19-102342 I I J
Plumbing
City of Federal Way Permit #:19-102342-00-PL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: CHARLEBOIS
Project Address: 31624 54TH AVE SW Parcel Number: 189850 0160
Project Description: Plumbing work to include partial waste water piping.
Owner Applicant Contractor
MICHAEL S CHARLEBOIS ALEX KUNIYOSHIRESCUE ROOTER RESCUE ROOTER
31624 54TH AVE SW 175A ROY RD SW SUITE 101 RESCUR*007Q7(1/1/20)
FEDERAL WAY WA 98023-2015 PACIFIC WA 98047
175-A ROY RD SW
PACIFIC WA 98047
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PERMIT EXPIRES Sunday, 10 November,2019
Permit Issued on Tuesday,May 14,2019
•
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 • of Federal Way.
Owner or agent: Date: S-i 1-l'j
• .1;04
THIS CARD IS TO REMAIN ON-SITE r '
Federal WayConstruction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 102342 00 Address: 31624 54TH AVE SW
Project: MICHAEL S CHARLEBOIS FEDERAL WAY WA 98023-2015
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.
0 Plumbing Groundwork
•
(4190) ` 11J Rough Plumbing(4230) El Final-Plumbing(4075)
Approved to cover Approved Approved
,By Date ; By Date By :0 Date S is 11
0 Rough Electrical CI Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED PERMIT APPLICATION
CITY OF
MAY 1 4 2019 PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835-2609 +permitcenterrcityoffederalway.com
CITY°F FECFr�gL WAY
1 �i _ 1 C�2 3� ° er
E' P 01 /a
PERMIT NUMBER
TARGET DATE
SITE ADDRESS SUITE/UNIT#
S1 VI 94 1icX Sties
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCS, j.# � � 0
-
TYPE OF PERMIT ❑ BUILDING PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION ' (w I GIA STi -fy oJ
Detailed description of work to
be included on this permit only
.. .. _ .. _. .- N - - -- PRIMARY PHONE
MAILINGG A
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PROPERTY OWNER � AD�l thwl�Sh�)S
ADDRESS 1 E-MAIL
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CITY ST TE ZIP
1-14t11/ ( 'Ckb -
N4ME ? PHONE
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MAILING ADDRESS E-MAIL
CONTRACTOR V�-I rd cid )° I Gt,��lA1�l114►�51410GYS- COMM.
Cr11 tr ZI S�7� FAX
WA STATE CONTRACTOR'S LICENSE# try
EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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Nmif.CX V1,�V11(�', ociAl. PRIMARY
APPLICANTMAILING ADDRESS I IL
CITY STATE ZIP FAX
PROJECT CONTACT N n� a1,14105-� AAZ. q(0 0/1
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 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 arty 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 a part of this application.
)
SIGNA ---. �// ����_— DATE c_I Li-1 1
(tittPRINT NAME:
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application