13-105554 •
• Mechanical
City of Federal Way
Community&Econ.Dev.Services Permit #: 13-105554-00-ME
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: MALCOM
Project Address: 31702 4TH AVE S Parcel Number: 794180 0050
Project Description: Installation of a new gs fireplace insert
Owner Applicant Contractor
PAT MALCOM PAT MALCOM ADVANCED INSTALLATIONS INC
ALLAN MALCOM 31702 4TH AVE S ADVANII033DU(3/13/14)
31702 4TH AVE S FEDERAL WAY WA 98003 16504 HWY 99 SUITE 101
FEDERAL WAY WA 98003 LYNNWOOD WA 98037
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
Mechanical Fixtures
Fireplace Inserts 1
PERMIT EXPIRES Wednesday, June 11, 2014
Permit Issued on Friday, December 13, 2013
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: ���x� Date: 42 /3 O/�
THIS CARD IS TO MAIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-105554-00-ME Address: 31702 4TH AVE S
Project: PAT MALCOM FEDERAL WAY, WA 98003-5235
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) CI Gas Piping(4125) ❑ Final-Mechanical (4065)
Approved Approved to release test Approved
By 14.x.. Date ` .g,,t ,By C..\rs�- Date t _‘ - 1 , 'By c:_•, `-+ Date ; .0g. _ 1
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
, • RECEIVE ,ERMITtPPLICATION
CITY OF
Federal Way DEC 13 2013
42`O
/ CITY OF FED RAL WAY
PERMIT NUMBER ( .5 _ / 0 5 S C _
ffl -6-
t 1 J TARGET DATE
SITE ADDRESSSUITE/UNIT#
. I 4. e s , ____
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ a5 -
TYPE OF PERMIT
0 BUILDING 0 PLUMBING 0 MECHANICAL ❑ DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT •.��- -�I�_��� � _ - 'PROJECT DESCRIPTION � �� (�t t2GG��-c Qi-t� � /-cf_e_ieLla l�Ytd -
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER fi((a ,GZ
MAILING ADDRESS E-MAIL
3(102. 4,117 Ave S . 2
iit e
CaY STATE ZIB
Fodenti 4y-
NPHONE /-,. 7
�.�z//c • ( S 112.5 "-i 11 /
MAIILIING ADDR /!, / E-MAIL
CONTRACTOR ` 6.,t c /- ?/C� Sg /0 I
CIT (1 STATE ZIP FAX
/ n bdA 51031
WA ATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ADN" N r :' 0.3 _I) l/. / / Q I O'i -7.fl
NAME NE
5 7/ / f
I PRIMARY P -L w `.�Q
%9'11
APPLICANT MAILING ADDRESS/f/C/ E-MAIL
0-2- w1e Cve C i� /t:U- e
CITSTZIP1
NAME �G ,/ / PRIMARY PHONE
PROJECT CONTACT / '/'L /�CQ4 60x2 J.: 0ji40,,9��
...(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME / OWNER-FINANCED
PROJECT FINANCING � �
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP - PHONE
(RCW 19.27.095)
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.
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..;t..as ..ft of this application.
SIG R -.----1";:.. ���0�_�4�r724✓ DATE /2.-/
PRINT NAME: PAT- Ai A L-(SIJ irl
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
• •
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION
Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2013 Page 2 of 3 k:iHandouts\Permit Application