07-106572CtkmmuCn'ty'Tf Faderil:ay
i* Developm t Services Mechanical Permit #: 07-106572-00-MF-
P.O. 8ox 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: LEE
Project Address: 30323 17TH AVE SW o Parcel Number: 005070 0010
Project Description: Gas fireplace insert L'
Owner
Applicant
Contractor
HWA LEE
AQUA REC'S INC
AQUA REC'S INC
30323 17TH AVE SW
1407 PUYALLUP AVE
AQUAR1*110RA (02/19/09)
FEDERAL WAY WA
TACOMA WA 98421
1407 PUYALLUP AVE
98023-3452
TACOMA WA 98421 J
Additional Permit inf 01,
or
Mechanical Valuation ................. ...........................3000 Over the Counter Permit? ........... * ........................... Yes
Mechanical'Fixtures
Fireplace Inserts ............................. 1
I hereby cerl
the occupa
Owner or agent:
PERMIT EXPIRES Monday, December 7, 2009
December 7, 2007
will
on
the construction on the above described property and
ws, rules and regulations of the State of Washington
Anrml %Aln%i
Date: —& 17- _�
. I
-A I
THIS CARD IS TO REMAIN ON -SITE ,
CITY OF' Community Development Inspection Recor* d
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 106572 -00 -ME
Owner: HWA LEE
Address: 30323 17TH AVE SW
FEDERAL WAY, WA 98023 -3452
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 '� Date /Z 1 (%
y7j
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CITY OF
Federal Way ,Ec 0 PERMIT
COMMUNHYDEVELOPMENT SERVICES
33325 8Tr AVENUE SOUTH • PO BOX 9718 r�
FEDERAL WAY. WA 98063 -97.I�/ APPLICATION
253 -835 -2607• FAX 253 -83b9` , `,4 o11v
www.citgoffederalwau.com B 1r
-0 4 - 14- 49 457 -1z
SF MF CO(E)EL PL DE EN FP
The following is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS 30-3Z 3 % 7 y`4 AVE FeM eA c- W'-r . Ldz& SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # _ _ — _ _ _ _ _ _ _ 9 8O Z'3 LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for lengthy legd descriptioN
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
C)AS 511ERA -LE tNAVI
PROJECT NAME (Name of Business or Owner Last Namel
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
LEE
PEOPLE INFORMATION
NAME
w4 -
PRIMARY PHONE
(%ow ) 0-0/ - c)?av
MAILING ADDRESS
CITY, STATE, ZIP
E -MAIL ADDRESS
305 Z 3 ( ,4+k A "CE Sw
fton
-
COMPANY NAME
Aft )A R-c2
APPLICANT NAME
OFFICE PHONE
(263) 68•L- - ML9Z
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
MAILING .CRESS
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUS S LIC NSE NUMBER
EXPIRATION DATE
FAX NUMBER
RELATIONSHIP TO PROJECT
FAX NUMBER
(W -S ) (01b I— - /"j/
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL ADDRESS
0462 Q l o AA
CrL- }, v 6
1 in^ e_,+Qug4eec • c a
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
v C
PHONE
(ZS3) - ntq Z
MAILING .CRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant Agent ❑ Other
NAME PRIMARY PHONE E -MAIL ADDRESS
Roc, (2 63 ) W2 - ! S 2 14PO - 4QUA -0 it - c
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 $.
PROPOSED USE
VALUE OF PROPOSED WORK
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHI,INE ❑ PRIVATE (SEPTIC)
y
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
SQ. FT.
TOTAL
S . FT.
BASEMENT
BASIC PLAN?
❑ YES
FIRST
CHANGE OF USE?
SECOND
c NO
c YES ❑ NO
THIRD
❑ YES
c NO
c YES c NO
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED?
c YES
c NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
ERiSTINO
PROPOSED
TOTAL
TOTAL MMTINO SF
TOTAL PROPOSED 9F
TOTAL SF
* *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.
AfECILANICAL '2"' -
Value of Mechanical Work $ 3i -004f- (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (or Tbb/Sho —r Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAYS (Bathroom Sinks)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (commeroiap
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS (Tone)
WASHING MACHINES
WOODSTOVES
MISC (Describe)
MISC (Describe)
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 support of this permit application is true and correct. I certify that I will comply with all applicable
City of Federal 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.
Ifurther agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys'fees incurred in the
investigation and defensW �tcl h claim), whic ay be made by any person, including the undersigned, and filed against the city, but only
where such claim arises e rel iance of a city, including its officers and employees, upon the accuracy of the information supplied to
the city as a part of this tion. /)
SIGNATURE:
c NEW c ADDITION
BUII.DING SHELL ONLY?
ZONING DESIGNATION
NEW ADDRESS REQUIRED?
PLATTED LOT?
1x--1 -cam
Agent
c ALTERATION
c REPAIR
❑ TENANT IMPROVEMENT
n YES n NO
BASIC PLAN?
❑ YES
c NO
CHANGE OF USE?
❑ YES
c NO
c YES ❑ NO
UP /SEPA /SU?
❑ YES
c NO
c YES c NO
DEMO PERMIT REQUIRED?
c YES
c NO
Bulletin #100 — August 16, 2007 Page 2 of 4 k\Handouts\Permit Application