10-104762' Mechatikal
City of Federal Way Permit #: 10-1047`62- 00-M E
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718FILE Line: Request Inspection Ins Re
Ph: (253) 835-2607 Fax: (253) 835-2609 P q (253) 835-3050
Project Name: CHURCH
Project Address: 2618 SW 308TH ST Parcel Number: 416660 0676
Project Description: Gas fuel line extension
wn r
Applicant
Contractor
MICHAEL B CHURCH
PILCHUCK CONTRACTORS INC
PILCHUCK CONTRACTORS INC
CHRISTINE CHURCH
PO BOX 2579
PILCHCI101MA (02/20/11)
2618 SW 308TH ST
KIRKLAND WA 98083
PO BOX 2579
FEDERAL WAY WA
KIRKLAND WA 98083
98023
a
r
CRY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
FILEConstruction Inspection Record
INSPECTION REQU TS: (253) 835-3050
10 -104762 -00 -ME Address: 2618 SW 308TH ST
MICHAEL B CHURCH FEDERAL WAY, WA 98023-7820
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 (4165)
Gas Piping (4125)Final
- Mechanical (4065)
Approved
Approved to release test
Approved
By Date
By Date a , (d
By Date
EJ
Rough Electrical
Approved
❑Final
Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Building Division
CITY OF 33325 Eighth Avenue South
Federal WayPO Box 9718
Federal Way, WA 98063-9718
Phone 253-835-2607
Fax 253-835-2609
CORRECTION NOTICE
ADDRESS: 2109 5w _1�U911'v `7"r PERMIT#: lo "l b q 76?, - 00 - oc4g-
div X6erJ a/ncl &16C /21 V . d/ - Z
IF YOU HAVE ANY QUESTIONS CALL r� (253) 835- Zi23
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page __1 of �_
Federal .,ay
COr6RAbNITY DEVELOPMENT SERVICES
25.1-835-2607• FAX 253-835-2609
nit rj
SPERMIT
APPLICATION
/0-/ 0 4T (z-
4MF COME PL DE EN FP
RECEIVED
NOV 0 9 2010
SITE ADDRESS SUITE/UNIT N
?-& Q OSO sq-- CITY OFFEDERAL WAY
PROJECT VALUATION
$laoo
ZONING
ASSESSOR'S TAX/PARCEL 0
4 _L k& & 0- a���
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING U(MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
PROJECT DESCRIPTION
as ans o/
Detailed description of work to
be included on this permit only.
NAME
PRDKARTPHONE
PROPERTY OWNER
MAILING ADDRESS
.17&tyj Sw 301slplcr
E-MAIL
CITY
4r4,( W
I STATEIP
1 .7,3
N
1 LC A(4A..0 t(_ prt-h-.,a�abf
PHONE
2S3 s !oS G g
AD NESS 9 -
V ZS
E-MAIL
OMAILING
CONTRACTOR
CI�YGI\ II�I`"
A>r'd
STATE
STATE
!rte-
ZIP
9 3
FAX
WA STATE CONTRACTOR'S LICENSE :i
P/1'r_ � �t /D/
EXPIRATION DATE
FEDERAL WAT BUSINESS LICENSE
NAME �✓ n.-,�� %P� �t�uc
PHONE 41z6s-6a
MAD.DIG ADDRESS
w 46o x zs- -7
E-MAIL
APPLICANT
CITY
STATE
Lam_
ZIP
g o 8 3
FAX
PROJECT CONTACT
(The individual to receive and
NAME
'�—
PHONE
MAHAYG ADDRESS
E MAII
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACTNAME:
PHONE
E-MAIL
PROJECT FINANCING
NA>IE
OWNER -FINANCED
Required value of $5, 000 or more
MAILING ADDRESS, CITT, STATE, ZIP
PHONE
iRCW 19.27095)
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 Wormation 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 flied 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
Wormation supplied to the city as apart of this application.
SIGNATURE:';✓ DATE
PRINT NAME: Y00'0.'►
Bulletin #100 —April 14, 2010 Page 1 of 3 k:\Handouts\Pernrit Application
a • +
VALUE of MECIL4NICAL WORK �0 0 0 (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 (c-rciA
BOILERS FURNACES HOT WATER TANKS (Gas)
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 for Tub/show combo)
LAVS (fundsinla)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (.Kitchen/utuiey)
WATER HEATERS (EL-ctric)
HOSE BIBBS
SUMPS
WASHING MACHINES
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Tye Stories
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Bulletin #100 — April 14, 2010 Page 2 of 3 k: flandoutsTermit Application