07-100100Cfty of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: RASHELL
Project Address: 515 SW 332ND CT
Project Description: Installation of gas log line
Mechanical Permit #: 07- 100100 -00 -ME
Inspection Request Line: (253) 835 -3050
Parcel Number: 729801 0150
. him
Owner
Applicant
Contractor
RONALD & ROSEMARY RASHELL
RONALD & ROSEMARY RASHELL
RONALD & ROSEMARY RASHELL
515 SW 332ND CT
515 SW 332ND CT
515 SW 332ND CT
FEDERAL WAY WA 98023 -6169
FEDERAL WAY WA 98023 -6169
FEDERAL WAY WA 98023 -6169
Additional Permit Information
Mechanical Valuation ................ ............................897 Over the Counter Permit? ...................................... Yes
THIS CARD IS TO REMAIN ON -SITE
CITIY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 100100 -00 -ME
Owner: RONALD & ROSEMARY RASHELL
Address: 515 SW 332ND CT
FEDERAL WAY, WA 98023 -6169
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 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
By Date By Date Zak By Date -�
�,y�Fecera�.way �•y��r IVEQ PERMIT
" 333€t J�W DQB JOUTH O Bt- �
FEDEPAL WAY, WA 98063_91718
,253.835.2 607• -FAX 253-8 35.21 60 9 J AN d 8 2A PP J I
C AT I O N
www.dIWffedrralwaa.com
SF MF CO
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The following is L*?P -VFiFMff*Ab V" incomplete application will not be accepted. Please print legibly (in inkj or type.
PROPERTY INFORMATION
SITE ADDRESS G c�� r ZZ1 SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # LOT: SIZE (sp
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) 1,e',"-77 C)
ideaeh - Pa —PWfw kMft legal d..ipdm )
PROJECT •- •
TYPE OF PERMIT ❑ BUILDING 1EAUMBING MECHANICAL
O DEMOLITION O ELECTRICAL ❑ ENGINEERING ❑, FIRE PREVENTION SYSTEM
PROJECT DESCRIIPTION (Provide detailed description of work included on this permit only)
PROJECT NAME (Name of Business or Owner Last Name1
PEOPLE •- •
PROPERTY
OWNER
CONTRA R
JJW
COPY of ev -gafre
wNL eye app
APPLICANT
PROJECT
CONTACT
LENDER
NAME
PRIMARY PHONE
7 s �°
_-
_ -2
MAILING ADDRESS
CI ,STAT 1
-E-MAIL ADDRESS
FAX NUMBER
Al NO A DR SS 6
( _
CITY STAT$, IP \
CELL PHONE
"COMPANY NAME
v
A CANT NAME _
OFFI E PHONE
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
Al NO A DR SS 6
( _
CITY STAT$, IP \
CELL PHONE
ITY F FED L WAY BUSIN SS LICENSE
UMB R EXPIRATION DATE
FAX NUMBER
CONTRACTORS REGISTRATION NUMBER
EXPIRATION DATE
E- MAILADDRESS
COMPANY NAM
APPLICA T NAME
OFFICE PHONE -
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( _
NAME PRIMARY PHONE EMAIL ADDRESS
NAME
Per RCW 19,27.095:
Lender Worfnation is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE O TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN O HIGHLINE ❑ .PRIVATE (SEPTIC) •
Indicate number of each type of fvdure to be installed or relocated as part of this project. Do• not include existing fixtures to remain.
Value of Mechanical Work $
(A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (commercisi)
COMPRESSORS
FURNACES
RANGES
DDCTga .. .,
GAS LOG SETS
EMS
EFRIG. SYSTEMS
,.. ..i'.
UP /SEPA /SU?
BATHTUBS (or Tub /Shover Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAVS (Bathroom sinks)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
URINALS MISC (Describe)
VACUUM BREAKERS
WATER CLOSETS jioaet)
WASHING MACHINES
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorised by the owner of the above premises to perform the work for which the permit application is made. 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 flied against the City of Federal Way, but only where such claim
arises out of the reliance of the city, Including Its officers and employees, upon the accuracy of the irtformation supplied to the city as apart of
this application.
NAME /TITLE - - DATE
(Si ature) (Title) '
RELATIONSHIP TO PROJECT t_kbWner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
o NEW ❑ ADDITION
o ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT.
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
❑ YES o NO
UP /SEPA /SU?
o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED?
Cl YES
o NO
Bulletin #100 — January l; 2007 Page 2 of 4 k\Handouts\Permit Application