16-104792Plumbing
City nityDFederal elopmeWay i Permit #:16 -104732 -00 -PL
Community Development Dept. 161: -'_a
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: (253) 835-3050
Ph: (253) 8352607 Fax: (253) 835-2609
Project Name: CHURCH OF BLESSING
Project Address: 1430 S 330TH ST Parcel Number: 172104 9045
Project Description: ALT - Underground plumbing work only to install sanitary sewer piping to connect toilet,
lavatory sink and mop sink (by others).
Separate Permit required for fixtures
Owner
Applicant
Contractor
CHURCH OF BLESSING
RYAN BURRELLWESTERN MECHANICAL
WESTERN MECHANICAL SYSTEMS INC
1430 S 330TH ST
CONTRACTORS
WESTEMS921BG (InII2)
FEDERAL WAY WA 98003
1911 SW CAMPUS DR
1911 SW CAMPUS DR SUITE 321
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Lavatories 1 Sinks
PERMIT EXPIRES Monday, 2
Permit Issued on Wednesday Sed
I hereby certify that the above information is
and the occupancy and the use will be ig
Owner or
�J Va u
f
Co
�v
and the GOii of F
2 Water CloSa 1
017
2016
ruction on the above described property
rules and regulations of the State of
Way.
Date:
arr of THIS CARD IS TO REMAIN ON-SITE
����
Federal Way Construction Inspection Record
y INSPECTION REQUESTS: (253) 835-3050
PERbW #: 16104792 00 Address: 1430 S 330TH ST
Project: CHURCH OF BLESSING FEDERAL WAY WA 98003-6302
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.
El
Plumbing Groundwork (4190)
0
Rough Plumbing (4230)
3❑
Final - Plumbing (4075)
Plumbing Groundwork (4190)
Rough Plumbing (4230)
Final - Plumbing (4075)
By
� Date 10
to (�
By
Date
By
Date
0
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
13y
Date
By
Date
By
Date
RVEIVEp
,► SEP PERMIT APPLICATION
CITY Of � 2 8 2at6
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal Way CM OF: FEDERAL VVAy 253-835-2607 + FAX 253-835-2609 + ermitcente a' cityoffederalway.
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PERMIT NUMBER 7-qZ- C jo D
TARGET DATE
SITE ADDRESS
E/
1y30 e(W W 003
PROJECT VALUATION
ZONIN
ASSESS TAX/PARCEL#
e5 q
TYPE OF PERMIT
❑ BUILDING fid PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
("ktLM11 COF lin
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PROJECT DESCRIPTION
Detailed description of work to
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nAP an llAt4 7n k
be included on this permit only
NAME A Fe0. P'Q� I W C
PRIMhIPNE
153 — A-36 -9, Tc
PROPERTY OWNER
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NAME
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EXPIRATION / � E
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FEDERAL WAY BUSINESS LICENSE
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NAME
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A-53 MARY PH
MAILING DRESS
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E-MAIL
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APPLICANT
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PROJECT CONTACTMAI
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(The individual to receive and
respond to all correspondence
C`Tz�l e4w e , \ 0
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STATE
�V /TP
-119023
9,53 (P 9
concerning this application)
PROJECT FINANCING
NAME
R OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
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 claim arises out of the re ance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of th' pplication.
SIGNATURE: DATE 1/ A
PRINT NAME: Nenwn P)urre
Bulletin #100 — January 29, 2016 Page I of 2 kAHandouts\Permit Application
05
QS
I
M 0
PLUMBING PERMIT
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VA LUE OF MECHANICAL WORK
MECHANICAL PERMIT
# of
Stories
Additional Information
VALUE WORK
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
Indicate how many of each type offirWre
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(commemal
BOILERS
FURNACES
HOT WATER TANKS iGosi
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
Additional Information
VALUE WORK
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
so—
ADDITION
❑ Yes ❑ No
LOb
qC
Indicate
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/Shower Combo)
LAVS Hand Sinks)
TOILETS
# of
Stories
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
4—
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
n� � rffrem
DRINKING FOUNTAINS
SINKS (K-hen/Uoecy)
WATER HEATERS (E)eadqj
7 (C
1 Z µd P S -AK
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
Additional Information
NEW BUILDING
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
ADDITION
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL -NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
--------- . ................... -.-..................................... - .......... - -- -----------------------
BASEMENT
FIRST FLOOR (or Mobile Home)
.................. _........................................ _....._.. ----------......-....----------------------
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
-......._..-.._.-.....-........-........-.....-.....-.------...-----.-.._..-.---------....
Area Totals EMSTING PROPOSED TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 —January 29. 2016 Page 2 of 2 k:\Handouts\Pennit Application
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Bulletin
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