07-105884{ � Z
M `ty of ityDeFederal
lopmentS Mechanical Permit #: 07 -105884 -00 -
`Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050,.>`
Project Name: VICTOR
Project Address: 31315 22ND AVE SW Parcel Number: 178980 0035
Project Description: Installing (2) gas pipe outlets for gas fireplace insertrange
Mechanical Valuation............................................1000
W� BE r
..................................... Yes
no f
-pe mi S��
Owner
A lic
Contractor
GARY & JUDI VICTOR
UTI
GA OLUTIONS INC
31315 22ND AVE SW
OW I 8T S
GA 966D5 (03-25-08)
FEDERAL WAY WA 98023-7800
W 9809
128TH PL SE
WA 98092
Mechanical Valuation............................................1000
W� BE r
..................................... Yes
no f
-pe mi S��
j THIS CARD IS TO REMAIN ON-SITE
C1W OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3950
PERMIT #: 07 -105884 -00 -ME
Owner: GARY & JUDI VICTOR
Address: 31315 22ND AVE SW
FEDERAL WAY, WA 98023-7800
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 mi spection 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 0�q By Date
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CRY of
Fhdafa y
oo� PERMIT
ODAONMTYDBVBLOPXWS&RVXW c� `3 Z SF MF CO�EL PL DE EN FP
99925dl•AV$M/BSOU1It.P3.9718 C�p �PLI CATI O N
FBDBRAL WA$ WA 9d069.971d
?59-d9b?607• PAX ?S9d95-?669
01,4 O �D�NG 0E?
The following is requiredormation - an incomplete application will not be accepted Please Print. legibly On ink) or type.
PROPERTY• •
SITE ADDRESS "-� 1 1-a SUITE/UN1T #
ASSESSOR'S TAR/PARCEL #
LEGAL DESCRIPTION (e g. Acme Estates, Lot 1)
PROJECT• •
TYPE OF PERMIT 17 BUILDING O PLUMBING . )kMECHANICAL
LOT SIZE (sj)
❑ DEMOLITION O ELECTRICAL O ENGINEERING ❑ _FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only
PROJECT. NAME (Name of Business or Oumer Last Name)
PROPERTY
OWNER
CONTRACTOR
le -
APPLICANT
PROJECT
CONTACT
LENDER
EX113TING USE
2`1 +-
PEOPLE INFORMATION
1 C_T-0Z
COMPANY AME
APPLICANT NAME
OFFICE PHONE
rA-S .pd..v no�5
1:6—tr
�T_((7 �. 7 - A14
MAILING &DDRESS
CYTYT$�CSIX
PHONE
JV
L563i2-
FAX NUMBER
-
Cr1Y OF FEDERAL WAY BU$INE39 LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
CONTRACTOR's REGISTRATION NUMBIR
Karil"TIONIVATM
E-MAILADDRESS
GessOslfs��.�
ata
GsssO.v1LQ^AQ
o
COMPANY S
APPLI NAME
OFFICE PHONE
rA-S .pd..v no�5
1:6—tr
�T_((7 �. 7 - A14
MAIWNO ADRESSI 21 Ir PL
CITY, STATE, ZIP �_j
ao_
• CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant Agent ❑ Other
_
NAME PRIMARY PHONE b -MAIL ADDRESS
&C -17\S 6(. $ - �Sso 10..
NAME
Per RCW 19.27.095:
Lender information is required (jproject value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP PHONE
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
VALUE OF PROPOSED WORK $_
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE ❑ TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDER 13 LAKEHAVEN o HIGHLINE o PRIVATE (SEPTIC)
C -%V. r.cT
PROJECT •••
AREAS
PROPOSED
SQ. FT.
TOTAL
80. FT.
AREA DESCRIPTION
.EXISTING
SQ. FT.
BASEMENT
a YES
o NO
ZONING DESIGNATION
FIRST
CHANGE OF USE?
a YES
a NO
SECOND
o YES o NO
UP/SEPA/SU?
a YES
nURD
PLATTED LOT?
a YES a NO
DEMO PERMIT REQUIRED?
ADDITIONAL FLOORS (DESCRIBE)
o NO.
DECK (O COVERED OR O UNCOVERED?)
GARAGE 0 CARPORT O
NUMBER OF FLOORS
m'T°'°
rsorosso
:or►r.
rorncs�rrorou
rorunroosss.r
ronasr
••NEW H02= ONLY".. NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $ C JD i (ACOP OF BIDOR ESTIIIIA INCLIIDF.D WITH APPLICATION)
AIR HANDLING UMTS EVAPORATIVE COOLERS Oq PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS �_ MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS (c..rd.q
COMPRESSORS FURNACESRANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
PLUJING} '
BATHTUBS (orT b/51w rcomb4 LAVS (B.ft. sb t.1 URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS irai q
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
1 cert fg under penalty of perfury that 1 am the property owner or authorized agent of the property owner. t cert(& that to the best of my
knowledge, the irnformation submitted in support of this permit application is true and corrscL I eerft 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 locat, state, or federal laws regulating construction or environmental laws.
I f urther agree to hold harmless a ttity of Federal Way as to any claim (including costs, expenses, and attorneys' Jess incurred in the
Investigation and defense of such el which may be made by any person, including the undersigned, and filed against the city, but only
where such claim arises out of the r i ce o the city, including its officers and employees, upon -the accuracy of the information supplied to
the city as a part of this application
SIGNATURE: DATE
Properly Owner and/or Authorized Agent
o NEW a ADDITION
a ALTERATION
a REPAIR a TENANT IMPROVEMENT
BUILDING SB'ELL ONLY?
o YES. a NO
BASIC PLAN? *
a YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
a NO
NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU?
a YES
a NO
PLATTED LOT?
a YES a NO
DEMO PERMIT REQUIRED?
o YES
o NO.
Bulletin #! 100 _ August 16, 2007 Page 2 of 4 . Mflandouts\Pennit Application