06-104516 +
` City of Federal Way •
Community Development Services Mechanical Permi : 06-104516-00- VIE
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: BELMOR PARK SPACE 212
Project Address: 2101 S 324TH ST Space 212 Parcel Number: 162104 9037
Project Description: NEW- installation of gas piping from meter to manufactured home.
,
Owner Applicant Contractor
BELMOR HOLDINGS LTD RESCUE ROOTER
1571 BELLEVUE AVE SUITE 210 RESCURL037R9(01/01/2008)
WEST VANCOUVER BC 8001 S 222ND ST
CANADA
WA
Additional Permit Information
Mechanical Valuation 1255 Over the Counter Permit? Yes
Mechanical Fixtures
Gas Piping 1
PERMIT EXPIRES Monday, March 5, 2007
Permit Issued on Wednesday, September 6, 2006
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use 4will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. `/r
Owner or agent: /' Date: ,Jr 6 " 6 C
THIS CARD IS TO MAIN ON-SITE
ommuni Develo m nt Inspection Record
CITY OF t3' p p
Federal Way IVR INSPECTION REQUEST PHONEP# (253) 835-3050
PERMIT#: 06-104516-00-ME
Owner:
Address: 2101 S 324TH ST Space 212
FEDERAL WAY, WA 98003
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) LiGas Piping(4125) ❑ Final -Mechanical(4065)
Approved + Approved to release test Approved
'
By Date Bye , Date ,
�� f: ,- By Date
i
%
OryoF ( 7'RECEIVED
Federal Way PERMIT — 0
SF MF CO dIE EL PL DE EN FP
t COMMUNITY DEVELOPMENTSERV!CES :" 0 6 20UF
33325 8TH AVENUE SOUTH•PO BOX 9718
FEDERAL WAY, 533-9718 A p p L I C A T I O N TD
253-835-2607•FAX
253-835-2609 OF FEDERAL /
mitt)cituo(fedemhoaa.cnm f
BUILDING DEPT,
The following is required i ormation-an roto •lete a••lication will not be acce•ted. Please print legibly in ink)or type.
■ PROPERTY INFORMATION
SITE ADDRESS 7-I 0 / S. 32-Li Spa e.L (•Z SUITE/UNIT# I -
ASSESSOR'S TAX/PARCEL# ( C9 Z I , . y - ® ( LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION ,;,,,
TYPE OF PERMIT 0 BUILDING 0 PLUMBING .MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
i , .00k up . 04•S tinn Au -v r (a;ti 11 s P;l f,�� N4it.- k»b;to h:=
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PROJECT NAME(Name of Business or Owner Last Name) nK +1�
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PEOPLE INFORMATION
PROPERTY NAMT6r, PRIMARY PHONE
OWNER J (,�•cf 1"�• --.k I ( ) _
MAILING ADDRESS CITY,STATE,ZIP
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CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 2
MAILING ARDRESS CITY,STATE,ZIP CELL PHONE
pc ,f x 19 ( 25-3) rc Y‘ _y vS 7
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
I Gl- 9 -1 C:: S: Z 1 y -B L f 2- / 5, /L ( ) -
Cr�ONTRACTORS required
REGISTRATION NUMBER(copy of card with each application) EXPIRATION DATE
rC E S C Lt E * _6 _7 !�, r / t- / /c s.
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
CC ri •tv Qf of ( ) _
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT ( )
FAX NUMBER
0 Architect ❑ Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT I NAME PRIMAP`r PHONEE-MAIL ADDRESS
S (� 444,27-1 al F t (2�)) �`Sb q"3 ) I r3i2uC�MA i<'ri.,1z,-. z. 1
LENDER NAME
GA,AT%; NCT
MAILING ADDRESS CITY,STATE,ZIPPHONE
I ( )
■ ;DETAILED,BUILDING INFORMATION`
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ •
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
S
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) ✓r
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL y < , S:=S, '(: •e2S'xt'
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLIN PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $ 1 Z‹7
EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
AIR HANDLING UNITS
BBQS FANS HOODS(Commvcisl) p WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES 1 '' MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS er7i�;JtCti od f J Styck)
DUCTS GAS PIPE OUTLETS crN m 644.he..
PLUMBINGMISC(Describe)
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(roles)
DISHWASHERS SINKS \\ _ DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS ` -_ RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ''- ELECTRIC WATER HEATERS
. ,:. .: , ...... DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 c ),whichbe made by any person
including
,and filed against the
ay,but only where such
m
arises oaut of the rel as ce of the city, including,
c uding� the
its officers employees,upon City upon the accuracy of theinformation supplied to the city as a partiof
this application.
NAME/TITLE giq t d V i� 4 C c k N,(1 c`i' DATE
(Signa re) (Title)
RELATIONSHIP TO PROJECT Q Owner ❑ Agent o Contractor 0 Architect Other
d Xi % :;1'-s,t I,e sem;:
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_ .. .. ,,. ' Pave 2 of 4 k\Handouts\Permit Application