19-101819 r
•
Mechanical
City of Federal Way Permit #:19-101819-00-ME
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: ADKINS
Project Address: 32215 11TH PL SW Parcel Number:926493 0730
Project Description: Installation of A/C.
Owner Applicant Contractor
JANET R ADKINS LARRY H ADKINS OWNER IS CONTRACTOR
32215 11TH PL SW 32215 11TH PL SW
FEDERAL WAY WA 98023-5558 FEDERAL WAY WA 98023
Additional Permit Information
Mechanical Work Valuation? 4200 Is this an Online or O.T.C.application? Yes
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Air Conditioners-Stand Alonl 1
PERMIT EXPIRES Monday, 14 October,2019
Permit Issued on Wednesday,April 17,2019
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
Washingtoninand the City of Federal Way.
Owner or agent: . V�CJL�J,� Date: tt—17-1q
i
40& THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 101819 00 Address: 32215 11TH PL SW
Project: LARRY H ADKINS FEDERAL WAY WA 98023-5558
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 Rough-in(4165) 0 Gas Piping(4125) GI Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By i I ) Date ‘ !
s.
o Rough Electrical E Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY OF ......._A.
A APR 11 2019
PERMIT APPLICATION
PERMIT CENTER+ 33325 8th Avenue South+Federal Way,WA 98003-6325
CI ITY OF FEDERAL WAY
Federal Way
253-835-2607 + FAX 253-835-2609 +pennitcenter@cityoffederalway.com
lOMMuNfTY DEVELOPMENT
PERMIT NUMBER / ej _ / 4 ` � V// ?_
r ( 111 E TARGET DATE
SITE ADDRESS SUITE/UNIT#
322(5 //Tu/ (m CE �.W, , f 2) fAL leiby7 7 k'/ V0 23
PROJECT. VALUATION ZONING ASSESSOR'S /PARCEL#
fZPO .fl TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 09 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT /crilkLL1 4 H P1)/4/() 4 wtl. Fmk 11
//
PROJECT DESCRIPTION
Detailed description of work to C ?f/Dr- / GAN 4
be included on this permit only
NAME �'DK _ PRIMARY PHONE
PROPERTY OWNER �i `P " f N 15317#16
3z D S /(�� dA CC 6w2 LtiOK'Nv&& d-G
SC 701 STArE/ 1 Z/SL /
NAME°�� PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
A/ ' j� ,/fin/ �// -`�/ / / is- -PRIi'
�/9
N H 1�/'�.. ! ,D/ "/'_`' id✓-P/S 7'- 6./�
APPLICANT MAILING ADD S E-MAIL
�zzi 87711 L4c - 1 14l�DI�i�r5*./10C,
FAX
- - - +�{/e V /i_ 44 " 1 STAT ZIP �D`� - PRIMARY PRONE
PROJECT CONTACT $ ,�P fip 4 25.3` �q-5��,(,3
(The individual to receive and MAILING ADD s / /� E MAI '/ /� �-n/�
respond to all correspondence 32 u 1I 1/ (/t" f�t t 31)�'W''/
concerning this application) cgs . Wty
STA , ZIP FAX
Fq) f G+JPOZ3
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27095)
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 Iaws 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 a part of this application. /
SIGNATURE:�ALW.1. _ ' 216.4e A
IDATE(i -(7-(q
PRINT NAME: I
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application