17-101604City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Mechanical
Permit #:17 -101604 -00 -ME
Inspection Request Line: (253) 835-3050
Project Name: OCHS
Project Address: 33139 3RD CT SW
Project Description: Inspection/pressure test of existing gas line to cook stove.
Parcel Number: 729802 0260
Owner
Applicant
ctor
DAVID C OCHS
J D K HOME SERVICES
J D RVICES
33139 3RD CT SW
3315 N 35TH ST
0 (3/28/19)
FEDERAL WAY WA 98023-6183
TACOMA WA 98407
3 1 TH ST
MA WA 98407
Mechanical Work Valuation.........
WW
Additional Permit lr�formarr
...250 Is this an C. application? .................. Yes
Gas Piping 1
PERMIT I
Permit
I hereby certify that the above in c
and the occupancy rad the
a
Owner or agent:
i
day, 7
y, p
Pordtrance
and that t wit e
and the City
3oc
IF 17
ruction on the above described property
rules and regulations of the State of
Way.
Date:
THIS CARD IS TO REMAIN ON-SITE
0. V OF Construction Inspection Record '
Fl Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 17101604 00 Address: 33139 3RD CT SW
Project: DENA L OCHS FEDERAL WAY WA 98023-6183
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.
13 Mechanical Rough -in (4165)
®
Gas Piping (4125)
FAI
Final - Mechanical (4065)
Approved
11yQ_s1h.=
Approved to release test
ily
Approved
ly Date
Date
Date
D
Rough Electrical
Final Electrical
0
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
CITY OF �� RECEIVED
Federal Way APR 10 2017
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
PERMIT NUMBER / CITENF �� � - /
COMMu '' w TARGET DATE
SITE ADDRESS
3 '� l 3q �� y4 Sw 6.,,
SUITEMNIT #
PROJECT VALUATION
$ 02, o -
ZONING
ASSESSOR'S TAR/PARCEL #
%(�-- - S 0 -:�, O (22 - v
TYPE OF PERMIT
❑ BUILDING,,E1"PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
CS
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
3 3 3 � c�.,� �- s 4.
E-MAIL
CITY�
STATE
ZIP��D��
NAME � n �i �,,�p �Q,,.✓Urdu+ �
Y P�V
PHONE
MAILING ADDRESS` �l /Lk I `,
3
E-MAIL
CONTRACTOR
CITY
'CCF. fLLG
STATE
ZIP g
l O?
FAX
WA STATE CONTRACTOR'S LICENSE #
J K Wo �T 8'30
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT-
MAILING ADDRESS
E-MAIL
CITY
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
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 cl I arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to he city as a part of this application.
SIGNATURE: 4!� DATE 7
PRINT NAME:
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application