06-101219I
City of Federal Way
Community Development Services • Mechanical Permit #• 06 -101219 -00 -ME
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
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Project Name: WAGNER-BERNAL
Project Address: 2409 SW 349TH PL Parcel Number: 176110 0220
Project Description: Replacing gas piping/furnace/water heater
Owner
Applicant
Contractor
LUIS ARIEL BERNAL
LUIS ARIEL BERNAL
LUIS ARIEL BERNAL
2409 SW 349TH PL
2409 SW 349TH PL
2409 SW 349TH PL
FEDERAL WAY WA
FEDERAL WAY WA
FEDERAL WAY WA
98023-3067
98023-3067
98023-3067
Additional Permit Information
I_
Mechanical Valuation............................................5000 Over the Counter Permit? ...................................... Yes
Mechanical Fixtures
GasPiping ...................................... 1
PERMIT EXPIRES Monday, September 11, 2006
Permit Issued on Wednesday, March 15, 2006
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: zi 1 v
,
r
THIS CARD IS TO REMAIN ON-SITE r
CITY OF Community Development Inspection Record
Federal Ways IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -101219 -00 -ME
Owner: LUIS ARIEL BERNAL
Address: 2409 SW 349TH PL
FEDERAL WAY, WA 98023-3067
This card is part of your required inspection documents. 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) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By - Date BY42 C Date �! 7 • d
CITY OF A
Federal Way RECEIVEDPERMIT
COMMUNW DEVELOPMENT SERVICES
93325JIM AVENUE WA,WA98063-9718.
•POBQK 971. MAR 15
1��PLICATION
FEDERAL WAY, WA 98063-9718 .
253-83S-2607• FAX 2S3 -83S-2609
wmm.dtuo/fe&mhmu.00m CITY OF FEDERAL WAY
The following is require.-NJQU&"Elan inamplete application will not be
ITE ADDRESS
ASSESSOR'S TAX/PARCEL #
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
-p—kpage/- 9wWft Ie®n[ desestp wq
SF MF CO L PL DE EN FP
Please
SUITE/UNIT #
LOT SIZE (sf)
or
TYPE OF PERMIT ❑BUILDING❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul
i -
PROJECT NAME (Name of Business or Owner Last Name) S /lJ A
PEOPLE INFORMATION
PROPERTY NAME l 7 PRIMARY PHONE
OWNER v ! S UJCi c141�L / t/ �% r� /'%/J �J �/v a d)Yi-�
MAILING ADDRESS CITY, STATE, ZIP
C' 2L c h'JS1A 1-120
CONTRACTOR
APPLICANT
CONTAC'
LENDER
COMPANY NAME
0-MUCANT NAME
OFFICE PHONE
J,1
c
���
✓ n—
yS U
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
U
/-)1-' 4:)
(
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
B L
R 3 ISTRA N NUMB
(copy of
d regnir th ch appH ons
EX
TIO DATE
P
aj
EXISTING USE
EXISTING ASS]
VALUE $_
SPRIN EREPT D BUILDING? ❑UPPI
WATER SERVICE PROVIDER ❑MM::�HIGHMLINE
SEWER SERVICE PROVIDER O LAKEHAVEN . 0 HIGHLINE
VALUE OF PROS
M SYSTEM PROP
❑ TACOMA ❑
0 PRIVATE (SEP
WORK $
1/REQUIRED? ❑ YES ❑ NO
AREA DESCRIPTION
EXISTING PROPOSED TAL
SQ. FT. S . FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT O
s�nsnNo reoroaso ror�r.
NUMBER ORS
••NEW HOMES ONLY"'' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or
MECFIANICAL
Value of Mechanical Work $ j Oyy
_ AIR HANDLING UNITS
BBQS
_ BOILERS
_ COMPRESSORS
.DUCTS
BATHTUBS (or Tub/Shower Combo)
7
MACHINES
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
as part of this project. Do not include existing fixtures to -
GAS LOGS REMO. SYSTEMS
HOODS (C -L4 WOODSTOVES
RANGES MISC (Deacnbe)
GAS WATER HEATERS
WATER CLOSETS (faleq _Aok (Describe)
ACUPS RAINWATER S T
URINALS HOSE BIBBS
VACUUM BREAKERS ELECTRIC WATER
I cert(fy under penalty of perjury that the igformation furnished by me is true and correct to the best of my knowledge, and further, that I
am authorised by the owner of the above premises to perform the work for which the permit application is made. 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 ciainQ, which may be made by any person, including the undersigned, and filed against the City of Federal Way, 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.
NAME/TITLE DATE G
(slg,eture) We)
RELATIONSHIP TO CT a Owner 13A o Contractor O Architect ii Other
MAI _. - ur nn t........... f Inns D— 9 ..PA 4U-ionAnmc\As r it Annliratinn
41k
CITY OF r
Federal - - -Y
+� DEPARTMENT OF CommuNITY DEVELOPMENT SERVICES
33325 81h Avenue South
PO Box 9718
Federal Way WA 98063-9718
253-835-2607; Fax 253-835-2609
www.citvoffederalway.com
Affidavit in Lieu of. General Contractor Registration
State of Washington )
County of King )
I, A) U L/v A G.Cj£�-, state as follows:
(Print name as signed)
I have made application for a building permit from the City of Federal Way, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the
Revised Code of Washington (RCW), a copy of which is printed on the reverse side of this affidavit.
I understand that prior to issuance of a building permit for work that is to be done by any contractor,
the City of Federal Way must verify either that the contractor is registered by the State of
Washington, or that one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Federal Way of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. l 2 , and will
therefore, not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any
decision to engage an unregistered contractor to perform construction work.
PLICANT'S SIGNATU
Signed
and sworn to before me this
J�Day of MigAi, 20M2.
71- ��-
Nva ame (Print)
Notarys ignature
NOTARY PUBLIC in and for the State of
Washington, residing at lis i"✓�� County
My Commission expires: (J07-1
Bulletin # 116 — October 1; 2004 Page I of 2 k:\Handouts\Contractor's Affidavit
Revised Code of -Washington
18.27.090 Exemptions. The registration provisions of this chapter do not apply to:
1) An authorized representative of the United States
other work upon land in rural districts for fire prevention
government, the state of Washington, or any
purposes; except when any of the above work is
incorporated city, town, county, township, irrigation
performed by a registered contractor;
district, reclamation district, or other municipal or
11) An owner who contracts for a project with a registered
political corporation or subdivision of this state;
contractor, except that this exemption shall not deprive
2) Officers of a court when they are acting within the scope
the owner of the protections of this chapter against
of their office;
and unregistered contractors;3)
Public utilities operating under the regulations of the
Ogislered
yperson working on hisorher own property, whether
utilities and transportation commission in construction,upied
by him or her or not, and any person working
maintenance, or development work incidental to their
on his or her personal residence, whether owned by him
own business;
or her or not but this exemption shall not apply to any
4) Any construction, repair, or operation incidental to the
person otherwise covered by this chapter who constructs
discovering or producing of petroleum or gas, or the
an improvement on his or her own property with the
drilling, testing, abandoning, or other operation of any
intention and for the purpose of selling the improved
petroleum or gas well or any surface or underground
property;
mine or mineral deposit when performed by an owner or
13) Owners of commercial properties who use their own
lessee;
employees to do maintenance, repair, and alteration
5) The sale or installation of any finished products,
work in or upon their own properties;
materials, or articles of merchandise that are not actually
14) A licensed architect or civil or professional engineer
fabricated into and do not become a permanent fixed
acting solely in his or her professional capacity, an
part of a structure;
electrician licensed under the laws of the state of
6) Any construction, alteration, improvement, or repair of
Washington, or a plumber licensed under the laws of the
personal property performed by the registered or legal
state of Washington or licensed by a political
owner, or by a mobile/manufactured home retail dealer
subdivision of the state of Washington while operating
or manufacturer licensed under chapter 46.70 RCW who
within the boundaries of such political subdivision. The
shall warranty service and repairs under chapter 46.70
exemption provided in this subsection is applicable only
RCW;
when the licensee is operating within the scope of his or
7) Any construction, alteration, improvement, or repair
her license;
carried on within the limits and boundaries of any site or
15) Any person who engages in the activities herein
reservation under the legal jurisdiction of the federal
regulated as an employee of a registered contractor with
government;
wages as his or her sole compensation or as an employee
8) Any person who only furnished materials, supplies, or
with wages as his or her sole compensation;
equipment without fabricating them into, or consuming
16) Contractors on highway projects who have been
them in the performance of, the work of the contractor;
prequalified as required by RCW 47.28.070, with the
9) Any work or operation on one undertaking or project by
department of transportation to perform highway
one or more contracts, the aggregate contract price of
construction, reconstruction, or maintenance work;
which for labor and materials and all other items is less
17) A mobile/manufactured home dealer or manufacturer
than five hundred dollars, such work or operations being
who subcontracts the installation, set-up, or repair work
considered as of a casual, minor, or inconsequential
to actively registered contractors. This exemption only
nature. The exemption prescribed in this subsection does
applies to the installation, set-up, or repair of the
not apply in any instance wherein the work or
mobiletmanufactured homes that were manufactured or
construction is only a part of a larger or major operation,
sold by the mobile/manufactured home dealer or
whether undertaken by the same or a different
manufacturer;
contractor, or in which a division of the operation is
18) An entity who holds a valid electrical contractor's
made into contracts of amounts less than five hundred
license under chapter gJPP1,$•*tC)V that employs a
dollars for the purpose of evasion of this chapter or
certified journeym.V41 ct ' ' citified residential
otherwise. The exemption prescribed in this subsection
specialty electrician $ ec &e meeting the
does not apply to a person who advertises or puts out
requirements pf Atc io perform
any sign or card or other device which might indicate to
plumbing w* that, s taffy, directly, and
the public that he or she is a contractor, or that he or she
immediately apipropria'te to the like -in-kind replacement
is qualified to engage in the business of contractor;
of a household pliancc..or �iher sr4l Household
10) Any construction 'or operation incidental to the
utilization equi�ti 9� egiAnifg�jjQQ'�I&Aric power
construction and repair of irrigation and drainage ditches
and limited WV ttl arid/or V6ater ' 1riictions. An
of regularly constituted irrigation districts or reclamation
electrical trainee'►pus et & - , a certified
districts; or to farming, dairying, agriculture, viticulture,
electrician while perf"ormipy plutrtbifi9 work.
horticulture, or stock or poultry raising; or to clearing or
Bulletin # 116 — October 1, 2004 Page 2 of 2 k:\Handouts\Contractor's Affidavit