02-102431City of Federal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Pb: 253.661.4000 Fax: 253.661.4129
Project Name: QUICK Adel
Project Address: 34112 35TH�SW
Mechanical Permit #:02 -102431 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 536020 0030
Project Description: MECH - Remove existing wood stove and install (1) gas stove and approximately 25 feet of gas piping in
existing residence..
Owner
Applicant
Contractor
Berniece Quick
NORTHWEST CLIMATE CONTROLS INC
NORTHWEST CLIMATE CONTROLS INC
34112 35TH AVE SW
1106 39TH AVE SE SUITE 100
1106 39TH AVE SE SUITE 100
FEDERAL WAY WA 98023-2937
PUYALLUP WA 98
PUYALLUP WA 98
(253) 435-8834
Mechanical Valuation..........................................2217
Over the Counter Permit......................................Yes
Mechanical Fixtures
_ Description ,Q `. ptr0 , .` Quanti
�i;pplace Inserts Gas Piping 25
PERMIT EXPIRES December 8, 2002, IF NO WORK IS STARTED.
Permit issued on June 11, 2002
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.
Z l
Owner or agent: �,� Date: t
RECEIVED
;°F G CONSTRUCTION PERMIT APPLICATION
uv Vi i-- JUN 1 1 2002 APPLICATION NUMBER: QZ - YJ Z - D_d_ Lt
APPLICATION NUMBER: _ _ - _ _ _ - _ - _
C►TY OF FEDERAL WAY _ -
BUILDING DEPT. APPLICATION NUMBER: -
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: 3-11112- `,_�/5!-ell S a J ASSESSOR'S TAX/PARCEL #: s.3 L O 2 O- O o
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING .MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): ,7 e--:.
/aze�L
Y
PROJECT NAME: Q U ( Cr
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP):
NAME:
DAYTIME PHONE:
//Y
y:�'3 ) -13
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
-3
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CO CTOR'S REGISTRA N NUMBER:
EXPIRATION DATE:
(copy of card required)
NAME: � �-- c" ' DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: _
❑ ARCHITECT []TENANT 11OTHER( DESCRIBE): FAX
NUM ) _
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 11 LAKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL 2 I
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE S)
BOILER(S) --7 FIREPLACE INSERT(S) RANGE(S) 2S,- MISC. 6 A NA16)
COMPRESSOR(S) FURNACE(S)
w
DUCT(S) GAS PIPE OUTLET -(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
]TSCLATMER/SIGNATURE BLC
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 claim), which may be made by any person, including the undersigned, and filed against the City of
Federal Way, 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 a part of this application. ;
NAME/TITLE:
❑ PROPERTY O ER ❑ APPLICANT ❑ CONTRACTOR
DATE: C'
COMMUNITY DEVELOPMENT SERVICES • 33S30 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.citvoffederalway.com