12-105086City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Mechanical
Permit #: 12 -105086 -00 -ME
Inspection Request Line: (253) 835-3050
Project Name: NGUYEN - PIKE
Project Address: 31313 42ND PL SW Parcel Number: 873199 0250
Project Description: In conjunction with Permit #12-104802, replace (2) bathroom fans and one range hood,
relocate heating vent.
Owner
ADAM PIKE
31313 42ND PL SW
FEDERAL WAY WA 98023
Ad(
Mechanical Valuation ........ ......... ..................400
Ducting...........................................
A► nlicant Contractor
VAN NGUYEN ' WNER IS CONTRACTOR
31313 42ND PL SW
FEDERAL WAY WA 980**4
nal Perm 9-1 on
I is an Online or O.T.C. application?.................Yes
pical Fl i!E!s
n......... if ........................... 3
�IT E ES Monday, 2013
>tt Issue n Wednesd ber 7, 2012
I hereby certify that&e ab informs . is correct and tha nstruction on the above described property and
the occupancN
UIP will be i ccordance with the s, rules and regulations of the State of Washington
and the City ofral Way.
Owner or agent: 27 Date:��(Z_�
%**sol/ Q
i
cd
CITY OF
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
12 -105086 -00 -ME Address: 31313 42ND PL SW
Project: ADAM PIKE FEDERAL WAY, WA 98023-2118
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 lnnoeA �„ fha 1 1, v.i.: --A
Mechanical Rough -in (4165)
Approved
- .. ., --------
Gas Piping (4125)
-- --aa-...,.. .,.� ...,..,. v. uu3 Cal U.
Final -Mechanical (4065)
Approved to release test
Approved
B Date I (O —1
By Date
By Date
Rough Electrical Final Electrical
Approved1:1 1:1Right of Way
Approved Approved
By Date By Date
BY Date
MIX
M
noF A�D
Federawvaely
COMMUNITY DEVELOPMENT SERVICES
253-835-2607• FAX 253- 090 L (•
uiwu-. rit, offeuera!u-a
• PERMIT
APPLICATION
� noem WAY
1- 5-0-a 6
MF C ME PL DE EN FP
SITE ADDRESS SUITE/UNIT N
hd i LA CE CVS eo(,ucd uva,,01
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCELELN _
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING YM–FJCRANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
I U \r
�l I
PROJECT DESCRIPTION
__
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
.9,40-(,Oq
MAILING ADDRESS
31 �1 3 0 VV
E-MAIL
CITY
cak
STATE
ZIP
NAME Q
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE N
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
NAME
PHONE
APPLICANT
MAILING ADDRESS
EMAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
AME (
tLt(�
oxE _
MAILING ADDRESS f
E-MAIL
CITY
Leff r V/
STATE
ZIP
n0, V
C 0
ALTERNATE CONTACT NAM
PHONE pp
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE
PHONE
—7
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to t ty as a pa of this application.
I
SIGNATURE: DATE
PRINT NAME: W
Bulletin #100–January 1, 2011
Pagel of 3
k:\Handouts\Permit Application
��
VALUE OF MECHAMCAL WQRii,$ to dove of bid or estimate must be
Indicate how many of each type off, I Ire ocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS 1 FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial(
BOILERS FURNACES HOT WATER TANKS (Gaa(
T COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Bulletin #100 — January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application