12-102092 ` IPMechanical
City of Federal Way
Community&Econ.Dev.Services Permit #: 12-102092-00-M E
Feder3aW5a8ythWAS8
003 ""'' "� Inspection(253)835-2607 Fax (253)835-2609iL ' Ipec
tion Request Line: (253)835-3050
Project Name: LITTLE
Project Address: 32347 10TH AVE S Parcel Number: 150240 0490
Project Description: Relocation of gas meter.
Owner Applicant Contractor
CHARLENE LITTLE INFRASOURCE CONSTRUCTION LLC INFRASOURCE CONSTRUCTION LLC
32347 10TH AVE S 8001 S 212TH ST INFRACL899CZ(2/14/13)
FEDERAL WAY WA 98003 KENT WA 98032 8001 S 212TH ST
KENT WA 98032
•
Additional Permit Information
Mechanical Valuation 1000 Is this an Online or O.T.C.application Yes
Mechanical Fixtures
Gas Piping 1
PERMIT EXPIRES Wednesday, November 7, 2012
Permit Issued on Friday, May 11,2012
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
d the City Federal Way.
Owner or agent: �,._ , ��� i Date:
FINKLOSI .
THIS CARD IS TO MAIN ON-SITE
CITY OF
• Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-102092-00-ME Address: 32347 10TH AVE S
Project: CHARLENE LITTLE FEDERAL WAY, WA 98003-5925
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) ❑ Final-Mechanical(4065)
Approved Approved to release test d/�/e5/ Approved
By Date • By Date �'-f/ /2 By,' Date.7" yz
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
anoFA PERMIT • MF CO ED
PL DE EN FP
Federal Way
\le*
COMMUNITY DEVELO + p PLICATION
253-835-2607•F 3
Unuu..rrtyoffed lVICEe
SITE ADDRESS Q� '� SUITE/UNIT#
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PROJECT GOON ZONING ASSESSOR'S TAX/PARCEL#
f00a00 l5Q q o - o 1
TYPE OF PERMIT 0 BUILDING 0 PLUMBING PMFCHANICAL
0 DEMOLITION , 0 ENGINEERING /❑ FIRE PREVENTION
NAME OF PROJECT AKZe/(Tenant Name/Homeowner Last Name) �
PROJECT DESCRIPTION
�� G G.4- T--o"1 OP- 6,--44 S /17e-- -7-6":2___
Detailed description of work to
be included on this permit only
i
NAME / A // PRIMARY PHONE
PROPERTY OWNER // i i /.
MAILING ADDRESS E-MAIL
,,,/.34/7 /a des S .
ATE I7��eIA, ST�k ZIP `
NAME PHONE
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MAILINGLIADDRESS / E-MAIL /'
CONTRACTOR t/✓3T30 jro^re �Gft/ a/?1t-7' L2?C-,o4/ti/
CIT`<.i� STATE ZIP q'ef/33 FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
_T-A/FAA G1,8`19 CZ— / /
NAME �f PHONE
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APPLICANT MAILING ADDRESS/ E-MAIL
Seri'2 6— /9 S ..eArl-4.4e-g)X(
CITYISTATE ZIP FAX
I I(
PROJECT CONTACT NAME P�H�O-N7E
(The individual to receive and y .��, x /�''�'�0 � Z ��S -76C�i'��
respond to all correspondence MAILING ADD E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAILez44.Qy,44,c:•InJ/.\47e
' PSC-. Cffi-p7
PROJECT FINANCING NAME O
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: _--G--fig/ DATE $ �
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PRINT NAME: ( G O y /2`2 S!/�},.`!/�
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK $ 11/ 0 (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture te installed or relocated as part of this project. Do not include exis g fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHE� r be)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES ,„ a " i
_ ' s r ff seri d
... ,-- �✓F�9 E� i 2- ) �P i 3 S .fit' ,t }
CRITICAL AREAS ON PROPERTY? W TER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZ (In Square Feet) EXISTING FIRE SPRINKLER -'STEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ • ❑Yes ❑ No
1 } i`"
AREA DESCRIPTION(in square feet) ELTING PROPOSED]' TOTAL FOR OFFICE USE
u
FIRST FLOOR(or Mobile Home)
COVERED ENTRY
F : Pon L 3 ; Axa ��v�, <"k :. _ �„, —...__ _._.._�—_.—_..—._—_—._.__.__ •____._—..__..—._._..—_
gr if
GARAGE 0 CARPORT 0
E7[IS7IR0 PROPOSED
TOTAL\ ----_—_._.._---_....._.__.._._.._...__..._.._..._._._._.__..—_
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
AREA DESCRIPTION ea Occupancy Group(s) Construction of Additional Information
in S.uare Feet .e Stories
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ADDITION
AREA DESCRIPTION Area Occupancy Groupie) Construction #of Additional Information
in S.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