19-100806City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 635-2607 Fax: (253) 635.2609
Mechanical
Permit #:19 -100806 -00 -ME
c_ Inspection Request Line: (253) 835-3050
Project Name: SAETEURN
Project Address: 120 S 304TH PL
Project Description: Remove and replace hot water heater and furnace.
Parcel Number: 339190 0050
Owner
Applicant
Contractor
SAAN SAETERUN
DAVID BENSONBENSON FILTER
BENSON FILTER MAINTENANCE
120 S 304TH ST
MAINTENANCE
BENSOFM831BD (3/22/19)
FEDERAL WAY WA 98003-4061
1324 SW 353RD ST
1324 SW 353RD ST
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Mechanical Work Valuation? .................................. 3234 Is this an Online or O.T.C. application?.................. Yes
z x y a101,111r s r f
Furnaces 1 Hot Water Tanks 1
PERMIT EXPIRES Monday, 19 August, 2019
Permit Issued on Wednesday, February 20, 2019
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: Gw%yl �J` AADate: 2�2U �2 d I Q
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Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
19100806 00 Address: 120 S 304TH PL
STACIE SAETEURN FEDERAL WAY WA 980034061
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.
El
Mechanical Rough4n (4165)
Q
Gas Piping (4125)
El
Final - Mechanical (4065)
❑
Approved
Approved to release test
Approved
By
Date
By
Date
ByAASDate
Date
Rough Electrical
Final Electrical
❑
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
` RECEIVED
CITY OF �PERMIT APPLICATION
FEB 2 0 2019 PERMIT CENTER + 33325 8c' Avenue South + Federal Way, WA 98003-6325
Federal Way CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcente _ccityoffederalway.com
COMMUNITY DEVELOPMENT"
PERMIT NUMBER 19 _ O _ TARGET DATE
SITE ADDRESS
SUITE/UNIT #
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PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 3 W3V
-- - - - --
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING LJ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
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PROJECT DESCRIPTION
Detailed description of work to
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be included on this permit only
NAME /
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PROPERTY OWNER
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WA STATE CONTRACTOR'S LICENSE #
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EXPIRATION DATE
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FEDERAL WAY BUSINESS LICENSE #
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NAME �a j
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(The individual to receive and
respond to all correspondence
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STATE
ZIP � �
FAX
concerning this application)
PROJECT FINANCING
ME
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING 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 as apart of this application.
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SIGNATURE: °
PRINT NAME: 40 qt/1 d / -/' 6 C 14 �( 0iq
Bulletin #100 - January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application