12-102067City 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: BLOOMQUIST
Project Address: 30124 17TH AVE SW
Nfeehdnical
Permit #: 12 -102067 -00 -ME
Inspection Request Line: (253) 835-3050
Project Description: Installing a new permanent generator with 12 fee of gas piping
Parcel Number: 005070 0120
OwnerArnlicant
Contractor
ROGER C BLOOMQUIST
WESCO NORTHWEST PERMIT
WASHINGTON ENERGY SERVICES CO
30124 17TH AVE SW
NORTHWEST PERMIT/ WESCO
(GENERAL)
FEDERAL WAY, WA 98023
1345 W GULF RD,
WASHIES9710B (9/2/13)
POINT ROBERTS WA 98281
2800 THORNDYKE AVE W
SEATTLE WA 98199
Additional Permit Information
Mechanical Valuation............................................5235
Is this an Online or O.T.C. application?.................Yes
Mechanical Fixtures
Gas Piping ...................................... 1
CONDITIONS:
A permanently installed generator is not allowed to be placed within required yards (setbacks). See Bulletin
#150 for placement details.
PERMIT EXPIRES Tuesday, November 6, 2012
Permit Issued on Thursday, May 10, 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 wile in�accQrdance��prit�lasles and regulations of the State of Washington
�tVVWI Way.
Owner or agent:
MAY 10 2012
\10
Date:
4/4'/IL
THIS CARD IS TO MAIN ON-SITE
CITY OF02& 0 Construction Inlection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 12 -102067 -00 -ME Address: 30124 17TH AVE SW
Project: ROGER C BLOOMQUIST FEDERAL WAY, WA 98023-3453
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
Right of Way
Approved to release test
Approved
By
Date
By
Date
By Date6--R
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
--v&ECEVEPMIT
Federal ul ER
COMMUNNTYDEVEIAPMENTSERVICES MAY l 0PLICATION
253-835-2607• FAX 253-835-2609
www. tw(iederalwau.com
CITY OF FEDERAL \NAY
-t C) (0 -
SF MF CO(!!",)L
DE EN FP
SITE ADDRESS
SUITE/UNIT #
30124 17TH AVE SW parcel 0050700120
PROJECT VAWATION
ZONING
ASSESSOR'S TAR/PARCEL #
W
_
5235.00
- -
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING a MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
INSTALL 8KW GAS GENERATOR WITH 12' GAS PIPING
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRDIARY PRONE
PROPERTY OWNER
ROGER BLOOMQUIST 253-839-9661
MAILING ADDRESS
EMAIL
30124 17TH AVE SW
CITY STATE Z P
FEDERAL WAY WA
98023
NAME
PHONE
WASHINGTON ENERGY SERVICES
800-398-4663
MAILING ADDRESS
E-MAIL
CONTRACTOR
2800 THORNDYKE AVE W
NAIDA@NWPERMIT.COM
CITY
STATE
ZIP
FAX
SEATTLE
WA
98199
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
WASHIES9710B 9/2/2013
2003104234BL
NAME
PHONE
SAME AS CONTRACTOR INFORMATION
APPLICANT
MAILING ADDRESS
E -MAD.
CITY STATE ZIP
FAX
PROJECT CONTACT
rMe individual to receive and
respond to all correspondence
concerning this application)
NAIa.
NAIDA KHAN / NORTHWEST PERMIT
PHONE
360-945-2787
MAILING ADDRESS
1345 GULF RD
E-MAIL
NAIDA@NWPERMIT.COM
CITY
STATE
ZIP
FAX
PT ROBERTS
WA
98281
360-945-2091
ALTERNATE CONTACT NAME: PHONE
E-MAIL
PROJECT FINANCING
NAME
El OWNER -FINANCED
Required value of $5, 000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certVy under penalty of perjury that I am the property owner or authorised agent of the property owner. I certVy that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certVy 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 clalm), which may be made by any person, including the undersigned, and filed against the city,
but only where claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
irtformation Supp to the kitylas a p rt this applica n.
SIGNATURE: or)(DATE 5/10/2012
PRINT NAME: i
Bulletin #100 —January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application
4,
GENERAL INFORMATION
PLUMBING Fili ruji s
Indicate how many of each type offwture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (Or lub/Shower Combo)
LAVS (H—d Saks) TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS
SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (wtche /Umtty) WATER HEATERS (Fi_t io
HOSE BIBBS
SUMPS WASHING MACHINES TOTAL FIRTURES
GENERAL INFORMATION
CRITICAL. AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
Occupancy Group(s)
Construction TypeSt
o)f�
Additional Information
EXISTING/PREVIOUS USE
LOT SIZE (Ln Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
PROJECT AREA ONLY
Bulletin #100 -January 1, 2011 Page 2 of 3 k:UIandouts\Pennit Application
CdAblk AL-NEw/AapDMON
AREA DESCRIPTION
Are
Occupancy Group(s)
Construction TypeSt
o)f�
Additional Information
Aare Feet
in SqNEA
BUUMI IO
ADDITION
21
Y.iO.till�„+'"`CabB�rl Z L' ll liJ
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
in Square Feet
TOTAL BUILMt
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 -January 1, 2011 Page 2 of 3 k:UIandouts\Pennit Application