18-102698ri
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 8352609
Project Name: LARSON
Project Address: 29821 3RD AVE SW
Project Description: Install gas piping and fireplace insert
Mechanical
Permit #:18 -102698 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 720532 0020
Owner
Applicant
Contractor
GARY LARSON
RABAN CONTRACTOR SERVICES LLC/R
RABAN CONTRACTOR SERVICES LLC/R
29821 3RD AVE SW
C S FIREPLACE
C S FIREPLACE
FEDERAL WAY WA
PO BOX 7291
RCSFIF*847R1 (12/22/18)
98023-3510
COVINGTON WA 98042
PO BOX 7291
USA
COVINGTON WA 98042
USA
Additional, Permit information
Mechanical Work Valuation? .................................. 4800 Is this an Online or O.T.C. application?.................. Yes
s�
-
wFireplace Inserts I Gas Piping
PERMIT EXPIRES Sunday, 16 December, 2018
Permit Issued on Tuesday, June 19, 2018
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: Date:
cm os 44A
Federal Way
THIS CARD IS TO REMAIN'ON=SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18102698 00 Address: 29821 3RD AVE SW
Project: BARBARA KLEIN FEDERAL WAY WA 98023-3510
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.
1❑
Mechanical Rough -in (4165)
Gas Piping (4125)
Final - Mechanical (4065)
Approved
Rough Electrical
Approved to release test
Final Electrical
Approved
By
Date
By #rJ
Date (A/Z
By
Date "1_
s
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
41k
CITY OF
Federal Way
PERMIT NUMBER 1
PERMIT APPLICATION
PERMIT CENTER + 33325 811,Avenue South + FREGEI VE003-6325
253-835-2607 + FAX 253-835-2609 + permitcenterncityoffedefalway.com
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JUN 19 2018
TARGET DATE CIT( OF FEDERAL WAY
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SITE ADDRESS ^ /` ^ &-zi �/�d ue vw(f _sI , /
SUITE/UNIT #
PROJECT VALUATION
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ASSEESSOR'S TAX/PARCE #
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TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
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PROJECT DESCRIPTION
P
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
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PROPERTY OWNER
MAILING ADD S
E-MAIL
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NAME
PHONE
MAILING'ADDRESS _
E-MAIL
CONTRACTOR
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FAX
WA S ATE CONT CTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
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APPLICANT-
MAILING ADDRESS C
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E-MAIL
CITY
STATE
ZIP Q yrs
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FAX
PROJECT CONTACT
NAMF,_
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $'5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that 1 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 1 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 apart of this application.
SIGNATURE: •/' / DATE
PRINT NAME:
Bulletin #100 — January 29, 2016
Page 1 of 2
k:\Handouts\Permit Application
MECHANICAL PERMIT VALUE OF MECHANICAL WORK
$
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 —4— FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (cas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING HERMIT
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
s
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing res 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)
ii........ ..... ............................................................ ..................
SECOND FLOOR I
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
............................. ...................................... ..................... ............ ............_............................................................ _.........
OTHER (describe)
............................ ............. .... ......................... .._.._..._................................................... _...... .................................................
Area Totals EXISTING PROPOSED TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information
Square Feet Type Stories
NEW BUILDING,
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information
Square Feet Type Stories
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TENANT AREA ONLY
PROJECT AREA ONLY.
Bulletin #100 — January 29, 2016
Page 2 of 2
k:\Handouts\Permit Application