12-10478311
City 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: PRESCOTT
0 'Plumbing
Permit #: 12 -104783 -00 -PL
Inspection Request Line: (253) 835-3050
Project Address: 32922 17TH AVE SW Parcel Number. 010455 0090
Project Description: Relocate plumbing fixtures in master bathroom
Owner
ARRIlcan
Contractor
FRANCIS PRESCOTT
M T S PLUMBING CONTRACTORS INC
M T S PLUMBING CONTRACTORS INC
3292217TH AVE SW
PO BOX 517
MTSPLCI164D7 (7/6/14)
FEDERAL WAY WA
AUBURN WA 98071
PO BOX 517
AUBURN WA 98071
Plumbing Fixtures
Lavatories ....................................... 2 Showers.......................................... 1
PERMIT EXPIRES Tuesday, April 16, 2013
Permit Issued on Thursday, October 18, 2012
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the ill bq in accordance with the laws, rules and regulations of the State of Washington
City of Federal Way.
Owner or agenDate: O��
F(N#J*R> I z/1 S/M
CITY" oAi�
Federal Way
PERNUT #:
Project:
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
12 -104783 -00 -PL Address: 32922 17TH AVE SW
FRANCIS PRESCOTT FEDERAL WAY, WA 98023-5413
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
Plumbing Groundwork (4190)
[3 Rough Plumbing (4230)
Gas Piping (4125)
Approved to cover
Approved
Approved to release test
By Date
By ��Date Yoz,!
4YDate
Final - Plumbing (4075)
Approved
By Date ,
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
0*
Federal lNaRyECEIVED I* PERMIT
C0MMUA9NYDEVELOPMENT SEIQPlGP 18 M AP P LI CA'T I ® N
253-835-2607- FAX 253-835-2609
www. druoMdem1wau.cow -
CITY OF FEDERAL WAY
CDS
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0 MF CO ME<2�E EN FP
SITE ADDRESS p
3 Z 9 22- 171-4
SUITE/UNIT @
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
® a
� o -45�_ ao g
TYPE OF PERMIT
❑ BUILDING PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/HomeoumerLast Name)
/
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME w � ( 1 h ► `. � a `��
PHONE 2! 12 �
MAILING RDRESS
`��-� N40" `�
E
CONTRACTOR
v u�l'V
STATE
1
FAX
15 3 317Z
31* STATE CONTRACTOR'S LICENSE 9
ICi 1 D72
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE 8
N
O 1 L/ -P
PHONE
Z57 7
MAILING ADDRESS
E-MAIL
APPLICANT
C tOMG®ieblr�"
4]:W
/
FAX
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
N
r v
PHONE
MAILING ADDRESS
E-MAIL.
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E•MAD,
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty ofperjury 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 taws.
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 c1 es out of the reliance of the city, including its officers and employees, upon the accuracy of the
information suppli the ity s part o lication.
SIGNATURE: DATE 6 G I" 4- 0 Z
PRINT NAME: -�/ 0" /-17-0
Bulletin #100 — January 1, 2011 Pagel of 3 k:\Handouts\Permit Application
4/G
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VALUE OPNECHAMCAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type o fixture to be installed or relocated as part of this project. Do not include existing res to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (caa)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type of frxture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (orTub/show combo)
�_ LAVS (Ha dSWc.)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
i SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS ptchm/voutv)
WATER HEATERS (electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
CRITICAL AREAS ON PROPERTY? I WATER PURVEYOR i SEWER PURVEYOR I VALUE OF rMSTINO IMPROVEMENTS
MaSTIN4/PREVIOUS USE LOT SIZE (In Square Feet) ESZSTINO FIRE SPRINKLER SYSTEM? I PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
Bulletin #100— January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application