13-102118r �
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax: (253) 835-2809
Mechanical
Permit #: 13 -102118 -00 -ME
Inspection Request Line: (253) 835-3050
Project Name: RODRIGUEZ
Project Address: 29041 18TH AVE S
Project Description: Installation of gas furnace, hot water tank & gas piping.
Parcel Number: 546280 0060
Owner
MARIO RODRIGUEZ
&Rlicant
MARIO RODRIGUEZ
Contractor
OWNER IS CONTRACTOR
GLORIA RODRIGUEZ
29041 18TH AVE S
29041 18TH AVE S
FEDERAL WAY WA 98003-3825
FEDERAL WAY WA 98003-3825
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes 144
y*4
Mechanical Factures' �s
Furnaces ......................................... 1 Gas Piping ..................................... 1 Gas Pip tlets............................. 3
Hot Water Tanks ............................ 1 Ranges............... . ... 1
PERMIT EXPIRE
Permit Issu
I hereby certify that the above information co
the occupancy and the use will be in actornrA
n . an
Owner or agent
Sun ovember 10
eda a ay, May 14, 201
that the constrtl pp on the above described property and
the laws, rul *a on
of the State of Washington
City of Federal Wavy
Date:
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 13 -102118 -00 -ME Address: 29041 18TH AVE S
Project: MARIO RODRIGUEZ FEDERAL WAY, WA 98003-3825
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)11
Gas Piping (4125)
Final Electrical
Approved
Final - Mechanical (4065)
Approved
By
Approved to release test
Approved
By
Date
By
Date r,, Z j— I -s
By
Date
Rough Electrical
Approved1:1
Final Electrical
Approved
Right of Way -^
Approved
By
Date
By
Date
By
Date
AF
Federal Way
I CEIVED
MAY 14 2013
CITY OF FEDERAL WAY
CDS
9
PERMIT APPLICATION
PERMIT NUMBER 1 & _ -(9,2?
,2? 1 l 11
/ / _ TARGET DATE
SITE ADDRESS
SUITE/UNIT #
29041 18th Ave S, Federal Way Wa 98003
PROJECT VALUATION
$ 1500.00
ZONING
ASSESSOR'S TAX/PARCEL #
- _(e.? 'y 0 - C) ( CP 6
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Furnace and appliance install
Install gas piping for new furnace, gas stove, and gas
PROJECT DESCRIPTION
Detailed description of work to
water heater. Install gas piping with 3 gas outlets.
be included on this permit only
PROPERTY OWNER
NAME
Mario Rodriguez
PRIMARY PHONE
253-569-5288
MAILING ADDRESS
Ave S
E-MAIL
E-MAIL18th
mcrodri98003 hotmail.com
CITY STATE ZIP
Federal Way WA 98003
NAME Home Owner
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME Home owner
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
Home owner
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
R OWNER -FINANCED
Required value of $5, 000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
2 -5 6 -528
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 city as a part of this application.
SIGNATURE: � DATE 4/3/1969
PRINT NAME: MAO Rodriguez
Bulletin #100 —January 1, 2013
Page 1 of 3
k:\Handouts\Permit Application
0
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing tures to remain.
AIR HANDLING UNITS FANS ` _ GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commeeoial
BOILERS FURNACES = HOT WATER TANKS cas Gas Stove
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 of
fixture to be installed or relocated as
part of this project. Do not include existing fixtures to remain.
BATHTUBS or Tub/ sbowercombo
LAYS nand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/ utility)
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
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTIONArea Occupancy Group(s) Construction # of Additional Information
in Square Feet Tvve I Stories
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Groupls) Construction # of Additional Information
in Square Feet Tvve I Stories
TENANT AREA ONLY
Bulletin #100 — January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application