07-104861City 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: DOCKSTADER
Project Address: 32648 39TH PL SW
dp , a
Mechanical Permit #: 07- 104861 -00 -ME
Inspection Request Line: (253) 835 -3050
Parcel Number: 873195 1630
Project Description: Installation of approximately 50 -feet of gas piping and a gas log set for existing residence.
Owner
Applicant
Contractor
ROBERT DOCKSTADER
GLENDALE HEATING & A/C
GLENDALE HEATING & A/C
BEVERLY DOCKSTADER
12462 DES MOINES WAY S
GLENDHA053Q2 11/2/07
SEATTLE WA 98168 -2266
12462 DES MOINES WAY S
SEATTLE WA 98168 -2266
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„ Addi #b l:ermllt Information
Mechanical Valuation ................. ...........................2095 Over the Counter Permit? ...................................... Yes
NiecfianaCal,Eixtulres
Gas Logs ......... ............................... 1 Gas Piping................
PERMIT EXPIRES Saturday, September 5, 2009
Permit Issued on Wednesday, September 5, 2007
1 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
a the City of Federal Way.
Owner or agent: Date: i�
THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104861 -00 -ME
Owner: ROBERT DOCKSTADER
Address: 32648 39TH PL SW -
FEDERAL WAY, WA 98023 -2648
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.
0 Mechanical Rough -in (4165) 0 Gas Piping (4125) Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date ! By /)7;?5 Date
For inspector reference on
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
cniror
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Federal Way SEP 2W 5 2
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3332 NUE5 0UfN• o ,0ESAL WAvPE RM IT
F=RuwnY, wa mm-9 JS SU 18 0F 1)`4G APPLICATIO
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253- 835.260 7• FAX 25335 -2608
www.cituofledera(way. o
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The following is required igformation - an incomplete application will not be accepted. Please print Iegligy (in ink) or type.
ASSESSOR'S TAX/PARCEL # 1 � -L � �— - __L (f2— j 5 () � LOT SIZE (sl
LEGAL DESCRIPTION (e.g. Acme Estates, Lot I) 1, i Ai : L l--fAA
ed-h ~kr> >vwa-- y
PROJEcT INFORMATION
TYPE OF PERMIT 0 BDILDDVG 0 PLUMBING 040'CHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGIFINE MG 0 FIRE PREVENTION SYSTEM
PROJECT DESCRDITION (Provide detailed description of work included on fts hermit onto)
PROPERTY
OWNER
CONTRACTOR
00pr of cud mqub,"
C=J
PROJECT
CONTACT
LENDER
EXISTING USE
PEOPLE INFORMATION
NAME
p
PR[MARY PHONE
F
V L v. � r
) B - 0 l
MAILING D
S A7E,
E ADDRESS
V A
COMPANY NAME
p
APPLICANT NAME
OFFICE PHONE�
CYIY. STATE, ZIP
_ 7
RELAMONSHIP TO PROJECT
❑ Architect o Tenant n Agent o Other
FAX NUMBER
D� t
C ,�T
tom`" ONE
v
-
CYIY O FEDERAL W{A %Y B SINE5S LICI ISSE NUMBER
EXPIRMON DATE
FAX NUMBER
V
CONTRACTOR'S REGISTRATION NUMBER
�L1 IN .d `C5
EXPIRATION DATE
II -ovo1
E -MAO. ADDRESS
COMPANY NAME ' (
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CYIY. STATE, ZIP
CELL PHONE
(
RELAMONSHIP TO PROJECT
❑ Architect o Tenant n Agent o Other
FAX NUMBER
NAME n PRIMARY PHON i E-MAM ADDRESS
0 v ( ) -
NAME
rprRCW .19.29.096:
Lender fgfornu Wan is required tf project value ezoeeds $6.000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPR]NKLERED BUILDING? 0 YES 0 NO Fmz SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHL110 0 TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN rI FIIGHLINE ❑ PRIVATE (SEPTIC)
9 PROJECT FLOOR
AREA DESCRIPTION
AREAS
ZXISTING
FT.
PROPOSED
$9. FT.
TOTAL
so. FT.
BASEMENT
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
FIRST
BUILDING SHELL ONLY? DYES ❑ NO
BASIC PLAN?
SECOND
o NO
ZONING DESIGNATION
THIRD
CHANGE OF USE?
❑ YES
o NO
ADDITIONAL FLOORS (DESCRIBE)
UP /SEPA/SU?
❑ YES
DECK (❑ COVERED OR ❑ UNCOVERED ?)
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
GARAGE ❑ CARPORT ❑
o NO
NUMBER OF FLOORS
103"M
raorasao
?MAL
70MMOM Or
IMAL saroeeow
70M Or
• "NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of ftxture to be installed or relocated as part of this project Do not include existhV j lures to remain.
V of Ml echanical Work $ iG� M �y (A CQPY OF BID OR ESITMATE MUST BE INCLUDED WIIH APPLICAITOM
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSCOVES
BB(QS FANS GAS WATER HEATERS MISC (Describe)
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (-Tab /Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELLSCCTTRIC WATER HEATERS
HOSE BIBBS
FIREPLACE INSERTS
FURNACES
GAS LOG SECS
LAVS (Bathroom Sink.)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
HOODS (Commerdaq
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS rr.&o
WASHING MACHINES
MISC (Describe)
I certV9 under penalty gf pedjury that the friformation,furnlshed 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 Wag as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and drjense of
such cl aim), which may be made by any person, including the undersigned, and jtled against the City of F ederal Way, but only where such claim
arises out of the r eligna of the city, including its g0iows and employees, upon the accuracy of the irtforneation supplied to the city as apart of
this application. \
NAME /TITLE
RELATIONSHIP TO PROJECT o Owner o Agent
o Architect o Other
FOR OFFICE USE ONLY
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? DYES ❑ NO
BASIC PLAN?
❑ YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
o NO
NEW ADDRESS REQUIRED? ❑ YES o NO
UP /SEPA/SU?
❑ YES
o NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
a YES
o NO
EN ED
SEP 0 5
r,JTY OF FEDERAL WAY
UIILDING DEPT.
Bulletin 11100 - April 2, 2007 Page 2 of 4 MHandoutsTermit Application