19-1000351
City or FederE836-2609]
Community Develo
33325 8th A
Federal Way, W
Ph: (253) 835-2607 Fax
Project Name: NG
Project Address: 31359 12TH PL S
Project Description: Install gas piping for new furnace
Mechanical
Permit #:19 -100035 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 787520 0170
Owner
Applicant
Contractor
PHILLIP NG
PHILLIP NG
OWNER IS CONTRACTOR
31359 12TH PL S
31359 12TH PL S
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Additional Permit Information
Mechanical Work Valuation? .................................. 2000 Is this an Online or O.T.C. application?.................. Yes
Furnaces
1 Gas Piping
1
PERMIT EXPIRES Tuesday, 2 July, 2019
Permit Issued on Thursdav, January 3, 2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or agent: Date: ( 3 1
4::.4' --'s LI�k-
F'1vy�I4
THIS CARD IS TO REMAIN ON-SITE
Fecleral Way CONnstruction S ECTION REQUESTS: (253) 835-3050 on rd
PERMIT #: 1910003500 Address: 3135912TH PL S
Project: KARRIE NGO FEDERAL WAY WA 98003-5311
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..OwSaingigspections are logged on the back of this card.
0 Mechanical Rough -in (4165) Q as Piping (4125) El Fiusl - Mechanical (4065)
Approved ed to rel eas e Approved
By Date By to C� �' By �/ Date
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
CITY OF �✓ JAN 0 3 2019
PERMIT APPLICATION
PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
Federal Way CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER _ l V 0 3 5 _ ✓f �l
TARGET DATE
SITE AD+D�RESS
SUITE/UNIT #
q
7 (�C� 1 I, Z� S te'
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING F MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
ex S LL
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
Ll -p
¢
7-4> (4, �a t�"3 Q \'A-\
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
PC> rl
i LLi P" Zz-S.Q
CIT
STA,T/EE
ZIP
NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
rj "') M'l�
MAILING ADDRESS
E-MAIL
APPLICANT-
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
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
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.
SIGNATURE DATE 1 3 t
PRINT NAME: L L�—
Bulletin #100 – January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application