22-100005City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 635-2609
"71
Project Name: WILLIAMS
Project Address: 30519 5TH AVE SW
Project Description: REPLACING EXISTING GAS FURNACE
Mechanical
Permit #:22-100005-00-ME
Inspection Request Line: (253) 835-3050
Parcel Number: 178890 0200
Owner
Applicant
Contractor
SIMON WILLIAMS
SUSAN DUNHAMBLACK HILLS INC
BLACK HILLS INC (GENERAL)
30519 5TH AVE SW
1003 85TH AVE SE UNIT A
BLACKHI066JL (7/19/23)
FEDERAL WAY WA 98023
OLYMPIA WA 98501
1003 85TH AVE SE UNIT A
USA
OLYMPIA WA 98501-5706
Additional Permit Information
Mechanical Work Valuation? .................................. 6000 Is this an Online or O.T.C. application?.................. Yes
Mechanical Fixtures
Furnaces 1
PERMIT EXPIRES Saturday, 2 July, 2022
Permit Issued on Monday, January 3, 2022
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: fete-
r� j
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CITY OF
Federal Way
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 22 100005 00 Address: 30519 5TH AVE SW
Project: KARLEY A WILLIAMS FEDERAL WAY WA 98023-3914
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) Q Gas Piping (4125) 0 Final - Mechanical (4065)
Approved Approved to release test Approved M1
By Date By Date By Date sV�
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date