07-106528City of Federal Way
Cbminunity Development 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 #: 07-106528-00-ME
MONSON
32600 1ST AVE S Unit 226
Installation of gas piping to fireplace insert.
Inspection Request Line: (253) 835 -3050
Parcel Number: 169730 1250
Owner
Applicant
Contractor
RITA R MONSON
KLIEMANN BROTHERS HTG & A/C IN
KLIEMANN BROTHERS HTG & A/C IN
32618 2ND PL S #226
4703 116TH ST E
kliembh02lbt (1/27/08)
FEDERAL WAY WA
TACOMA WA 98446
4703 116TH ST E
98003 -5780
TACOMA WA 98446
Z�--
Additional Permit Information
Mechanical Valuation ................ ............................735 Over the Counter Permit? ...................................... Yes
'Mechanical Fixtures
Gas Pik O utlets ............................. 1
CONDITIONS:
PL South
PERMIT EXPIRES Saturday, December 5, 2009
Permit Issued on Wednesday, December 5, 2007
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: (�� / Date:
N
THIS CARD IS TO REMAIN ON -SITE
r
CITY OF ` Community Development Inspection Re'cor'd
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 106528 -00 -ME
Owner: RITA R MONSON
Address: 32600 1ST AVE S Unit 226
FEDERAL WAY, WA 98003 -5700
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 By g:= CO3 Date „ p
For inspector reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
i° CITY of .. • ''%
Federal Way RECEIVED PERMIT
COMMUNITY DEVELOPMENT. SERVICES
339 25 D AVENUE SOUTH . BOX 9718
FEDERAL WAY, FAX 98063-9718 -260 } 0 APPLICATION
253 - 835 -2607• FAX 253 -835 -2609 t,J L C 5
_nrt:,•. df.��etiercaaatt.txm
.0-`? - 106- ?I K—
SF MF COC9 EL PL DE EN FP
TD
The following is fQ0yrQFihA0iiR EitYi incomplete application will not be accepted. Please print legibly (in ink) or type.
DI III r\ihlh r1crl'r
SITE ADDRESS /�,n, SUITE /UNIT #
op
ASSESSOR'S TAX /PARCEL # L (P - LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page /or lengthy legal description)
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING "ECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION.(Provide d ailed description of work included on this permit onlul
PROJECT NAME (Name of Business or Owner Last Name) �\ \ �V '4
PEOPLE •- •
PROPERTY
OWNER .
CONTRACTOR
COPY of card requlred
with each application
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PRIMARY PHONE
('�s )$ - r , Z
MAILING ADDRESS
CITY, STATE, ZIP
E -MAIL ADDRESS
OMPANY NAME
APPLICANT NAME -
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
1 03 I-1.
CITY, STATE, ZIP
T c- ,C_ONI Pc •
CELL PHONE
-
CITY� FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
C/ O( NTRACTTO^ RS REGISTRATION (NUMB `ER
EXPIRATION DATE
E -MAIL ADDRESS
COMPANY ME
APPLICANT NAME -
OFFICE PHONE
CITY, STATE, ZIP
PHONE
MAILING (A/-•D��DRESS
V V/A"��
CITY,�SaTATE, ZIP
a
CELL PHONE
-
RELATIONSHIP TO PROJECT -
❑ Architect ❑ Tenant ❑ Agent VQther
FAX.NUMBER
NAME PRIMARY PHONE E -MAIL ADDRESS
( ) - SCA ID
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER ❑ LAKEHAVEN,
PROPOSED USE
V -ALUE OF PROPOSED WORK $
N SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
ET HIGHLINE �� TACOMA ❑ PRIVATE (WELL)
❑ HIGHLINE ❑PRIVATE (SEPTIC)
ar:�ri uma� rurIIva
EXISTING
5 . FT.
PROPOSED
SQ. FT.
TOTA
S . FT.
BASEMENT '
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
FIRST
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS goacq
.SECOND
SINKS
WASHING MACHINES
HOSE BIBBS
THIRD
CHANGE OF USE?
o YES
ADDITIONAL FLOORS (DESCRIBE)
NEW ADDRESS REQUIRED?
o YES o NO
DECK (0 COVERED OR ❑ UNCOVERED ?)
o YES
o NO
PLATTED LOT?
GARAGE ❑ CARPORT ❑
DEMO PERMIT REQUIRED?
d YES
NUMBER OF FLOORS
O
rROrOSeo
TOTAL
TOTAL rarsmro sr
Ton+c rROrosco Sr
TOTAL St
"NEW HOMES ONLY"* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part 'of this project: Do not include existing fixtures to remain
MECHAAWAL
Value of Mechanical Work $__7L S tp Q (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WVH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS . FANS GAS WATER. HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS (commarclaq
COMPRESSORS FURNACES- RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
UMBING
BATHTUBS (or Tub /Shower combo)
LAV.S (Bathroom Sinks(
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS goacq
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
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 filed 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.
/ nn
NAME /TITLE
DATE
PROJECT ❑ Owner O Agent Contractor ❑ Architect o Other
Bulletin #100 —April 2, 2007 . Page 2 of k \Handouts \Permit Application
o NEW o ADDITION
o ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO.
BASIC PLAN?
D YES
n NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU?
o YES
o NO
PLATTED LOT?
o YES a NO
DEMO PERMIT REQUIRED?
d YES
o NO
Bulletin #100 —April 2, 2007 . Page 2 of k \Handouts \Permit Application