13-103638R T
Mechanical
City of Federal Way Permit #: 13-103638-00-M E
Community &Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 25
Ph: (253) 835-2607 Fax: (253) 835-2609 P 4 3) 835-3050
Project Name: ANDERSON
Project Address: 3919 SW 324TH ST Parcel Number: 873196 0240
Project Description: Relocation of gas meter.
Owner
ApRlican
Contractor
CHARLES W ANDERSON
INFRASOURCE SERVICES LLC
INFRASOURCE SERVICES LLC
1911 SW CAMPUS DR
14103 STEWART RD
INFRASL871C2 (2/22/15)
FEDERAL WAY WA 98023
SUMNER WA 98390
14103 STEWART RD
SUMNER WA 98390
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Mechanical Fixtures` f`
GasPiping ...................................... 1
PERMIT EXPIRES Saturday, ary 15, 2014
Permit Issued on Monday, gust 19,
I hereby certify that the above information is correct a at the constra above described property and
the occupancy and the use w� be in accorda9z i e laws, rulesko
ns ofthe State of Washington
Owner or agent:
Date: fZ ! —/�
THIS CARD IS TO REMAIN ON-SITE
�rnoF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 13 -103638 -00 -ME Address: 3919 SW 324TH ST
Project: CHARLES W ANDERSON FEDERAL WAY, WA 98023-2425
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 (41 5)Gas
Piping (4125)
Final Electrical
Approved
Final - Mechanical (4065)
1:1Approved
Approved
By
Approved to release test
Approved
By
Date
By
f G Date 'j� 2l 13
By
Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY Of
Federal Way
COMMUNITY DEVELOPMENT SERVICES
253-835-2607• FAX 253-835-2609
wum..61r.1o((edeMILVau. rnm
PERMITRECEIVfpF
APPLICATIO�
UG 192013
CM 0FF;:r,„ .
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CO E PL DE
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SITE ADDRESS —r\'i
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SUITE/UNIT #
PROJECT VALUATION
,1cwo
ZONING
ASSESSOR'S TAR/PARCEL #
�
-0-711-?-6-0
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
�✓
be included on this permit only
PROPERTY OWNER
��t-C►C �'v C��'
PRIMARY PHONE
DIG7 SS 3cl(I TlS,
E-MAIL
CITY —'
l/
STA (A
ZIP
NAME
/ Sd we
PHONE
-
CONTRACTOR
MAU.ING ADDRESS ,Q/
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E-MAIL j�
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CITY
f
STAT
ZIP
FAX
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WA STATE CONTRACTOR'S LICENSE
-Z/UrIZ + SL
E TI011i DATE
FEDERAL WAY BUSINESS LICENSE #
(fI
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APPLICANT
MAILING ADDkESS
E-MAIL
.
C
$TATE
ZIP
FAX
—314 -c
/liC/1
PROJECT CONTACT
~`
PHONE
(The individual to receive and
MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIPFAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
E] OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
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. Z 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.
Z 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 relianc f the city, i cludirzg its officers and employees, upon the accuracy of the
information supplied to the c' a part of th' ap tion.
SIGNATURE: DATE` /
PRINT NAME:
Bulletin #100 — January I, 2011 Pagel of 3 k:\Handouts\Permit Application
AW7
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 Sin")
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kirch=/utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FIXTURES
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE )In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUII.DING a y
_rAy
ADDITION
Bulletin #100 — January 1, 2011 Page 2 of 3 k:Wandouts\Pennit Application