08-103407City of Federal Way
Community Development Services
PO Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) B35.2609
Project Name: WOJNICZ
Project Address: 2301 S 304TH ST
Mechanical Permit #: 08-103407-00-M E
Inspection Request Line: (253) 835-3050
Parcel Number: 053700 0135
Project Description: Installation of (1) gas pipe outlet and gas piping to run from meter to basement
Owner
Applicant
Contractor
BOB & DEBORAH WOJNICZ
BOB & DEBORAH WOJNICZ
BOB & DEBORAH WOJNICZ
2301 S 304TH ST
2301 S 304TH ST
2301 S 304TH ST
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Additional Permit Information
Mechanical Valuation ..................................... :...... 200 Is this an Online or O.T.C. application?................ Yes
Mechanical Fixtures
Gas Piping................... ................... 1 Gas Pipe Outlets........................... 1
PERMIT EXPIRES Sunday, January 11, 2009
Permit Issued on Tuesday, July 15, 2008
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: � — -- f— Date: d IU 10?
_ -_
THIS CARD IS TO REMAIN ON -SITE
CITY OF 1 %-;ommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 08-103407-00-ME
Owner: BOB & DEBORAH WOJNICZ
Address: 2301 S 304TH ST
FEDERAL WAY, WA 98003-4872
This card is part of your required inspection documents. 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. Ongoing 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
By Date By Date By `� Date X 1310
For inspector reference only �T
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
Fe d�eral W r-
aRECE VE�ERMIT
F�
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33395 80 VENVE
iksdertelm•aPO
BOX 97I8
FEDERAL WAY, WA 98U5971 15 253T8t3576X885-2609 J " L APPLICATION
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SF MF C ME L PL DE EN FP
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The foliowinylY -[ it iKta,1VarI'ih84fete application will not be accepted. Please print legibly (in ink) or type.
r PROPERTYINFORMATIONf
XSITE ADDRESS .-, Z 3 0 I 30 -!�t _ h2* C' fscl 1 GLo '0003 SUITE/UNIT i1 —
ASSESSOR'S TAX/PARCEL # o- 0 ( 3 S I( z
— LOT SIZE (s�
X
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for Ieng ft legal descriptfaN
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed desea'iption of work irtc(uded on
6AA 5Eeli�tr f, AfE7,-2 t14 1,eJ 4,/ ASc rn3 Z
i J —1-D
r
RON.) 6 q3 'OI1?� r /Ul, /V1PIfae I/V,-T7 h>fiSC/i?cN7- is I?Uyt 1i
(-IT-a gs �, e 60-f . - - -
PROJECT NAME (Name of Business r er Last Name] ` - 0'�K N i C ? _
PROPERTY
OWNER
x CONTRACTOR
<APPLICANT
PROJECT
CONTACT
LENDER
to IA
EXISTING USE
NAME PRIMARY PHO &
�o� i,J o�N(c��z�.D. - oSzb
MAILING ADDRESS CITY, STATE, ZIP E-MAIL ADDRESS
COMPANY NA )
APPLICANT NAME
/OFFICE PHONE
MAILING ADDI $
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REOIOTRATION NUMBER EXPrRATION DATE
E-MAIL ADDRESS
COMPANY NA APPLICANT NAME
OFFICE PHONE
MAILING ADDR&W CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
( ) -
NAME PRIMARY PHONE E MAILADDRESS
4� OE N(C 20�,(- (ZL3 (<el �F,cyusn�IL G�
NAME
Per RCW 19.27.095:
Lender ir{%rmation is required ffprofect value exceeds of 5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
m.&IL:f AiviLum L Al if i•Qrlt(f j OrJ f � fflj+yr l k:Wu�' '� pp, �;' ` � We
Value of Mechanical Work ' Z V O (A COPY OP BID OR ESTIMATE MUST BE INCLUDED WITHAPPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLER 1
GAS PIPE OUTLETS
WOODSTOVES
BBQS
FANS
�
GAS WATER HEATER MISC.(Describe)
BOILERS
FIREPLACE INSERTS
HOODS p atmordq
�'[ $',P/N� • ,
COMPRESSORS
DUCTS
FURNACES
RANGES -
,�.p
-6 kw
GAS LOG SETS
REFRIG. SYSTEMS
rl-44? r "l j+-
J 1, I11 `I /-cA^,
PLUMBING
BATHTUBS (orTub/shower combo)
LAVS (BathroomBhdW
URINALS
MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS rmt q
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
I cart(& under penalty of perjury that I am the property owner Or authorized agent of the property owner. I certM that to the best of my
knowledge, the Wormation submitted in support 4f this permit application is true and carrect. I cert(/y 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 reaponsibility for compliance with local, state, ar federaI Iaws regulating construction or environmental taws.
I further agree to hold harmless the City of Federal Way as to any claim (including casts, expanses, and attorneys' fees incurred in the
investigation and dQjenae of such claim), which may be made by any person, including the undersigned, and filed against the city, but only
when such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the Warmation supplied to
the city as apartothis application,
SIGNATURE:
❑ NEW o ADDITION
BUILDING SHELL ONLY?
ZONING DESIGNATION
NEW ADDRESS REQUIRED?
PLATTED LOT?
'3 t- _ DATE 41 I S v a
Pro and/or Authorized Agent
❑ ALTERATION a REPAIR o TENANT IMPROVEMENT
DYES o NO BASIC PLAN? a YES o NO
CHANGE OF USE?
o YES o NO UP/SEPA/SUP
o YES o NO DEMO PERMIT RE
o YES ❑ NO
o YES a NO
o YES o NO
Bulletin #100 —January 1, 2008 Page 2 of 4 MandoutsTermit Application