E
CITY OF Construction I ection Record `
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 12 -101411 -00 -ME Address: 32802 13TH AVE SW
Project: TETSUKO LADUKE FEDERAL WAY, WA 98023-5201
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 [Boy Date By / C�f'� Date V -&- /
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
ECF1V*iRM1T
un or
Federal a
COMMUNITY DEVELOPM&VT253-8 SERUCES MAR 2 AP p L I CATI O N
253-835-2607• FAX 253-835-2609
u_!u�u!__rrr�r,rf•ue:n(p:rtu turn
rjTY OF FEDERAL WAY
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SWF CO ME PL DE EN FP
SITE ADDRESS
32g'62- /3 s�V
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
TYPE OF PERMIT
❑ BUILDING PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant NamelHomeoumer Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
et5U L
PRIMARY PHONE
-
MAILING ADDRESS
-72,
E-MAIL
CITY I
715e-rl
STAT
ZIP -2
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U dl?
NAME
`
PHONE
?�
MAILIdG ADD ESS
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E-MAIL
CONTRACTOR
CITY
STATE,
lr
ZIP
'��
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PHONE
APPLICANT
MAILING ADDRESS WIWI DIU 1 V
E -MAIL
CITY I
STATE I
ZIP
FAX
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
wwp
CITY
STATE
FAX
ALTERNATE CONTACT NAME:
PHONE
EMAIL
PROJECT FINANCING
NAME
OWNER FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27095)
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 the city as apart of this application.
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SIGNATURE:(��'y . DATE a2 �z
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PRINT NAME:
Bulletin #100 - January 1. 2011 Page 1 of 3 k:\Handouts\Permit Application
0
VALUE OFMECHAIUCAL WORK $ ( () M (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 (comm dao
BOILERS FURNACES _� HOT WATER TANKS (cas)
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 (or Tub/Sho rCombo) LAVS (Hand SinkTOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS (Kitchen/vtaitA WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES I<
CRITICAL AREAS ON PROPERTY? I WATER PURVEYOR I SEWER PURVEYOR I VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE Ila Square Feet) EXISTING FIRE SPRINKLER SYSTEM? I PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No o Yes a No
Bulletin #100- January I, 2011 Page 2 of 3 k:\Handouts\Permit Application