15-101199 •
1VYechanical
City Community&Federal
�� Permit #: 15-101199-00-ME
33325 8th Ave S
Federal VVay,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: BENSON
Project Address: 1324 SW 353RD ST Parcel Number: 502860 0960
Project Description: Replacing gas hot water heater and installing a recirculating pump.
Owner Applicant Contractor
SURANG M BENSON DAVID H BENSON OWNER IS CONTRACTOR
DAVID H BENSON 1324 SW 353RD ST
1324 SW 353RD ST FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Mechanical Fixtures
Hot Water Tanks. 1
PERMIT EXPIRES Monday, September 7, 2015
Permit Issued on Wednesday, March 11, 2015
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 2) C% r/! ? J. !-5_2,..- Date: 3 //1 /.00 kr
r LED
INA
THIS CARD IS TO MAIN ON-SITE ,
4111&'
Federal Way Construction In ection Record
INSPECTION REQ TS: (253)835-3050
PERMIT#: 15-101199-00-ME Address: 1324 SW 353RD ST
Project: SURANG M BENSON FEDERAL WAY, WA 98023-6948
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 Mechanical Rough-in(4165) - -0 Gas Piping(4125) El Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date
Date 3 q:tS♦
0 Rough Electrical El Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
IweverkEllvveD
CITY OF PERMITtPPLICATION
Federal Way 10 2015
,R
vC1102015
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LWAY
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PERMIT NUMBER ,5--
_ CC / 7
nE- /04
, _
TARGET DATE
SITE ADDRESS SUITE/UNIT#
/ 3 a L/ ., id, 3s 3 ro/ Srf- ke,`-t' -r,E1., Wcy�� ?
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# /
$ �, � � � ,3"--64a CD - d Ce (a0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 12MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT ...e.,r 4�n� /„,tte kV�-l1/QAC'/C rt) /7(71' G/rC4- �[%1rs----"
o 4.4 .Z/h.s t L44..I) /2&r' /�C W4LC ,-UU74 d 4'-c d 'f0
PROJECT DESCRIPTION f J �''
Detailed description of work to rt, c.1... wc-` 4f" Ckc1 t--) -¢.,4,.-- d'.•- �v ` �/4t J t j/��,> c1,,J
be included on this permit only CI, n rret .T e ii C tet.,3^c rc-,- ea -Co--- a ���J y
etc
NAME n PRIMARY PHONE
PROPERTY OWNER cav,rd teLe u 3,,,, 2sz - 374— 7,77 Z
MAILING ADDRESS,+ E-MAH,
/3 21/ ,i. I 3 1,7 rJ d{-4,4,4— 6r44a.,c t2 24 a._
CITY / ,� STATE ZIP p ' e�AME jC( V"!Z l' �1/trig_ 9(J o C,k3 Coc {x c c, 4-t xts--
7 PHONE
z Li)4/..� 4..s 0 lel/fin
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME ("‘ PRIMARY PHONE
PROJECT CONTACT V C li f / ge,,,,J Cui
(The individual to receive and MAILING ADD,1S E-MAIL� " /—
respond to all correspondence / 3 2 7 �`' ��3 ✓� r�� 6E-e40
t 2 Cc�.0 �6M��/
concerning this application) clp 1 STAT ZIP FAX
Cieatet WCf vV4 . lfcf e2
NAME
PROJECT FINANCING 0 OWNER-FINANCED
Required value of$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 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 tototthe city as a partyof this application.
SIGNATURE: pCJ Si /Y, 4DATE ‘2/o /ad i
PRINT NAME: ° a we' d iTd. j d2,/t!c(0/'%
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application