11-104560City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
e i i
• •. Mechanical
Permit #: 11 -104560 -00 -ME
Inspection Request Line: (253) 835-3050
Project Name: MONTGOMERY/FEATHERSTONE
Project Address: 2820 SW 300TH PL Parcel Number: 416660 0140
Project Description: Gas piping for permanent generator installation.
Ownr
Applicant
Contractor
PAT MONTGOMERY
DOUGLAS JOHNSON & CO INC
DOUGLAS JOHNSON & CO INC
2820 SW 300TH PL
1100 NW 52ND ST
DOUGLJC055LE (5/17/12)
FEDERAL WAY WA 98023
SEATTLE WA 98107
1100 NW 52ND ST
SEATTLE WA 98107
Mechanical Valuation............................................1000
Gas Piping ...................................... 1
Is this an Online or O.T.C. application?.................Yes
PERMIT EXPIRES Saturday, May 12, 2012
Permit Issued on Monday,November 14, 2011
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:
;irrau> 11 /15///
1 '
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
11 -104560 -00 -ME Address: 2820 SW 300TH PL
PAT MONTGOMERY FEDERAL WAY, WA 98023-2325
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 (4165)
Approved
Gas Piping (4125) !�
Approved �f�
Final - Mechanical (4065)
to release test
Approved
By Date
By 10W Date //' l r
By Date //_/S //
V 2G7 S-79
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
IY�
CITY ciofA P RMT
Federal WayD �CEIv
COMMUNITY DEVELOPMENT SER P L I C A'T I O N
253-835-2607• FAX 253-835-2609
uf!fw.dtuoffetiernlu�aLrom .4,'� y; 14 2011
—At %AIAV
I c -� �s�-L
OMF CO ME PL DE EN FP
SITE ADDRESS CITY ut I
g a Coss
SUITE/UNIT #
PROJECILYfALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
Af L/1.11
be included on this permit only
PROPERTY OWNER
NAME PRIMARY PHONE
0
MAILING ADD R E-MAIL
CITY
ZD'
PHONE
0-4
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY TE
ZIP FAX
WA STATE CONTItNeTORIS LICE #
EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE #
NAME PHONE
APPLICANT
MAILING ADDRESS EMAIL
CITY
STATE
ZIP FAX
PROJECT CONTACTJ
(The individual to receive and
HG
MAIL DIG E-MAIL
respond to all correspondence
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: HONE
PROJECT FINANCING
NAME ❑ OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)7
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 claiFN, 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 a part of this application.
SIGNATURE: DATE
PRINT NAME:
Bulletin #100— January 1, 2011
Page 1 of 3
kAl-landoutsTermit Application
VALUE OF MEcxAMcAL WOAK
(a copy of bid or estimate must be provided)
Indicate how many of each type of fixture forTe 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)
BOILERS
FURNACES
HOT WATER TANKS (cas)�
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
Indicate how many of each type of fixture 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 WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
RAINS
SHOWERS
VACUUM BREAKERS
D NKING FOUNTAINS
SINKS (Bimhen/Uwiry)
WATER HEATERS (Electric)
HOS BIBBS
SUMPS
WASHING MACHINES
CRITICAL AREAS ON PRO]
EXISTING/PREVIOUS USE
WATER PURVEYOR
LOT SIZE (In Square Feet)
SEWER PURVEYOR VALUE OF EXISTING SIPROVEMENTS
EXISTING FIRE SPRINKLER SYSTEM? PRO ED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
AREA DESCRifION I a- Q.lea
".— ree� I Occupancy
FOR OFFICE USE
TOTAL
Construction# of
__ _ _ Additional Information
Bulletin #100 -January 1, 2011 Page 2 of k:\Handouts\Permit Application