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12-105689e , it City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Project Name: KIEFFER Project Address: 31921 53RD AVE SW Project Description: Install gas piping for new generator LAiwey3 Mechanical Permit #: 12 -105689 -00 -ME Inspection Request Line: (253) 835-3050 Parcel Number: 189860 0090 Owne ARRIicant Contractor WILLIAM KIEFFER WILLIAM KIEFFER OWNER IS CONTRACTOR JUDITH KIEFFER 31921 53RD AVE SW 31921 53RD AVE SW FEDERAL WAY WA 98023-2027 FEDERAL WAY WA 98023-2027 Additional Permit Information Mechanical Valuation............................................2000.00 Is this an Online or O.T.C. application? ................. Yes GasPiping ...................................... 1 Mechanical Fixtures CONDITIONS: A permanently installed generator is not allowed to be placed within required yards (setbacks). See Bulletin #150 for placement details. PERMIT EXPIRES Monday, June 24, 2013 Permit Issued on Wednesday, December 26, 2012 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 a rdance with the laws, rules and regulations of the State of Washington and i of Federal Way. Owner or agent: — // KDate: r CITY OF 44A Federal Way PERMIT #: 12 -105689 -00 -ME THIS CARD IS TO MAIN ON-SITE Construction In ection Record INSPECTION REQ TS: (253) 835-3050 Address: 31921 53RD AVE SW Project: WILLIAM KIEFFER FEDERAL WAY, WA 98023-2027 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)11 Approved Gas Piping (4125) Approved to release test Final Electrical Approved Final - Mechanical (4065) Approved By Date By Date By Date 1 -; Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date A# .'."oA" Federal W%ECEIVED • PERMIT C253_u-8,u3.5u-.2. aDt�!erieXRVICES ZA P P L I C A T I O NMEVELOPMENSEr g L01 rvfw CITY OF FEDERAL WAY � z l 0 • MF CO ME PL DE EN FP SITE ADDRESS CD5 SUITE/UNIT # 3 t 7,�_ 1 S:y ,4ep 5V PROJECT VALUATION �O©d ZONING ASSESSOR'STAXp/P-ARCEL # � _ Q � ^ -A o -9970 — — — — — C) TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 2(MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT (Tenant Name/Homeowner Last Name) / /�% ��✓� PROJECT DESCRIPTION Detailed description of work to be included on this permit only PROPERTY OWNER NAME ��jt7 `� �� �C PRIMARY PHONE —1r,3 913 MAILING ADDRESS 4 CITYpfd F_ STATE ZIPCj NAME LA PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # N PHONE MAILING ADDRESS E-MAIL APPLICANT CITY STATE ZIP FAX PROJECT CONTACT NAME PHONE (The individual to receive and respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E-MAIL 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 1 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 2 - PRINT NAME: Bulletin #100 –January 1, 2011 Pagel of 3 UHandoutsTermit Application VALUE OFMECHAMCAL WORK $ (a copy of bid or estimate must be provided) 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. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial) BOILERS FURNACES HOT WATER TANKS (Gas) 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) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS • SINKS (Kitchen/Utility) WATER HEATERS (Electric) HOSE BIBBS SUMPS WASHING MACHINES z� CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? r ❑ Yes ❑ No []Yes ❑ No Bulletin #100 —January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application