11-104460 MeOW*a1
City of Federal Way Permit #: 11-104460-00-ME
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p Q
Project Name: STOCKMAN FILL
Project Address: 5142 SW 311TH PL Parcel Number: 321020 0160
Project Description: Remove/replace existing boiler and install gas piping and outlets
Owner Anolicant Contractor
SUSAN STOCKMAN REYNOLDS CUSTOM PLUMBING LLC REYN s DS CUSTOM PLUMBING LLC
PO BOX 24645 12621 230TH ST E REYNOCP972B1(2/3/13)
FEDERAL WAY WA 98023 GRAHAM WA 98338 12621 230TH ST E
GRAHAM WA 98338
> t eL a.,, y .J,.sr y' 'i, % ,4 ., ,3L • S. •
•
Mechanical Valuation 90001 nline or O.T.C.application? Yes
rLi..t+:. £. ,j"t.•, .v •ij�.t^$`.'.y;i• �, , * .. n..: 'w:'# s ns''x .. ,. 74i`ra; -
Boilers 1 Gas Piping •1 1 Gas Pipe Outlets 1
PERMIT EXPIR- =0 nesday, May 2, 2012
Permit Issued ay, Nove -r 4, 2011
I hereby certify that the above information is correc =nd that the constr ,. ion on the above described property and
the occupancy and the use will be in accordant- ith the law regulations of the State of Washington
and - City of Fed- I A - .
Owner or agent: w r Date: ) / — I
11.
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THIS CARD IS TO REMAIN ON-SITE `
CITY rF ""� Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 11-104460-00-ME Address: 5142 SW 311TH PL
Project: SUSAN STOCKMAN FEDERAL WAY, WA 98023-2029
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) El Gas Piping(4125) ` ❑ Final-Mechanical(4065)
Approved Approved to release test vte-p,.(iApproved
By Date By r�� Date 11-9-.ii By Date
•
El Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
s I I - ( 0 4 4W
CITY OF ERMIT
Federal Way • MF C•410 PL DE EN FP
COMMUNITY DEVELOPMENWectde PLICATION
253-835-2607•FAX 253-8
wwwrLt o egeralwall ,,�,
(�
SITS ADDRESS D�lz P� SUITE/UNIT#
%1.‘t-191V531 - fPcACcPROJECT VALONING ASSESSOR'S TA7C/PARCEL#
r-D - — —
❑ BUILDING 0 PLUMBING \IA MECHANICAL
TYPE OF PERMIT
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
/
PROJECT DESCRIPTION "5�� ta'�`�c' %i n"' O I G.-/Q S 'PI P(n)6 s s 7 & 'fl I it /)
Detailed description of work to 1�i=�G�A c:C=T--t�—���T ("
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER L -7)-it) `IL f A
MAILING ADDRESS E-MAIL
rk-Fz 5, ii ✓� ��
CITY STATE ZIP
FED C-r2.40 ` (-Zqw i
NAME PHONE
►�- 'Yn)c�4-0< i�.<,Tr>m l�C Co-(' a P mgr Z5 � L1 Z Z1
MAILING ADDRESS E-MAIL
CONTRACTOR f Z� 2 1 7 3 r 5=7" c�s
CITY STATE ZIP FAX
( -RSH i
WA STATE CONTRACTOR'S LICENSE II EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE II
REY,a0c r CI ,-)3 l / I
NAME PHONE
MAILING ADDRESS E-MAIL
APPLICANT r�rS r�J_d3 Cr
CITY STATE ZIP FAX
PROJECT CONTACT NAME PHONE
(The individual to receive and IJ t ry% I 'T r3 b L 0
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) .S ' i -- •
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME ❑
OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 city as a part of this application.
SIGNATURE: a DATE / 1 ` 1
PRINT NAME:t;<:% h''t T") . (�-Z-ni L r
Bulletin#100-January I,2011 Page 1 of 3 k:\[-iandouts\Permit Application
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VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS / GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commeraaq
I BOILERS FURNACES HOT WATER TANKS(cas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING / GAS PIPING WOODSTOVES
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utihty) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES LtdL` 17QRP<S st• 1.
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR(or Mobile Home)
COVERED ENTRY _---_
--
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c . ro.x•4ii.,. yam . Y:-r '"• .''',1144
--- --------'
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GARAGE 0 CARPORT 0
• ig $ «4l•:•••,+''''.';‘•;,:s'>'„l,,7 f,.:." .- < • : .< .;
=STING PROPOS=D TOTAL
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
u .. <'Y,. 4 ..c - .�,. , )- ( 1 <Jy,t'l `i 1.5,
Area Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
in 'uare Feet Aye Stories
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ADDITION
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AREA DESCRIPTION Area Occupancy Group(s) Construction of Additional Information
in -.uare Feet ` .e Stories
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TENANT AREA ONLY
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Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application