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16-100833A . > a City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Mec ianicaL Permit #: 16 -100833 -00 -ME Federal Way, WA 98003 Ph: (253) 8352607 Fax: (253) 835-2609 Inspection Request Line: (253) 5-,3050 4 Project Name: VALLEY HARVEST MARKET Project Address: 28855 MILITARY RD S Parcel Number: 042104 9037 Project Description: Connect new meter from PSE to existing gas line. Owner AR1211cant Contractor EXECUTIVE HOUSE INC MIGUEL ORTEGA TEKAS FIRE & HOOD INSTALLATIONS 7517 GREENWOOD AVE TEKAS FIRE & HOOD INSTALLATIONS LLC LLC SEATTLE WA 98103 14611 AMBAUM BLVD SW TEKASFH888JW (4/18/16) BURIEN WA 98166 14611 AMBAUM BLVD SW BURIEN WA 98166 Additional Permit Information Mechanical Work Valuation?.................................1000 Is this an Online or O.T.C. application? ................. Yes Mechanical Fixtures Gas Piping ...................................... 1 PERMIT EXPIRES Sunday, Permit Issued on Tuesday,rFl I hereby certify that the above information is correct a(l the occupancy and the uwill be in accordance with 1 T/- and the City Owner or agent: i1l111lSe7/. V. o do op W2016 2016 16structiclp on the above described property and les and r4kulations of the State of Washington Way. 0 41;:% - Date: © �, CITY OF Fdd4aral Way PERMIT #: THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record INSPECTION REQUESTS: (253) 835-3050 16 -100833 -00 -ME Address: 28855 MILITARY RD S a f Project: EXECUTIVE HOUSE INC FEDERAL WAY, WA 98003-7912 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)El Gas Piping (4125) Final - Mechanical (4065) Approved Approved to release test By Approved By Date Date Z 1 g_ ( Cl By Date Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date CITY OF Federal Way *ECEIVED PERM ITOAPPLICATION FEB 16 2016 CITY OF FEDERAL WAY PERMIT NUMBER' _ ' V 0 eC3 3 _ TARGET DATE SITE ADDRESS SUITE/UNIT # 'Z- g?)j5 Mi Li 1 p 5 _ 1-7I PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL # Gj TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING RMECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT PROJECT DESCRIPTION Detailed description of work to r An be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER ,- " MAILING ADDRESS S E-MAIL 2 3 CIT STATE I ZIP { NAME PHONE v MAILI?Iff ADDRESS �� E-MAIL � 1 CONTRACTOR1gro�`I� CITY'' ZIP FAX 77 ,S,T11A Q 8 �] U � WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # cn / NAME PRIMARY PHONE r— r ING ADDRESS I C7 E-MAIL APPLICANTM� '� tie ' `r CITY LeLk STATE ZIP �. FAX NAME PRIMARY PHONE PROJECT CONTACT MAILING ADDRESS E-MAIL (The individual to receive and respond to all correspondence CITY STATE ZIP FAX concerning this application) PROJECT FINANCING NAME ElOWNER-FINANCED Required value of $5,000 or more MAILING ADDRESS, CITY, STATE, ZIP PHONE (RCW 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 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 th ci apart of this application. SIGNATURE: DATE PRINT NAME: Bulletin #100 — January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application D L4^-, ChuI