16-104305Mechanical
City ��Cmm&Ew,. Permit #: 16 -104305 -00 -ME
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 P 4
Project Name: EVERGREEN PARK 2 ADULT FAMILY HOME
Project Address: 32020 11TH AVE SW Parcel Number: 926493 0040
Project Description: Installation of gas piping for generator.
Owner
Annlicant
Contractor
MARIJANA MORROW
VOGNYK GAS PIPING LLC
VOGNYK GAS PIPING LLC
EVERGREEN PARK
9829 KOOLEY DRIVE KP N
VOGNYGP852JG (4/27/17)
3202011TH AVE SW
GIG HARBOR WA 98399
9829 KOOLEY DRIVE KP N
FEDERAL WAY WA 98023
GIG HARBOR WA 98399
Additional Permit information
Mechanical Work Valuation?................................250 Is this an Online or O.T.C. application? ................. Yes
Mechanical Fixtures 9
GasPiping ...................................... 1 r\ f
CONDITIONS:
A separate electrical permit is required for transfer swi/conftb
iion.
A permanently installed generator is not e o be plteed with' re ands (setbacks). See Bulletin
#150 for placement details. • t`"
PERNT EXPIRES MondpfjWbruary 27, 2017
Permit Issued on Wednes , August 31, 2016
I hereby certify tt the nforrn6tion is correct that the construction on the above described property and
the occupancy an e I bein accordance I he laws, rules and regulations of the State of Washington
and tty of Federal Way.
"4x•31 l�
Owner or agent=::;:,Date:
r
N
y1�
a IBM
MY or
Federal Way
PERMIT #:
rojecct:
THIS CARD IS TO REMAIN ON-SITE `
Construction Inspection Record
INSPECTION REQUESTS: (233) 835-3054
16 -104306 -00 -ME Address: 32020 11TH AVE SW
MARWANA - _ FEDEFUkU VAY, WA 98023-5548
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 )
[3
as Piping(4125)
Fina - Mechanical
Approved
Approved to release test ZOP
By
Approved
By Date
By
A r,� Date cRI 7/As
By
Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
` RECEIVED
CITY OF At auG 302016 PERMITGIPPLICATION
Federal Way
CITY OF FEDERAL WAIF
^ CDS
PERMIT NUMBER `rv„ _ _ f
Lo O ` TARGET DATE
SITE ADDRESS
3�,G-c),o 01, Ave w,4 y s
SUITE/UNIT M
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL i
$
& � !?- 3- b
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING 9 MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
G Pr P(1: �`�/� exle Rom
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
3 tti AVe Svc/
E-MAIL
CITYSTATE
- edeRA1 VJ
w>4
ZIP
V0�3
NAMEPHONE
D g N y k S pl } LLC
Ir'
` �
.J
MAILING ADDRESS ay n
SO2 oc C e I\ fK p
E-MAIL
CONTRACTOR
CITY
aX K ok
STATEZIP
w
FAX
rWA'STATE CONTRACTOR'S LICENSE N
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
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 19.27.095)
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 reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATuR DATE
PRINT NAME:
Bulletin #100 — February 22, 2016 Page 1 of 2 k:�Handouts\Permit Application
MECHANICAL PERMIT
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
Is
PLUMBING PERMIT
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing res to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
BATHTUBS (or Tub/shower combo)
BOILERS
FURNACES
HOT WATER TANKS (cast
DISHWASHERS
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DRAINS
DUCTING
GAS PIPING
WOODSTOVES
DRINKING FOUNTAINS
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
# of
Stories
Additional Information
NEW BUIL G
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how memy of each type offLxture
to be installed or relocated as
part of this project. Do not include existingfLytUres to remain.
BATHTUBS (or Tub/shower combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
TOTAL BUILDING
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
# of
Stories
Additional Information
NEW BUIL G
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
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (ddescribe))_
Totals ota W EwsTixc PROPOSED TOTAL
**NEW 510M S ONLY—
ESTIMATED SELLING PRICE $ # OF BEDROOMS
FOR OFFICE USE
COMMERCIAL - NE ADDITION
AREA DESCRIPTION
Area in
S uare Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUIL G
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
Square Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 22, 2016 Page 2 of 2 k:\Handouts\Pennit Application