13-1026040 •
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Fedillral Way, WA 98003
Ph: (253) 835-2807 Fax (253) 835-2809
Project Name: ST LUKE'S LUTHERAN CHURCH
Mechanical
Permit #: 13 -102604 -00 -ME
Inspection Request Line: (253) 835-3050
Project Address: 515 S 312TH ST Parcel Number: 082104 9038
Project Description: Repair/replace gas piping to furnace (in east mechanical closet).
Owner
AR11111cant
Contractor
ST LUKES LUTHERAN CHURCH
HERMANSON COMPANY LLP (GENERAL)
HERMANSON COMPANY LLP (GENERAL)
515 S 312TH ST
1221 2ND AVE N
HERMACLO05BJ (8/25/14)
FEDERAL WAY WA 98003-4033
KENT WA 98032
1221 2ND AVE N
KENT WA 98032
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Mechanical Fixtures'
GasPiping ...................................... 1
PERMIT EXPIRES Tuesday, December 10, 2013
Permit Issued on Thursday, June 13, 2013
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: 6/ 1 �✓ 2-0 i
THIS CARD IS TOrTS:
ON-SITE
Cr". Construction Inon Record
Federal Way INSPECTION REQ3) 835-3050
PERMIT #: 13 -102604 -00 -ME Address: 515 S 312TH ST
Project: ST LUKES LUTHERAN CHURCH FEDERAL WAY, WA 98003-4033
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 (41-6Gas
Piping (4125)
Final - Mechanical ( 065)
Approved
Approved to release test
Approved
By Date
By Date
1;�r7 Dat6/zk
Rough Electrical
Approved
1:1Approved
Final Electrical
n
Right of Way
Approved
By
Date
By
Date
By
Date
04
CITY OF
Federal Way
PERMIT NUMBER /3
RIVED
JUN 13 2013
CITY OF FEDERAL WAY
- /-�)- '�' 6 6 —V
PERMIT APPLICATION
TARGET DATE
SITE ADDRESS
SUITEMNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
TS 0, 00
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() 0 2 1 D 4- a O
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBINGG MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
1,,-.Vk V,,- 1 o"IrC k - 6 G(S i tVLO- J? -e VC1
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PROJECT DESCRIPTION'
Detailed description of work to
c G V) i ( C t-0 se
be included on this permit only
NAME..
PRIMARY PHONE
PROPERTY OWNER
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MAILING ADD
EMAIL
CITY
STATE
ZIP
1
NAME tie r r i\ I/ t I l J V Y"
PHONE
'24) C1 -7 0
MAILING ADDHEBB
Ave (
E-MAIL
CONTRACTOR
LiK
CITY
K � 1
�W�..
_
FAX
WASTATE CONTRACTOR'S LICENSE t
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
Fi6?--rAAt, V.j
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NAME
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PRIMARY PHONE
S _ �j ra
--16' 5 V ( 2
MAILING ADDRESS
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EMAIL
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APPLICANT
CITY
V1t
STATE
WA I
Z[P
2ric'52
FAX
2s3 1'1G -�fiep2
NAME
PRIMARY PHONE
PROJECT CONTACT
�Ot
MAILING ADDRESS
EMAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
I ZIP
FAX
concerning this application)
.i
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5, 000 or more
MAII.IN6 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.
�l
SIGNATURE: F'U�� DATE
PRINT NAME:
Bulletin #100 — January 1, 2013
Page 1 of 3
k:\Handouts\Permit Application
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICALWORK
MECHANICAL PERMIT
# of
Additional Information
$ '-7 ST . C? O
Indicate how many of each type offixture
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 (commercial(
WATER PIPING
BOILERS
FURNACES
HOT WATER TANKS (Gaa(
OTHER (Describe)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DRINKING FOUNTAINS
SINKS (Kitchen/Utility(
WATER HEATERS (Electric(
DUCTING
= GAS PIPING
WOODSTOVES
TOTAL FI%TURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
# of
Additional Information
in Square Feet
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing res to remain.
BATHTUBS (or Tub/Shomercombo(
LAVS (Hand Sinks(
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/Utility(
WATER HEATERS (Electric(
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FI%TURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Additional Information
in Square Feet
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
a
Stories
f
fi,
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
Occupancy Groupls) Construction
# of
Additional Information
uare
in 3 Feet
a
Stories
Tt7tAL BknLDDA4,p'f
TENANT AREA ONLY
<,,,
(PROJECT AREA OIfLY
Bulletin #100 - January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application