07-106298city of Federal Way
Community Deveiopment Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name:
Project Address:
Project Description:
Mechanical Permit #: 07- 10629$ -00 -M E
Inspection Request Line: (253).835 -3050
ADAMS
29810 24TH PL S Parcel Number: 768220 0150
Install gas log fireplace, gas range and associated gas pplhg in existing residence.
Owner
Applicant
Contractor
JEFFREY L ADAMS
NORDIC HEATING, INC.
NORDIC HEATING, INC.
M C ADAMS
P.O. BOX 2581
NORDIHI099BJ (1/9/08)
29810 24TH PL S
AUBURN WA 98021
P.O. BOX 2581
FEDERAL WAY WA
AUBURN WA 98021
98003 -4203
M
.� THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 106298 -00 -ME
Owner: JEFFREY L ADAMS
Address: 29810 24TH PL S
FEDERAL WAY, WA 98003 -4203
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 Bye,- Date b"l By G C�j Date // • 21 -p
For !!!!Rector reference only ___
O Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
i
an 0
Fa&iral W y PERMIT -�- - — --
COM111um"DEYBbOPIfEPSERMS SF MF CO �EL PL DE EN FP
s33?S0AY�sWl,>t,.Po9718 �,` i' °�°�; D,I CATI O N
rBDSRAL WAY, WA 9d063 -9718 1`10 Y 2 /
?59 d95 ?607• FAX ?S?d95 ?6d9
cl-fY OF F�DEnEAP.T
The following is required 4iW2 &n - an incomplete application will not be accepted. Please print, legibly (in ink,► or type.
SITE ADDRESS _ 1 U i'l t s
SUITE /UNIT 9
ASSESSOR'S TAX /PARCEL 9 LOT SIZE (Sp
J
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(dearAa�medPgpelor�hY�d�Ptlunl -
PRojECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING WMECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRZ PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Permit o i
—A'l� • `% 6w-S 1 a S_ 1 s � C� A Lots /Ww- /o
PROJECT. NAME (Name of Busin or Owner Last Namel
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
E PEOPLE INFORbIATION
NAME ' /
S .��^ �
PRIMARY PHONE
_
MAILING ADDRESS S
v .
, TE, ZIP
+o
E-M IL ADDRESS
CITY, STATE, ZIP
'(l1
ncoo
CO PAN NAME
`�,J
r
APPLICANT NAME
OFFICE PHONE
V�
CITY, STATE, ZIP
'(l1
(253 X13 = o a
I AD
3
, 8TATE, ZIP
C LL PHONE
i
_
OF FEDERAL
WAY BUSINESS LICENS MBER EXPIRATION ATE
FAX NUMBER
.� 00 10k. X_3b
CO 0 8
IST ON NU T[/O�N A
Q'
EMAIL ADDRESS
Y
/�
` v V
P NAME
APPLICANT NAME
OFFICE PHONE
Lender information is required {f project value exceeds $6,000 .
MAILING ADDRESS
CITY, STATE, ZIP
M-1 NG A RESS
ITY, TATE, 2IP
k
CELL HONE
-
RE IONSHIP 710 PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( _
NAME PRIMARY PHONE EMAIL ADDRESS
NAME
Per RCW 19.9.7.095:
Lender information is required {f project value exceeds $6,000 .
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
MATER SERVICE PROVIDER ❑ LAREHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 11 HIGHLINE ❑ PRIVATE (SEPTIC)
L
ROJECT FLOOR
AREA DESCRIPTION
BASEMENT
EXISTING
S . FT.
PROPOSED
80. FT.
TOTAL t
S . FT.
FIRST
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
SECOND
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (r.&q
THIRD .
SINKS
WASHING MACHINES
HOSE BIBBS
ADDITIONAL FLOORS (DESCRIBE)
a YES a NO
UP /SEPA /SU?
DECK (❑ COVERED OR ❑ UNCOVERED ?)
a NO
PLATTED LOT?
a YES o NO
GARAGE ❑ CARPORT ❑
DEMO PERMIT REQUIRED?
o YES
o NO.
NUMBER OF FLOORS
azurao
ra °egos°
mr'°
+°z ws�°s sr
rorar�eeMassDer
TWALEr
"NEW HOMES ONLY". NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of furture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
I Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS OAS PIPE OUTLE'T'S WOODSTOVES
BBQ9 FANS GAS WATER HEATERS M1SC (Describe)
BOILERS FIREPLACE INSERTS HOODS (co=acLq
COMPRESSORS FURNACES RANGES
DUCTS _�_ OAS LOO SETS REFRIG. SYSTEMS'
PLVIYIBINICN '
a ALTERATION
o REPAIR o TENANT IMPROVEMENT
BATHTUBS (orTub /Shomrcombo)
LAVS patbro msk*4
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (r.&q
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
a YES a NO
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 my
knowledge, the information submitted in =Wport of this permit application is true and correct. I eert(jy that I will comply with all applicable
City of Fedsral.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 farther agree to hold harmless the City of Pederai Way as to any claim (including costs, &Vw-es, and attorneys' fees incurred in the
investigation and defense of such clalrN, 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, upon -the accuracy of the information supplied to
the city as apart of this application. r
SIGNATURE:
Owner and /or
-zo -o7
a NEW o ADDITION
a ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES. a NO
BASIC PLAN?
a YES
o NO
ZONWG DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
a YES a NO
UP /SEPA /SU?
a YES
a NO
PLATTED LOT?
a YES o NO
DEMO PERMIT REQUIRED?
o YES
o NO.
Bulletin # I W _ August 16, 2007 Page 2 of 4 . MliandoutsTermit Application