12-101112w �
Medhanical
City of Community & Econ. Dev. Services Permit #: 12 -101112 -00 -ME
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253
Ph: (253) 835-2607 Fax: (253) 835-2609 P q ) 835,3050
Project Name: CEDAR CREEK CONDOMINIUM UNIT 37
Project Address: 32820 20TH AVE S Unit 37 Parcel Number: 144170 0370
Project Description: Relocate meter and extend gas line
Owner A2nlicant
WILLIAM & SANDRA VANKEULEN INFRASOURCE CONSTRUCTION LLC INFRAS URTION LLC
32820 20TH AVE S UNIT 37 8001 S 212TH ST CL8 14/13)
FEDERAL WAY WA 98003 KENT WA 98032 01 S 212TH ST
NT WA 98032
Additional Permit Informati f -'
Mechanical Valuation............................................1000.00 Is this an Onli or O.T.C.apolication?................. Yes
Mechanical Fixtures
Gas Piping ...................................... 1
PERMIT EXPIR ay, Sept mber , 2
Permit Issuooand�'
nday�flarch 12, 201
I hereby certify that the above informal i tt ai the construction he above described property and
the occupancy and the use will be in ac iVe with; laws, rulesWnd tions of the State of Washington
Owner or agent:
Date:
i'
CITY OF VA�p
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
12 -101112 -00 -ME Address: 32820 20TH AVE S Unit 37
Project: WILLIAM & SANDRA VANKEULEN FEDERAL WAY, WA 98003-9431
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 - Mechanical (4065)
Approved
Approved to release test
Approved
By Date
By—(�-S Date --;g:
By Date
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
COMMUNITY DEVELOPMENT SERVICES
253-8352607• FAX 253-835-2609
wu:w.rtuotTedei 1wau.mni
PERMIT
APPLICATION
Z_ 1 1 I I Z
E EDN FP
MAR' 4 8 20012
rTTV i1F 1=FnGDAI IAIAW
SITE ADDRESS IT
3a8a0 ac)+"4vc Ab9i N?#
PROJECT VALUATION
$ 10�
ZONING
ASSESSOR'S TAX/PARCEL @
14 4 1 2 ()- v o Oo
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
,
��� G/`�� �✓/ / N V
PROJECT DESCRIPTION
G 114 e- o uG G S rhe ie r ,Irl ho h1 Q
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
MAILING ADDRESS
gL -
CITY
STATE
ZH'
NAM
n frOt So>Arde.
PHONE
MAILING ADDRESS
OO Rouse -vel} Ra :StC
�L
CONTRACTOR
CUp
lcc I �1
STATE
�L.
G()13
FAX
WA STATE CONTRACTOR'S LICENSE /
Gl. gG�-
EXPIRATION DATE
tS�, i i'- f dd A
FEDERAL WAY BUSINESS LICENSE M
loo
NAMF{' +,eve- Toh n 5(3n
PHONEAS3_37 v- a
DIGDREss
00 Sow h a 1 d" S hrcF�c �-
APPLICANT
E-MAIL
CITY h -e rl +_
wT+ l
ZI§ IJ o 3 0`,
FAX
PROJECT CONTACT
(The individual to receive and
NAME
�� i4G 3 h"�"n
PHONE
S3- 37e�- ae/
AD RESs L
1 . 47 h a` t� SrrCL
E-MAIL
respond to all correspondenceLING
concerning this application)
CI ken
STATE
W
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
Required value of $5,000 or more
(RCW 19.27.095)
NAM /1 fra `
' 1 J(UlrGc Com",.pt, t, I C
OWNER -FINANCED
MAILING AD REBS, CITY, STATE, ZIP,y/
►1a,60aosc4c 'h' t2 U str- L1,00 00 E11 n jll(y
PHO
�3t�, X13- 3S'18 I
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 tiff apart of this application.
SIGNATURE: yy L DATE
PRINT NAME: 5 4"ge, JGh !n & r1
Bulletin #100 —January 1, 2011 Page] of 3 k:\Iandouts\Permit Application