12-101562r
0 Plu riling
City of Federal Way
Community & Econ. Dev. Services Permit #: 12 -101562 -00 -PL
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 25
Ph: (253) 835-2607 Fax (253) 835-2609 P Q 3) 835,3050
Project Name: LIGHT OF CHRIST CHURCH
Project Address: 34249 21ST AVE SW Parcel Number. 242103 9005
Project Description: Replace kitchen sink, lav, water closet, hose bib, water heater and double check backflow
Owner
A olicant
Contractor
COMMUNITY PRESBYTERIAN CH
WESTERN MECHANICAL CONTRACTORS
WESTERN MECHANICAL CONTRACTORS
PO BOX 25365
INC
INC
FEDERAL WAY WA
1911 SW CAMPUS DR SUITE 321
WESTEMC919QL (1/15/14)
98093
FEDERAL WAY WA 98023
1911 SW CAMPUS DR SUITE 321
FEDERAL WAY WA 98023
,,"Plumbing Fixtures
Lavatories ....................................... 1 Other Plumbing Fixtures................ 2 Sinks......................... 1
.....................
Water Closets ................................. 1 Water Heaters................................. 1
PERMIT EXPIRES Wednesday, October 3, 2012
Permit Issued on Friday, April 6, 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: ��-�-� f `� Date: (0' zc I
THIS CARD IS TO MAIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 12 -101562 -00 -PL Address: 34249 21ST AVE SW
Project: COMMUNITY PRESBYTERIAN CH FEDERAL WAY, WA 98023-7702
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.
Final - Plumbing (4075)
Approved
By Date �-��-25
❑
Plumbing Groundwork (41 0)
Rough Plumbing (4230)
Final Electrical
Approved
Gas Piping (4125)
Approved to cover
By
Approved
Approved to release test
By
Date
By
Date fo —//— /2�
By
Date
Final - Plumbing (4075)
Approved
By Date �-��-25
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way -�
Approved
By
Date
By
Date
By
Date
„,.,AECE1V PERMIT
Federal Way
'o"UN........(....7'sEHVg 0 6 20 2APPLICATION
253-835-2607 FAX 253-835-2609
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SITE ADDRESS —
SUITE/UNIT #
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PROJECT VALUATION
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ASSESSOR'S TAR/PARCEL #
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❑ BUILDING PLUMBING ❑ MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
rfenant Name/Homeoumer Last Name)
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PROJECT DESCRIPTION
Detailed description of u)ork to
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be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
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MAILING ADDRESS
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E-MAIL
CITY
STATE
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NAME
PHONE
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MAD.WG ADDRESS
E-MAIL
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CONTRACTOR
CITY
STATE
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ZIP
9$0Z3
FAX
253
WA STATE CONTRACTOR'S LICE 8E #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
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NAME
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PHONE
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MAILING ADDRESS
E-MAIL
um
APPLICANT
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CITY
ReD C Lt
STATE
ZIP
FAX
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PROJECT CONTACT
NAME
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PHONE 0
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(The individual to receive and
MAILING ADDRESS
icL ti 5�o CA-V-tO5 S DR—,# 3L1
EMAIL
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respond to all correspondence
concerning this application)
CITY
STATE
ZIP
2
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FAX
q4P-1q &
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I cert(fy under penalty of perjury that I am the property owner or authorized agent of the property owner. I certwy 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 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.
1 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 to thecityasas part of this application.
T/� J�j /7� �7
A uC 1I � O�
SIGNATURE: DATE
PRINT NAME:
Bulletin #100 - January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application
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VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must beprovided)
Indicate how many of each type offudure to be installed or relocated as part of this project. Do not include exist' fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type offixture xture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/Shower combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
��•uCK
DRINKING FOUNTAINS
�_ SINKS (Kitchen/Mi y)
WATER HEATERS (sleUric)
HOSE BIBBS
SUMPS
WASHING MACHINES
`r TOTAL FUETURE8
Bulletin #100 - January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application