07-100961City of Federal Way
Community Development services
P.O. Box 971.8 ..
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Mechanical Permit #: 07- 100961 -00 -ME
Project Name: MORAN
Project Address: 29621 11TH PL S
Project Description: Installation of 12' of gas piping to new generator
Inspection Request Line: (253) 835 -3050
Parcel Number: 515160 0370
Owner
Applicant
Contractor
GEORGE & KATHY MORAN
KEN DELLSITE
GEORGE & KATHY MORAN
29621 11 TH PL S
PERFECT TEMP INC
29621 11 TH PL S
FEDERAL WAY WA 98003
1442 BRIDLE DR SE
FEDERAL WAY WA 98003
TUMWATER WA 98501
Additional Permit Information
Mechanical Valuation ................ ............................800 Over the Counter Permit? ...................................... Yes
Mechanical Fixtures'
GasPipes ....... ............................... 1
I her
the
Owner or agent:
31U,�
z-
THIS CARD IS TO REMAIN ON -SITE `
y 1
CITY OF
Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 100961 -00 -ME
Owner: GEORGE & KATHY MORAN
Address: 29621 11TH PL S
FEDERAL WAY, WA 98003 -3727
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 Date3- 2.. v By _ C-� Date 5 a ?.�
clrrop. CEIVED j V dC� iCLLa�L,
Federal PAM 1Ve
COMMUNITYDEVEIAPMB c {� `� Z SF MF CO E EL PL DE EN FP
333258WAVENU SOUTH 9 %2 2007 20d%
FEDERAL WAY, FAX 98063.9718 p p L I �• To
253- 835 -2607• FAX 253 835• ?609
WWI,,.dl d F FEDEFt�LWA � AL W /
UILDiNG DEPT. 0�p7 AY
The following s required ir{formation -an incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY •- •
SITE ADDRESS _ fv 1 (� f L s SUITE /UNIT #
ASSESSOR'S TAX/PARCEL # ^ - LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach- PC—Pa9efo►laVftIeawldesotp -0
PROJECT •' •
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING /MECHANICAL
0 DEMOLITION O ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Permit only)
1 oZ / d► � 7' 9.4 S �''�;,�y % � .r�' �d,1 A' e.v��a.To �--
0-P A AJ
PROJECT NAME (Name of Business or Owner Last Namel
PEOPLE •- •
PROPERTY
OWNER
CONTRACTOR
COPY of evd ragairod
with eS.h.wppllcatloa
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAM
PRIMARY PHONE
MAILING ADETRESS CITY, STATE, ZIP
E -MAIL ADDRESS
CO
,,_W�ANY NAME
(T�y fec f
APPLICANT NAME
De
OFFICE PHONE
MAILING ADDRESS
/ y z <'• " /� ' L"
CITY, STATE, ZIP
7 40. 9 r:<b
CELL PHONE
Teo Frio - �2
CITY OF FBDERAL WAY BU %SfNESS LICENSE NUMBER
FAX NUMBER
EXPIRATION DATE
FAX NUMBER
f�
CONTRACTOR'S REGISTRATION NUMBER
4°e /'J--e T�
EXPIRATION DATE
E -MAIL ADDRESS
COMP Y NAME
� r- 14,e e-T /Ic a i� aC,1/C .
APPLICANT NAME n
e-✓ .ill ��5.
OFFICE PHONE
(.?60)
MAILING ADDRESS
%7 �- a7Jt^- P 7 /V�. A✓�..�
CITY STATE, ZIP g /
11/f R�/i�� ! s�� '°1
CELL PHONE
-
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant o Agent ❑ Other
NAME PRIMARY PHONE E-MAIL ADDRESS
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $S,000
MAILING ADDRESS
CITY, STATE, ZIP
7HONE
) -
EXISTING ASSESSED /APPRAISED VALUE $+
SPRINKLERED BUILDING? D YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SERVICE PROVIDER ❑
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
• HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
• HIGHLINE ❑ PRIVATE (SEPTIC)
i%_
AREA DESCRIPTION
EXISTING
S ; FT:
PROPOSED
80. FT.
TOTAL
SO. FT.
BASEMENT
D ALTERATION
D REPAIR ❑ TENANT IMPROVEMENT.
FIRST
DYES ONO
BASIC PLAN?
SECOND
ONO
ZONING DESIGNATION
THIRD
CHANGE OF USE?
D YES
D NO
ADDITIONAL FLOORS (DESCRIBE)
❑ YES o NO
UP /SEPA /SU?
DECK (O COVERED OR O UNCOVERED ?)
D NO
PLATTED LOT?
D YES D NO
GARAGE Cl CARPORT 0 .
DEMO PERMIT REQUIRED?
D YES_
D NO
'
NUMBER OF FLOORS
L706TIna
PROPOS:D
TOTAL
r6rU A;9"7JVO er
TOTAL PROPOeRO or
TOTAL sr
" "NEW HOMES ONLY"* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of
Value of Mechanical
AIR HANDLING SU"
BBQS
BOILERS
COMPRESSORS
Du.CTS=
G ,
BATHTUBS (orTui /shower combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
be installed or relocated as. part of this project. Do not include existing fixtures to remain.
OPY OF BID
-OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
VAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
FANS GAS WATER HEATERS MISC (Describe)
FIREPLACE INSERTS HOODS (coaunerdaq
FURNACES RANGES
GAS LOG SETS REFRIG. SYSTEMS
LAVS (B.thr�,n sinks( URINALS MISC (Describe)
RAINWATER SYST VACUUM BREAKERS
SHOWERS WATER CLOSETS (Toileq
SINKS WASHING MACHINES
SUMPS
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 authorized 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 information supplied to the city as a part of
this application.
NAME /TITLE
r�
-zza -ate
. )aignuEurci
RELATIONSHIP TO PROJECT �Qwner ❑ Agent
• •�.
on � actor O Architect o Other
D NEW ❑ ADDITION
D ALTERATION
D REPAIR ❑ TENANT IMPROVEMENT.
BUILDING SHELL ONLY?
DYES ONO
BASIC PLAN?
D YES
ONO
ZONING DESIGNATION
CHANGE OF USE?
D YES
D NO
NEW ADDRESS REQUIRED?
❑ YES o NO
UP /SEPA /SU?
o YES
D NO
PLATTED LOT?
D YES D NO
DEMO PERMIT REQUIRED?
D YES_
D NO
r
Bulletin #100 — January 1, 2007 Page 2 of 4 MilandoutAPermit Application .