15-105350IV __ . MeclAnical
Cityof Federal Way Permit #: 15 -105350 -00 -ME
Community 8 Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003IZIL roman Ph: (253) 835-2807 Fax: (253) 835-2609 Inspection Request Line: (25
3j 835-3050
Project Name: KIBBE
Project Address: 36921 5TH AVE SW Parcel Number: 218820 2175
Project Description: Install (2) underground propane pipes
Owner
Aplio cant
Contractor
CHARLEEN ONEIL
HENRY KIBBE
OWNER IS CONTRACTOR
LLOYD ONEIL
36921 5TH AVE SW
36921 5TH AVE SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application ................Yes A /
Mechanical Fixti
GasPiping ...................................... 2
PERMIT EXPIRES Sunday,
Permit Issued on Tuesday, Oc
I hereby certify that the above information is correct
the occupancy and the use till be in accordanc&i
Owner or agent:
1% y
r
CI
-17,2016
20, 2015
on the above described property and
ulations of the State of Washington
Date: f o � f�
I
CIYV OF-7�"-'^�r 1
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
15 -105350 -00 -ME Address: 36921 5TH AVE SW
Project: CHARLEEN O'NEIL FEDERAL WAY, WA 98023-7346
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.
EJ
Mechanical Rough -in (4165)
0
Gas Piping (4125)
Final Electrical
Approved
Final - Mechanical (4065)
Approved
By
Approved to release test
Approved
By
Date
By VA
Date I b YY
By
Date
EJ
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
RECEIVED
CITY OF 4 * PERM
I�APPLICATION
Federal Way OCT 2 0 2015
CITY OF FEDERAL WAY
CDS
PERMIT NUMBER � � _ I � � � J O _ r�/�, S
III--- TARGET DATE
SITE ADDRESS
36, % .a1A-e_ _S'iv F-P—i�,l
SUITE/UNIT #
PROJECT VALUATION
6C A lY �
ZONING
L#$
ASSESSOR'S TAX/PARC
//��/
� Y_ � -;LL-- -2— 4
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING XMECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
`l
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
S'
MAILING ADDRESS /r
e.
E-MAIL
CI
--�1 rrr��-
STAT
�.✓,
ZIP
NAME�.
C9
PHONE
E-MAIL
MAILING ADDRESS "
CONTRACTOR
— -
CITY .. STATE -4 ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
MAILING ADDRESS
EMAIL
APPLICANT
CITY
STATE
ZIP
FAX
NAME /
PRIMARY PHONE
PROJECT CONTACT
C/� }
- j
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
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 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 the ci a part oft is cation.
SIGNATURE: DATE
PRINT NAME:
Bulletin 4 100 —January 1, 2013 Pagel of 3 k:\Handouts\Pennit Application
h of
{
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existingfLxtures 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
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
FOR OFFICE USE
"BASEMEW/,,' r
r, ,�y,
$
Indicate how many o each type offixture
to be installed or relocated as
part o this project. Do not include existing res to remain.
BATHTUBS (or Tub/Shower combo)
LAVS (Hand sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/utility)
WATER HEATERS (Electric)
DECK,""
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
FOR OFFICE USE
"BASEMEW/,,' r
r, ,�y,
EXISTING/PREVIOUS USE
LOT SIZE (Iu Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
"BASEMEW/,,' r
r, ,�y,
r.
_............ _.— ........ ..........
FIRST FLOOR (or Mobile Home)
---__—_—
SECiND� fr
,rr",r rf,
r
r,
r r
COVERED ENTRY
DECK,""
y ,,r
r .
GARAGE ❑ CARPORT ❑
OTHER {describe)
Area Totals
MSMG
PROPOSED
TOTAL
*,pro
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL— NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
-NEW BUmGDurt;t;
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDIN€} r r r
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application