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14-104798t l � Mechanical City of Federal.Dev. y Permit #: 14 -104798 -40 -ME Community 8 Econ. Dev. Services 33325 8th Ave S F LE Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (2 53) 835050 Project Name: CLARK Project Address: 32421 51ST AVE SW Parcel Number: 189830 0040 Project Description: Installation of gas piping for cook stove and outlet for future generator, vent fan in utility room. Owner nlicant Contractor REBECCA S CLARK REBECCA S CLARK OWNER IS CONTRACTOR RONALD V CLARK 324215 1 STAVE SW 324215 1 ST AVE SW FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 Additional Permit Information Is this an Online or O.T.C. application?.................Yes Mechanical Fixtures Fans .................................. :............. 1 Gas Piping ...................................... 1 Gas Pipe Outlets...........................: 2 PERMIT EXPIRES Monday, March 16, 2015 Permit Issued on Wednesday, September 17, 2014 I hereby certify that the above ' formation is correct an at the construction on the above described property and the occupancy and these 111 be in accordance wi laws, rules and regulations of the State of Washington an t F al Way. Owner or agent: Date: CITY OF VAI Federal Way PERMIT #: Project: THIS CARD IS TOMAIN ON-SITE Construction In ection Record INSPECTION REQU TS: (253) 835-3050 14 -104798 -00 -ME Address: 32421 51 ST AVE SW REBECCA S CLARK FEDERAL WAY, WA 98023-1936 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. Is ❑ Mechanical Rough -in (4165)Gas Piping (4125) Final - Mechanical (4065) Approved Right of Way Approved Approved to release test Approved By Date By Date _ Date � l Is ❑ Rough Electrical Approved ❑Final Electrical Approved Right of Way Approved By Date By Date By Date J) VFE ENSPECTOR AREA AND TYPE 0" INSPECTION "wNaRI( e-,cWOw,sr Fa -J DV"--t-s^ bl- Tb GCV- r CITY OP Federal Way RECEIVED ; EP 1704 CITY OF CDSRAL WAY PERMI16APPLICATION PERMIT NUMBER TARGET DATE SITE ADDRESS SUITE/UNIT # PROJECT VALUATIONZONING .o C) ASS � TA%/PAJEL # 3 O _ © O W 9'a — TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT PROJECT DESCRIPTION Detailed description of work to ` be included on this permit only PROPERTY OWNER NAME �j4fcyf D PRIMARY PHONE MAILING ADDRESS � s' f �� E•MAD, �j 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 ePIS ale— MAILING ADDRESS E-Nnn. APPLICANT CITY STATE ZIP FAX NAME PRIMARY PHONIC PROJECT CONTACT MAILING ADDRESS EMAIL (The individual to receive and respond to all correspondence CITY STATE ZIP FAX concerning this application) PROJECT FINANCING NAME OWNER -FINANCED Required value of $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 agreeto hold ess the City of Federal Wa to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense f such claim), which made by any person, including the undersigned, and filed against the city, but only where such ciai ses out of the reli f the city, including its officers and employees, upon the accuracy of the information supplied t ty as apart f t anon. SIGNA _ DATE PRINT NAME: fl Bulletin # 100 — January 1, 2013 Page I of 3 k:\Handouts\Permit Application lak VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ Indicate how many of each type of flxt4re to be installed or relocated as pqrt of this project. D( 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 (G.* COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR VALUE OF PLUMBING WORK PLUMBING .PERMIT $ Indicate how many of each ti ype offixture to be installed or relocated as part o this project. Do not include existigg flxtures to remain. BATHTUBS (or Tub/shower combo) LAVS (Hand Sink* TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (ritcbm/utility( WATER HEATERS (Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FEKTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF ERISTINO EMPROVZMZNTS ZRISTUIG/PREVIOUS USE LOT SIZE (In Square Feet) ERISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑ Yes ❑ No ❑ Yes ❑ No Bulletin #100 — January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application