15-103486Mectlauical
City of Federal way Permit #: 15 -103486 -00 -ME
Community .& Econ. Dev. Services
33325 8th Ave SFiLE
Federal Way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2809 p �
Project Name: BRUELL
Project Address: 30008 23RD AVE SW Parcel Number: 012103 9087
Project Description: Install gas line for BBQ pit
Owner
DAVID BRUELL
ARRIoLcan
JENNY PETERSON
Contractor
PAT'S PLUMBING INC
JANICE BRUELL
PATS PLUMBING
PATSPI*083N5 (4/8/16)
30008 23RD AVE SW
30459 MILITARY RD S
30459 MILITARY RD S
FEDERAL WAY WA 98023
FEDERAL WAY WA 98003
DERAL WAY WA 98003
Additional Permit Info ation
Is this an Online or O.T.C. application?.................Yes
Mechanical Fins A
FA
.A
Pipe Outlets ............................. 1 ��
PERMIT EXPIREST #s -day Jan 12, 2016
Permit Issued o hursday, , 2015
I hereby certify that the above it
the occupancy and the use will
Owner or agent:
ct and
with ti
City]
Ponstruction on the above described property and
rules and regulations of the State of Washington
-al Way.
Date: 7 i �° ��
CITY OF
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
15 -103486 -00 -ME Address: 30008 23RD AVE SW
Project: DAVID BRUELL FEDERAL WAY, WA 98023-2309
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.
2% PSl
Mechanical Rough -in (4165)Gas
Piping ( 125)
Final Electrical
Final -Mechanical (4065)
Approved
By
Approved to release test
Approved
By
Date
By
y Date -1 i-1 (S
By
Date
2% PSl
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
*RECEIVED
' cmc' JUL 16 2015 PERMIT IPPLICATION
Federal Way
CITY OF FEDERAL WAY
CDS %
PERMIT NUMBER 1� _ V —,?5 L1 � C _ m C TARGET DATE � ` /i I
SITE ADDRESS
to
SUITE/UNIT #
Go () 6 a;,� "J
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
0 7:4-
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING AMECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
G1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
\
NAME� � ��
A
PPRIMARY PHONE
3DREBS
(i)--5cO50
EMAILw
CI \
W
STATE
w_\
PI^P
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NAME U.r�
PHONE _946--n
MAILING ADDRESS C AL
MAIL '
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CONTRACTOR
CI
(�
STATE
L.lfi
ZIP
GG
FAX
X53- `i -c)
A STATE CONTRACTOR'S LICE SllE''# L
E;[PIRATI7 DATE
FEDERAL WAY BUSINESS LICENSE #
OZd�I�
NAME r
PRIMARY PHONE
MAILING ADDRESS
Az
E-MAIL _
APPLICANT
CITY STATE
ZIP
FAX
Na
' `j
PRIMARYQ'HONE
5 3`- - q
PROJECT CONTACT
�/�/
I
MS
E -respond
(The individual to receive and
to all correspondence
C
STATE
ZnIP
Fj�[ _C> J 9 `1 Lfia
concerning this application)
S?CXI
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095
1 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. 1 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 aim ari s out of he eliance of the city, including its officers and employees, upon the accuracy of the
Wormation supplied the cit application.
Lapo;thirs
\ !�
SIGNATURE: DATE
PRINT NAME:
�t
Bulletin #100 — J n Ull3 Page 1 of 3 k:\Handouts\Permit Application
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
$ S 0-0
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing res to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
WATER PIPING
BOILERS
FURNACES
HOT WATER TANKS (Gas)
OTHER (Describe)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type offtxture
to be installed or relocated as
part of this project. Do not include e)dsting fixtures to remain.
BATHTUBS (or7Lb/Shower combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (xiahen/umhA
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
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
Bulletin #100 —January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application