07-106818� w
r City of Federal Way Mechanical Perlrn C: 07-106818-00-M t s
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609FIF
Project Name: HUNTER
Project Address: 29426 4TH AVE S Parcel Number: 186270 0110
Project Description: Installation of (1) log set, (1) gas insert into existing wood burning fireplace and replacing
(1) gas furnace.
Owner
MARY HUNTER
29426 4TH AVE S
FEDERAL WAY WA
98003
Applicant
BURIEN NATURAL GAS
153 SW 154TH ST
BURIEN WA 98166
Contractor
BURIEN NATURAL GAS
BURIENG0270D 8/19/09
153 SW 154TH ST
BURIEN WA 98166
Additional Permit Information
Mechanical Valuation ....... ......... ...................8842 Over the Counter Permit? ...................................... Yes
Mechanical Fixtures
Fireplace Inserts ............................. 1 Furnaces........... ........... 1 Gas Logs................,....................... 1
I hereby certify that I
the occupancy and
Owner or agent:
City of Federal Way.
)ove described property and
of the State)f Washington
Date: /I
THIS. CARD IS TO MAIN ON-SITE
CITY OF ommunity Developm t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -106818 -00 -ME
Owner: MARY HUNTER
Address: 29426 4TH AVE S
FEDERAL WAY, WA 98003-3666
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)
Approved
By Date
❑ Gas Piping (4125)
Approved to release test
By 01� Date ? i
❑ Final - Mechanical (4065)
Approved
By ALjDate 1—/mlo
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
Federal way PERMIT
COMWWnyDEVELOPMENTSERVICES SF MF CO EL PL DE EN FP
333FW AA . W 9°X pc 1 g 20APPLI CATI ON
253-835.2607• FAX 253-835-2609
CITY OF FEDERA WAY
The following is reed" KA - an incomplete application will not be accepted. Please print le9ib41 fin ink) or type.
ASSESSOR'S TAB/PARCEL N —� -K
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
f4ftwh separate pm- -f- Ierc^,l Wd dewrWi0fe
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING I1 MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul
PROJECT NAME (Name of Business or Oumer Last N ---j H a, yv �
PROPERTY
OWNER
CONTRACTOR
PROJECT
CONTACT
LENDER
EXISTINGUSE
NAM
APPLICANT NAME V
PRIMARY P OL( -
3�
MAILING
�AI�6IRE.SS
tZY:JC>'�
C . STATE. ZIPLj
E-MAIL AD
FAX NUMBER
COMPANY NAME
0 j C�
APPLICANT NAME V
OFFICE PHONE
aLSL
LL 4" A s
=,,, ` A20 sok,
cav(,� On
FAX NUMBER
WdLING ADDRESS (,,/ C Jp
S
C , STATE, ZIP / n (
/CELL PHONE
l C}^
v• L - VV-
nY OF FEDERAL WAY BUSINESS LICENSE NUMBERr1(
- l 63&� - o o
DN TE
Z 6
FAX NUMBER
COIYIRACTOW S RBrRWRATION
I EXPEtATION DATE
E-MAIL DRESS
13/
i= �0 I�
-
u.
s
C,QA4FANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY. STATE. ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
NAME PRIMARY PHONE E-MAILADDRFSS
NAME
PerRCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY. STATE. ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAHEHAVEN ❑ MGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAEEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
)w,
PROJECT FLOOR AREAS
AREA DESCRIPTION
E30BMG
FT.
PROPOSED
SO. FT.
TOTAL
SQ. FT.
BASEMENT
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
FIRST
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
❑ YES
SECOND
ZONING DESIGNATION
CHANGE OF USE?
THIRD
o NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP/SEPA/SU?
ADDITIONAL FLOORS (DESCRIBE)
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
DECK (❑ COVERED OR ❑ UNCOVERED?)
o NO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
�mrc
PROPOS®
7e1"'
rarer: csF
71 r I" -8F
rorecsF
"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 jbdures to remain.
MECHANICAL G
Value of Mechanical Work $ O 2 iA COPY OF BID OR ESTaNA7E MUST BE IlVCLUDED W1I73 APPLICATTOIVJ
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (or Mib/Shower combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
EVAPORATIVE COOLERS
TFANS
1 FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVS (Bathroom sinks)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (comme 1M
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS nouet)
WASHING MACHINES
WOODSTOVES
MISC (Describe)
MISC (Describe)
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I cert(jy that to the best 4f my
knowledge, the thf rrmatlon 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 authorised by the issuance 4f a permit. I understand that the issuance of this permit
does not remove the owner's responsibilityfo- compliance with local, state, orfederal laws regulating construction or environmental laws.
I further agree to hold harmless the City 4f 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 out of the reliance of the city, including its officers and employees, upon the accuracy 4f the information supplied to
the city as a p 4f t application. / G
SIGNATURE: l/ DATE /t� / D G
Property Owner and/or Authorized Agent
FOR OFFICE USE ONLY
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
❑ YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
❑ YES
o NO
Bulletin #100 - August 16, 2007 Page 2 of 4 k\Handouts\Permit Application