18-102658 A
Mechanical
City ofFederal way Permit #:18-102658-00-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: NGUYEN
Project Address: 290 2ND PL SW Parcel Number: 119600 3760
Project Description: Relocate existing gas meter.
•
Owner Applicant Contractor
MINH NGUYEN COREY ALEXANDERINFRASOURCE INFRASOURCE SERVICES LLC
29520 2ND PL SW SERVICES LLC INFRASL871C2(2/22/19)
FEDERAL WAY WA 13330 STONE AVE N
SEATTLE WA 98133 14103 STEWART RD
SUMNER WA 98390
•
Additional Permit Information CI
Mechanical Work Valuation 1000 Is this an Online C. • cation Yes
,1
1'W
PERMIT EXPIRE > > 5 D cera ,2018
Permit sued is i 1 . ,ay,June cel
8
•
I hereby certify that the above informati I - • and that the ction on the above described property
and the occupancy and the use will bei a • ance ' the , rules and regulations of the State of
•W •• d the Ci , Federal Way.
Owner or agent: ,V Date: `y
I •
a e
t* �V
` + THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
F@del'�1 /c'a�/ INSPECTION REQUESTS:(253)835-3050
PERMIT#: 18 102658 00 Address: 2420 2ND PL SW
Project: MINH NGUYEN FEDERAL WAY WA 98023
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 t / Approved
By Date S Dat 19).`By Date
•
0 Rough Electrical E Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date `By Date
DECEIVED„,„___4_, PERMIT APPLICATION
CITY OF
Federal `n, JUN 18 L^010 V PERMIT CENTER+ 33325 8th Avenue South + Federal Way,WA 98003-6325
Way 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
CITY OF FEDEFAL.WAY
COMMUNITY DEVELOPMENT kVA-
PERMIT NUMBER l g — 1 0 - ( s C‘ - 14 C TARGET DATE I—'A-
SITE ADDRESS SUITE/UNIT#
Z CIa0 Zti0 PtSvi,/
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ I1WC). 0U 1 l g 0 o 0 - 3 7 G o
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING ECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT I v r�„ u y�'�h t\-1
1 NJ �'1:. / �(
PROJECT DESCRIPTION `J` l� 1 `I '” 1 w 1
Detailed description of work to R LS F D3'/ 0 F -r t-r c'- Ciz i-S t - /C`rC=f--
be included on this permit only
NAME PRIMARY PHONE
N
PROPERTY OWNER N(710 ye w 4 1- VIA/it
SS
Z L95-2O
�2 O zi O I�L S t E-MAIL
NAME PHONE
_.RI PI-I W `/ STATE
W A ZIP
) q so V 3
N r lSett gt.t.' 111&ILItZCCS I,LC. Ye5'-s16-q
MAILING'ADDRESS ` E-MAIL �,.r
CONTRACTOR QJ 0 3 ,Sre i 6ocr /� c(Le-1Kct.'r�(DC ie px+.c_cle
M til tN�f SIA�^f ZI�V 3?6 FAX
WA STATE C TRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NN `/l� �K�M c- K PRIMARY=s7(,-(13 eft
APPLICANT MAILING ADDRESS �, E-MAIL
/41x,3 src et 4-x-i
CI STATE ZIP FAX
Of/VC'K t e)/4- x93 76
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NA A i ('1< PRIMARY PHONE
PROJECT CONTACT `/..—��) �/4>-'/��' K
(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 19.27095)
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 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 t reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to . ty as a p.
of/' application./
SIGNATURE: s..., .1
DATE / 645
/-
PRINT NAME: 6--y ' —';(--.4f Pc/ ��
Bulletin#100—January 29,2016 Page 1 of 2 k:U-Handouts\Permit Application