12-101305r � ,
Mechanical
City of Federal ay
Community & Econ. Dev. Services Permit #: 12 -101305 -00 -ME
33325 8th Ave S
Federal Way, WA 98003 Ins ection Request Line: 253 835-3050
Ph: (253) 835-2807 Fax: (253) 835-2609 p q
Project Name: BELKNAP
Project Address: 35812 15TH AVE SW Parcel Number. 713780 0105
Project Description: Replacing gas water beater
wne
ARRI11can
Contractor
CHARLES 13ELKNAP
WASHINGTON CORROSION SRVC INC
WASHINGTON CORROSION SRVC INC
35812 15TH AVE SW
1425 BLAINE AVE NE
WASHICS055KC (5/4/12)
FEDERAL WAY WA 98023-7246
RENTON WA 98056-2774
1425 BLAINE AVE NE
RENTON WA 98056-2774
Mechanical Valuation ..............
Hot Water Tanks ............................ 1
Additional Permit Information
......450.11 Is this an Online or O.T.C. application?.................Yes
Mechanical Fixtures
PERMIT EXPIRES Wednesday, September 19, 2012
Permit Issued on Friday, March 23, 2012
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 accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date:
ski/iz
1 • THIS CARD IS TO MAIN ON-SITE d
CWT OF - Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 12 -101305 -00 -ME Address: 35812 15TH AVE SW
Project: CHARLES BELKNAP FEDERAL WAY, WA 98023-7246
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 Electrical
Approved
Final - Mechanical (4065)
El
Approved
By
Approved to release test
Approved
By
Date
By
Date
By
Date —5 --
El
Rough Electrical
Approved
Final Electrical
Approved
El
Right of Way —�
Approved
By
Date
By
Date
By
Date
�or 'A
Federal Way
COMMUN17Y DEVELOPMENT SERVICES
253-835-2607- FAX 253-835-2609
www. rituoffedemkoau, aom
.PERMIT
APPLICATION
(2— — 10 0O�
_---- FP
MAR
SITE ADDRESS CIS
r
PROJECT VALUATION
ZONING
ASSESSORrS TAX/PARCEL #
$ qty` . 0e
o_ o[ C) 5
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Lost Name)
%� I
0 �� p
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
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P,�e>I*IARY PRONB
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!►1LiNG ADDRESS
FINUUL
7�-I'(?�, GIL-�
STATE
(7°r=,
PHONE
MAILING ADD7.
2
MAD -
CONTRACTOR
SrrTATE
A STATE CONTRACTOR'S LICENSE #
WanKATION DATE
FEDERAL WAY BUSINESS LICENSE #
_ ,ll �y R
PHONE
APPLICANT
MAIKANG ADDRESS
CITY
STATE
ZDV
FAX
PROJECT CONTACT
M f� /
PH,_
117
(The individual to receive and
G
WMAD-
respond to all correspondence
concerning this application)
C
STATBzr,
—�—
FAX
ALTERNATE CONTACT NAME:
PRONE
E-MAIL
PROJECT FINANCING
NAM
0 OWNER -FINANCED
Required value of $5,000 or more
M U DUG ADDRESS, CITY, STATE, ZIP
PRONE
(?CW 19.27.095)
I ceitVy under penalty ofperjury that I can the property owner or authorised agent of the property owner. I cerWy that to the best
of my knowledge, the igformation submitted in support of this permit application is true and correct. I cert(fij that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
i4ormation supplied to the ci as a part of this application.
SIGNATURE:/
.S�f�.� r` �.� DATE
PRINT NAME: ,� ` `' t G , _ / l L • _.f t
Bulletin # 100 — April 14, 2010 Page T$f 3 UHandoutsTermit Application
0
VALETR OF MCEAWCAL Wogs S (a copy of bid or estimate must be proadecJ
Indicate how massy of each type officture to be installed or relocated as part of this project, Do not include ev;stingfixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commerciei)
BOILERS FURNACES HOT WATER TANKS (aa�
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/shoo comms LAVS (Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS gates—/utility) WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FISTURES
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in oars Feet Stories
N&ar $I1ILD1@
�d r
ADDITION
Bulletin # 100 — April 14, 2010 Page 2 of 3 k:\Handouts\Permit Application