18-105359 Mechanical
cam,„; ryeral Way, , . Permit #:18-105359-00-ME
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: ANDERSON
Project Address: 31332 13TH AVE S Parcel Number:787520 0035
Project Description: Extending a gas line to the new room.
Owner Applicant Contractor
JENNIFER ANDERSON JENNIFER ANDERSON OWNER IS CONTRACTOR
31332 13TH AVE S 31332 13TH AVE S
FEDERAL WAY WA 98003-5313 FEDERAL WAY WA 98003-5313
Additional Permit Information
Mechanical Work Valuation 500 Is this an Online or O.T.C.application Yes
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Gas Piping 1
PERMIT EXPIRES Wednesday,8 May,2019
Permit Issued on Friday,November 9,2018
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
Washingtonand the City of Federal Way.
i
Owner or agent: R eA�C 2 rv�!_rct ('�7 Date:
_
r
(/1G
THIS CARD IS TO REMAIN ON-SITE
""'°' Construction Inspection Record
FeueraI way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 18 105359 00 Address: 31332 13TH AVE S
Project: JENNIFER ANDERSON FEDERAL WAY WA 98003-5313
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.
Q Mechanical Rough-in(4165) � Gas Piping(4125) •0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By G ii,) Date , .2
Rough Electrical 0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
` RECEIVED
PERMIT APPLICATION
CITY OF �.� NOV 0 9 2018 PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
CITY OF FEDERAL WAY
COMMUNfTY DEVELOPMENT
PERMIT NUMBER -1 "Q - J 0 � � ,..s. sY /)�/ 0 TARGET DATE
SITE ADDRESS SUITE/UNIT#
3133a 13'= APC, S reallw k/h- 93
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL i
TYPE OF PERMIT Dall ti
° k❑ PLUMBING ED MECHANICAL 0 DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT a5 -ii 1W i
�,��PROJECT DESCRIPTION1r
Detailed description of work to QX 4-evl�l 1 KQ_ Cs (EAS I, .rtL - 11A-e- ✓L.e t,) fOl51�
be included on this permit only O Q 111
NAME (� PRIMARY PHONE
PROPERTY OWNER �e on; ,ht,s� _25 3 -XI -0'7)(o
MAILING ADDRESS E-MAIL /44145/,
313,3 2 ►3 - S . , ( , , . . .
CITrZIP
�: i✓W�� y_ 14/ fq
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
/ /
PRIMARY PHONE
NAME_.
'I - Alb' sovi 4;5'3 - c 0) -07) S!
APPLICANT- MAILING ADDRESS E-MAIL
3 13c 13-- Ate, s
CI STATE ZIP FAX
__ w y WA- 9 -
NAMEr n A -.-- PRIMARY PHONE
PROJECT CONTACT l etin i IAC 1 f[ t S CA/\-
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
-
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 0 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 ci • a part of this application.
ili
O A�1)
SIGNATURE• DATE
P )
PRINT NAM . 'ii. & t AU LA
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application