08-100727 --' City of Federal Way Mechanical Permi t• 08-100727-00-ME
ornmunity Development Services •
P. .
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: KELLY
Project Address: 30005 8TH PL LI S Parcel Number: 514980 0070
Project Description: Add gas piping for gas cooktop.
•
Owner Applicant Contractor
MICHAEL&ROBERTA KELLY MICHAEL&ROBERTA KELLY MICHAEL&ROBERTA KELLY
30005 8TH PL S 30005 8TH PL S 30005 8TH PL S
FEDERAL WAY WA 98003-3746 FEDERAL WAY WA 98003-3746 FEDERAL WAY WA 98003-3746
Additional Permit Information
Mechanical Valuation 485 Over the Counter Permit? Yes
Mechanical Fixtures
Gas Piping 1
PERMIT EXPIRES Sunday, February 14, 2010
Ohl
Permit sued on Thursday, February 14, 2008
vmoVo
I hereby oertifYthat4he,,above info atton, ec t t o const tri mon the move red pro
the occuOency and the i e will b in ac r ce h t a": `d relation cf the ofWashington
end the i e€terl a�
Owner or agent: .�C ''d Date: / '/6 z IP
FINALED
•
THIS CARD IS TOAIN ON-SITE
CITY OF Developmit me t Ins ection Record
Federal WayIVR INSPECTION REQUEST PHONE# (253) 835-3050
PERMIT #: 08-100727-00-ME
Owner: MICHAEL & ROBERTA KELLY
Address: 30005 8TH PL S
FEDERAL WAY, WA 98003-3746
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) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
•
By Date By s,doDate05-, s.c B Date
•
•
For inspector reference only _
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
ai ECEI ED - loo 7-
Y PERMIT SF MF C' L PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES FEB 14 2008
33325 811(AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 p ,�AT I ON To
953-835-9607•FAX 953-835.9609 ,--,,,r7
F F
pww.dtuof-edemhoauef
The following is required Infor>kaa-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
INFORMATION
-�iSITE ADDRESS 300 0 5 1 h /0/ Sa f',9-fa/vrGiU/'V'1
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 5 / ( ( go 007b 910o3
LOT SIZE(sJ
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach=fangs Page ibr lengthdllegaldesaiPtiorq
IN PROJECT INFORMATION,
TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL r 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide de d description of work included on this •-rmit o _
—1> =fir,y — it 1 z-- Got ' A2/-/
PROJECT NAME(Name of Business or Owner Last Name) //G%Iif7i•M
• PEOPLE INFORMATION
PROPERTY NAME . PRIMARY PH NE
-----11"-----11" OWNER /467/.rg /t / (Z52)� / -S77/
MAILING ADDRESS / CITY,STATE,ZIP poo E-MAIL ADDRESS
5°0,05 ?'`"'�/. So Fe-,ler,/Gvaxf r/fl
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
eW/7z /' ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
APPLICANT COMP NAME APPLICANT NAME OFFICE PHONE
( ) -
MA1L O ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant 0 Agent 0 Other ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ( ) -
LENDER NAME Per RCW 19.27.095:
Lender Information is required if project value exceeds$5,000
MAI c DDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING T_Ni ORMATION
EXISTING USE IIIIIPI PROPOSED USE
EXISTING ASSESSED/APPRAISED -' VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE$c' •RESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ■ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 P'1 E(SEPTIC)
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE) •
DECK(0 COVERED OR 0 UNCOVERED?)
•
GARAGE 0 CARPORT 0
•
NUMBER OF FLOORS PRAMS= TOTAL TOTAL=SENO Sr —.." TOTAL PROPOSED sr Tom SP
•
""NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
MI FIXTURES
..jadicatenumber of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL . ...
Value of Mechanical Wor 7 (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
RHANDLING UNITS EVAPORATIVE COOLERS 1 GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS — FIREPLACE INSERTS , HOODS(Commeid.q
COMPRESSORS FURNACES RANGES ' •
DUCTS. • GAS LOG SETS REFRIG.SYSTEMS
PLUMBING •
BATHTUBS(orTtb/shower Combo) LAVS(B.threom ssuo URINALS MISC(Describe)
• DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS froaeq •
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
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SIGNATURE •
I cert{fy under penalty of perjury that I am the property owner or authorised 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.
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,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 p of this application.
SIGNAT //I: 7 ���Z04.09
Property Owner and/ r Authorized Agent /
DATE /
a NEW a ADDITION . a ALTERATION a REPAIR a.TENANT IMPROVEMENT
,
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? • a.YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? a YES o NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application