19-101521City or Federal Way
Community Development Dep4
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: ROLINSKI
Project Address: 31508 8TH AVE S
Mechanical
Permit #:19-101521-00-ME
Inspection Request Line: (253) 835-3050
Parcel Number: 858800 0185
Project Description: Installation of tankless water heater and gas piping to HWT and line for future barbeque,
fireplace and cook stove.
Owner
Applicant
Contractor
AARON ROLINSKI
FEDERAL WAY FURNACE REPAIR AND
FEDERAL WAY FURNACE REPAIR AND
31508 8TH AVE S
CLEANING
CLEANING
FEDERAL WAY WA
10523 8TH ST E UNIT 5
FEDERWF832QB (11/2/19)
98003-5303
EDGEWOOD WA 98372
10523 8TH ST E UNIT 5
EDGEWOOD WA 98372
Additional Permit Information
Mechanical Work Valuation? ..... ---- ...... ........ I... 3500 Is this an Online or O.T.C. application? ......... I........ Yes
Mechanical istu
Gas Piping i Gas Pipe outlets Hot Water Tanks 1
PERMIT EXPIRE t ay, 28 Septern'19
Permit Issued onday, Ap ' , +i0T9
I hereby certify that the above informa correct and tha4opee"deral
cnstruction on the above described property
and the occupancy and the use will b in accordance wilaws, rules and regulations of the State of
Washington and the City Way.
Owner or agent: �!72 Date:
V
r�
c,rr OF
Federal Way
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 19 101521 00 Address: 31508 8TH AVE S
Project: AARON ROLINSKI FEDERAL WAY WA 98003-5303
Scheduled inspections may be failed if this card is not on -site. DO NOT LASE 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) ❑ Gas Piping (4125) Q Final - Mechanical (4065)
Approved 1 a pproved to release test Approved
By Date By anp� Date 9. a5 • a,b By Date
Rough Electrical
❑
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
g C C E`V E D
1% PERMIT APPLICATION
tirr vr Fir
Federal 'L�lay +� qr Way, WA 98003-6325
V pM tri PERMIT 3,s 5-2 oR + FAX 233325 53 35-2609 + permi cen1h Avenue South + terc@cityoflederalway.cQm
�QMMI}N4T•{ DEVtwLQ
PERMIT NUMBER �`r/ p� _ Y
TARGET DATE
SITE ADDRESS
PROJECT VALUATION ZONING
SUITE/UNIT #
ASSESSOR'S TAX/PARCEL #
G .. c s—
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING N,
MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT / o / / VS't/
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
""� le"/V rN
j MAILING ADDRESS T
9/5-v'R
PROPERTY OWNER
CITE^ /
I �UUf L�i(� fr
NAME I r
y ,
MAILING ADDRESS
—
0-A 5 ✓ OS
CONTRACTOR
CITY
e ) v
WA STATE CONTRACTOR'S LICENSE #
-- _ -
NAME 1
7KR'C fir
MAILING ADDRESS
APPLICANT
CITY
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
PROJECT FINANCING
When value is $5,000 or more
(RCW 1927.095)
NAME Of v/ d S 9j, o f
MAILING ADDRESS
CITY
NAME
MAILING ADDRESS, CITY, STATE, ZIP
rs f,G
STATE ZIP
Lv/s,
STATE ZIP
9,S �? 72
EXPIRATION DATE
STATE ZIP
STATE I ZIP
PRIMARY PHONE
_;,7 o 6 ^.; 4/ -
E-MAIL
Q d. J^ DIil(�D %h CC If, D M
PHONE
15`3-S7,�(•-4I65—
E-MAIL
f^"VfU/%C�i4CC
FAX
FEDERAL WAY BUSINESS LICENSE #
PRIMARY PHONE
E-MAIL
FAX
PRIMARY PHONE
E-MAIL
FAX
❑ OWNER -FINANCED
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 any knowledge, the information subinitted 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, tepon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE: .. DATElL'
PRINT NAME: 0,-AA UX_
Bulletin #100 - January 29, 2016 Page 1 of 2 UIIandouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
$ 3 Soo
Indicate haw of each type o
re to be installed or relocated as pail of this ra' ct. Do not include existing res to remain.
AIR HANDLING UNITS
FANS �_
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
BOILERS
FURNACES _L
HOT WATER TANKS (cas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
PLUMBING PERMIT $,"---
--- .. ........
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing uctures to remain.
BATHTUBS (or Tub/shm-rCombo) LAYS (Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS (Mtehen/Ut ity) WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
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
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals
EXISTING
PROPOSED
TOTAL
**NEW HOMES
OISY**
ESTIMATED SELLING PRICE $
F-OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJEOT AREA ONLY
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application