08-102269City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Mechanical Permit4k. 08 -102269 -00 -ME
Inspection Request Line: (253) 835-3050
Project Name: MENARD
Project Address: 32109 33RD AVE SW - a P el Numb 73190 0650
Project Description: Installation of gas fireplace insert. 4
Owner
Applicant
Co r
MARY F MENARD
AQUA REC'S INC
C' INC
32109 33RD AVE SW
1407 PUYALLUP AV
A 11 ORA 0 19/09)
KO7
FEDERAL WAY WA 98023-2275
TACOMA WA 98421
RVE
TA A 8421
Mechanical Valuation ...........................................
Firepl ftsects........................
I he
the
Owner
v-
Jalication? ................Yes
LArWPIRES Tuesday, November 4, 2008
lssucd on Thursday, May 8, 2008
�rnation is correct and that the construction on the above described property and
be in accordance with the laws, rules and regulations of the State of Washington
/-and the City of Federal Way.
;�/ Date:
" THIS CARD IS T(� EMAIN ON-SITE
CITY OFp
- Community Develo ent Inspection Record
p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 08 -102269 -00 -ME
Owner: MARY F MENARD
Address: 32109 33RD AVE SW
FEDERAL WAY, WA 98023-2275
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) Gas Piping (4125) E] Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By G L'J
For, inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
Federal WaRECEIVEkRMIT b�- -- - - -
COMMUNITY DEVELOPMENT SERVICES SF MF CO EL PL DE EN FP
3332FEDERAL NUE WAY. WA 98063-9718 O BOX 9718 MAY u 8 ' p LI CATI O N --
FEDERAL WAY. FAX
53-8-260n
253-835-2607• FAX 253-835-2609
u:uu-.ciluollederalwau com CC�ee� //�� ``/(��,, ��//
The followi �u�inf 0:ED vMLirW Ir4 ete application will not be accepted. Please print legibly (in ink) or type.
ASSESSOR'S TAX/PARCEL # 52 23— 1
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
ab
LOT SIZE (sfi
(Attach s P—a' Page Jor lengthy legal d—fplin)
PROJECT1 • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
detailed description of work
/ XL' -Ni�•
PROJECT NAME (Name of Business or Owner Last Name) K i LVvilr
PEOPLEI • •
PROPERTY
NAME
OWNER W0, LL 17)
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
LING AD S ^ SCILTY. SfATE. IP E-MAIL ADDRESS
C 1 NAME -Az
I ADDRF � I � , C'E. ZIP�� `ELL PHONE]/C�/J�
20 _CITY OF FEDERAL I O IiN� Lb� NUMBER _ V E�ION E
.� l( j /�1 E, �j /I ' • 1 I
CONTRACTOR'S REGISTRATION NUMBER 00
EXPIRATION DATE S-L/MAIL ADDRESS
v 1;:-�" I-- FA 02 I O @ G ktY
COMP NAME 1 APPLICANT NAME OFFICE PHONE -
1`r'`x'C/
MAILING ADDRESS CITY. STATE, ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
NAME /PRIMARY PHONE E-MAIL ADDRESS
1 � -
NAME Per RCW 19.27.095:
Lender information is required f project value exceeds $5,000
MAILING ADDRESS CITY, STATE, ZIP PHONE
EXISTING ASSESSED/APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ^u LAKEHAVEN ❑
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑
PROPOSED USE
VALUE OF PROPOSED WORK $
N SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
❑ TACOMA ❑ PRIVATE (WELL)
❑ PRIVATE (SEPTIC)
i
'C oven
EXISTING ASSESSED/APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ^u LAKEHAVEN ❑
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑
PROPOSED USE
VALUE OF PROPOSED WORK $
N SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
❑ TACOMA ❑ PRIVATE (WELL)
❑ PRIVATE (SEPTIC)
i
'C oven
1 0 PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING
Sq. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
FIRST
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
SECOND
SUMPS
CHANGE OF USE?
THIRD
NO
NEW ADDRESS REQUIRED? o YES ❑ NO
UP/SEPA/SU?
ADDITIONAL FLOORS (DESCRIBE)
- NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
DECK (❑ COVERED OR ❑ UNCOVERED?)
NO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
FausravG
PROPOSED
TOTAL
TOTALEMMGSF
TOTAL PEOPOSEDSF
TOTAL SF
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type offixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
Value of Mechanical Work $ ` J 1 Z) J 7 ( COPY F BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS RAT VE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS T FANS GAS WATER HEATERS MISC (Describe)
BOILERS / FIREPLACE INSERTS HOODS (comme c a�)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
BATHTUBS (or Tub/Shower Combo)
LAVS (BalbmomSinks)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS rrolk0
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
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 responsibilityfor compliance with local, state, orfederal 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 9,f such claim), which may be made by any person, including the undersigned, and filed against the city, but only
where such claim arises Of of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to
the city as a pai a lication.
SIGNATURE:
Owner and/or Authorized
DATE V V/OT
FOR OFFICE USE ONLY
❑ NEW L ADDITION
= ALTERATION
REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? YES NO
BASIC PLAN?
n YES
NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
NO
NEW ADDRESS REQUIRED? o YES ❑ NO
UP/SEPA/SU?
o YES
- NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
❑ YES
NO
Bulletin #100—January 1, 2008 Page 2 of 4 k\Handouts\Perrnit Application