13-104736City 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: DECEAULT
Project Address: 1717 SW 317TH PL
Project Description: Relocation of gas meter.
Mechanical
Permit #: 13 -104736 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 122103 9110
Owner
Anulicant
Contractor
LOIS DECEAULT
INFRASOURCE SERVICES LLC
INFRASOURCE SERVICES LLC
1717 SW 317TH PL
14103 STEWART RD
INFRASL87IC2 (2/22/15)
FEDERAL WAY WA 98023-5106
SUMNER WA 98390
14103 STEWART RD
SUMNER WA 98390
Additional l
Is this an Online or O.T.C. application?.................Yes
Mechanical Fixtures
Gas Piping ...................................... 1 J*
PERMIT EXPIRES Tuesday ril 22,
Permit Issued on Thursday ct r 24,
1 hereby certify that the above information is dCt fii t the co c . on the above described property and
the occupancy and the use wil in accordan a laws, a regulations of the State of Washington
r of Fedora
Owner or agent:
Date: _/O Z Y -/3
CITY of THIS CARD IS TO REMAIN ON-SITE
Federal WayConstruction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #:
13 -104736 -00 -ME Address: 1717 SW 317TH PL
Project: LOIS DECEAULT FEDERAL WAY, WA 98023-5106
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)
❑
Approved
By
Approved to release test
Approved
By
Date
By
Date
By
Date
Rough Electrical
Approved
Final Electrical
Approved
❑
Right of Way
Approved
By
Date
By
Date
By
Date
• Federal Way
CWKWITY DEVELOPMENT SERVICES
253-835-2607• FAX 25.3-8.35-2609
2 mm
PERMITRECEI 61;
CO ME PL DE EN FP
APPLICATION CT
2 4 2013
SITE ADDRESS P YVHT SUITE/UNIT M
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N
$ OW -0c -
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ENG RING ❑FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) �i la�/� i'
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
Ks) ZM*17t"i $j1q
APPLICANT
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
PROJECT FINANCING
Required value of $5,, 000 or more
(RCW 19.27.095)
NAME
4FRA4S�C�s Czyyrc
IADDRESS
'6 3 �57��-t�J A K- - 2b
WA STATE CONT
N
MAILING ADDREI
NAME
MAILING ADDRESS
CITY
LICENSE 9
ALTERNATE CONTACT NAME:
NAME
MAILING ADDRESS, CITY, STATE, ZIP
ZIP
ZIP
12-D
STATE I ZIP
PRIMARY PHONE
I�
E-MAIL
PHONEz-S- s-l�-Y
3
E-MAIL
FAX
EXPIRATION DATE
STATE I ZIP
PHONE
FEDERAL WAY BUSINESS LICENSE M
PHONE
E-KAIL
t-1
FAX
PHONE
E-MAIL
FAX
E-MAIL
OWNER -FINANCED
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_iaws
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 claims out of the reliance ok the city, including its officers and employees, upon the accuracy of the
information supplied to the apart of this jopplicyfion.
SIGNATURE: DATE
PRINT NAME:
Bulletin #100 -April 14, 2010 Page 1 of 3 k:\Handouts\Pernvt Application
d—
VALUE of MECH"ZCAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS _� GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (comm ciaU
BOILERS FURNACES HOT WATER TANKS (caa)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain
BATHTUBS (or Tub/Shower Combo)
LAVS (aaudSm1m)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
FOR OFFICE USE
DRINKING FOUNTAINS
SINKS (Ritchm/utility)
WATER HEATERS (P]ectric)
HOSE BIBBS
SUMPS
WASHING MACHINES
••
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AREA DESCRIPTION (in square feet) EXISTING PROPOSED
TOTAL
FOR OFFICE USE
FIRST FLOOR (or Mobile Home)
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COVERED ENTRY
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_--. —.--.
GARAGE ❑ CARPORT ❑
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Z=5=G PROPOSED
TOTAL
Area Totals
ESTIMATED SELLING PRICE $
# OF BEDROOMS
AREA DESCRIPTIONI Area
in Square Feet
ADDITION
AREA DESCRIPTIONI Area
in Square Feet
TENANT AREA ONLY
Occupancy Group(s)Construction I # of I Additional Information
1vve Stories
Occupancy Groups) I Construction I # of I Additional Information
1Trpe Stories
Bulletin #1100 -April 14, 2010 Page 2 of 3 k:\-Iandouts\Perrrit Application