10-101781 .
� Mechanical
City of Federai Way A �AC
CommunityDevelopmentServices PerlYllt �: 1 0-1 01 781 �oo�l�lG
P.O.Box 9718
Federal Way,WA 98063-9718 �, Ins ection Re uest Line: 253 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 y. R� y� p q � �
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Project Name: GITOME "'�`"�' �
Project Address: 28620 14TH AVE S Parcel Number: 720300 0410
Project Description: Emergency repair/relocation of gas meter.
Owner Aoolicant Contractor
MBURU&MARGARET GTI'OME PILCHUCK CONTRACTORS INC PILCHUCK CONTRACTORS INC
28620 14TH AVE S PO BOX 808 PILCHCIlO1MA(02/20/1 I)
FEDERAL WAY WA 98003-3157 BOTHELL WA 98041-0808 PO BOX 808
BOTHELL WA 98041-0808
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Mechanical Valuation............................................1000 Is this an Online or O.T.C.application?.................Yes
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PERMIT EXPIRES Saturday, October 30, 2010
Permit Issued on Monday, May 3, 2010
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 accardance with the laws, rules and regulations of the'State of Washington
and the City of Federal Way.
Owner or agent: ��� �_ Date: �� " �C�
F'IN � �/! �
� THIS CARD IS TO REMAIN ON-SITE �
arr oF ������� ' � �
Federal Wa � Construction In�ction Record
y INSPECTION REQLTESTS: 253 83�3050
� )
PERMIT#: 10-101781-00-ME Address: 28620 14TH AVE S
Owner: MBURU & MARGARET GITOME FEDERAL WAY, WA 98003-3157
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections aze 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.
� Mechanical Rough-in(4165) � Gas Piping(4125) � Final-Mechanical(4065)
Approved Approved to release test Approved
i
By Date By '� Date /" f,� By �`� Date /
� so� -�e� ��.
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P
eY L e� 5��
� Rough Electrical � Final Electrical � Right of Way
Approved Approved Approved
By Date By Date By Date
. ,_ � . _� �L - � f��L
�..,,}::::::::.:.:.:::::::: �ERMIT
�'�������� ; QF C ME PL DE EN FP
rrJ2�'R'.�f��7•E��S;�R35-2609ES APPLICATIOI�RE�E��� � � ��,�3
i!•U:I��;;ill'f•i;l:_rf^rJ_Il':ly:Cr�r1 � . �
-- - MAY 0 � ;��;����,
SITE ADDRE3S �'ITE/UNIT 8
Z ! ��°��S CI1"Y �� FE�ERA�. W
�ROJECT VALUATION ZONINCi ASSESSOR'S TAX/PARCEL N
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TYPE OF PERMIT �B�LDING ❑ PLIIMBING �MECHAIQICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/HomeownerLast NameJ
PROJECT DESCRIPTION �����
Detailed description of work to
be included on this permit oniy
K� PRIMARY PHOPE
PROPERTY OWNER - � � ��
�G ADDREBS ��� . . E-MAIL
CITY STATE 2IP .
� �
x PHONE
�L C��
�°aDXgs E_�.
CONTRACTOR
C1TY STATE ZIP FAX
I v�.�-h D G�- �'1$O
WA STATE COFTRACTOR'S LICENSE! E7�IRAT20N DATE FEDERAL WAY BIISIlYESS LICLNSE N
/LC�I CI �6i MA 7 � �/Z
F�BE t/ t,�dc� ��LE�vGl� p7 r �d5--b S-'6 $�
APPLICANT �cs enaasss E-ntau.
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PROJECT CONTACT
� FA� P80lfE
/The individual to receive and "���� ' L�`3 �d�``�6�j
respond to all correspondence �G ADDRE33 E.�,
concerning this applicationJ /�C/ 7g
CITY STATE 2IP FAX '
'�r.-�L lano t� �'i O
ALTERFATE COHTACT HAME:� PHOFE E-MAO.
PROJECT FINANCING p�
� OWNER-FINANCED
Required value of.$5,000 or more
(RCW 1927.095J AIAILIIYQ ADDRESS,CI1R,3TA1E,Z1P PHOPL �
I certify under penaLty of per,/ttry that I am the property owner or authortzed agent of the property owner.I certtfy that to the 6est
of my knowledge, the tnformatton su6mitted in support ojthis permit application is true and correct. I certify that I wifl comply wfth
aIl applicable Clty of Federal Way regec[attoru pertaining to the work authorized by the issuance of a permtt. I understand that the
issuance of this permit does not remove the owner's responsibiifty for complQance with locai, state, or federal iarua reguiattng
constrrcction or en.rrironmental[aws. __ _ _ ----_ ---
I further agne to hoid harmleas the City of Federal Way as to any ciaim(including costs,expensea, and attorntys'fees tncurred in
the investigation and defense of such clairr�, which may be made by any person, inciudtng the unders{gned, and jiled agatnst the ctiy,
6ut on[y where such claim arises out of the reiiance of the city, including its ofj3cers and empioyees, upon the accuracy of the
ir4/'ormation supplied to the city a part of this appitcation.
SIGNATURE`=�+E/�`"� DATE J '`j /�
PRINT NAME: � ✓�
Bulletin#100—April 14,2010 Page 1 of 3 k:�Handouts�Pernrit Application
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V.wuE oF MEcxaIVICAL Wo1¢8 .� � ��� (a copy of bid or estimate must be providedJ
Indicate how neany of each type of fixture to be installed or relocated as part of this project. Do not incLude existing fixtures to remain.
AIR HANDLING iJNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE tNSERTS HOODS�commerc���
BOILERS FURNACES HOT WATER TANKS�c��
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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Indicate how many of each type of fixture to be tnstaIled or reiocated as part of this project. Do not include exist"vi.g fixtures to remain.
BATHTUBS(or�b/show�rcombo) LAVS�gends7nl�) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS�x�ahca/utility� WATER HEATERS(�c�tac�
SUMPS WASHING MACHINES �?;;E;:;E?1�`�.':��:;i;;i;;;?:;:�:;^
HOSE BIBBS ��:`�'�::`"'`:
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CRiTICAL AREAS ON PROPERTY?. WATER PURVEYOR SEWER PIIRVEYOR VALUE OF EIQSTIIYG IAtPRDVE�NTS
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E]QSTIIY6/PREVIODS IISE LOT SIZE(In Square Feet) F.2Q51'IDiG FIRE SPRDYR.LR SYS1'EM? PROPOSED FIRE SIIPPRE83ION SYS1'EM?
❑Yes ❑ No ❑ Yes ❑ No
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AREA DE3CRIPTION(ia square feet) EXISTING PROPOSED TOTAL FOR OFFICE IISE
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=7QSTA0 PROYOSSD TOTAL �
Area Totats
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ESTIMATED SELLING PRICE$ # OF BEDROOMS
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AREA DESCRIPTION �ea Occupancy Group�s� �nstructioa #of Additional Infozmatioa
in S uaze Feet e 3tories
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AREA DESCRIPTION �ea Occupancy Group(s) Constructioa #of Additional Iaformation
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