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04-101278City of Federal Way Couuuunity Development Services 33530 1st Way S Federal Way, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 Mechanical Permit #:04 -101278 - 00 - ME Project Name: ROBERTS Project Address: 523 SW 321ST 5t - Project Description: Install fireplace insert w/gas piping and install A/C unit. Inspection request line: 253.835.3050 Parcel Number: 926490 1120 Owner Applicant Contractor Quentin K Roberts & Lisa E Roberts WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO 523 SW 321 ST ST 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199 98023-5655 (206)282-4700 Mechanical Valuation..........................................8867 Mechanical Fixtures Description Quanti Description :TQuantity DescriptionQuantity Air Handling Units l� Fireplace Inserts �� Gas Piping F-1 PERMIT EXPIRES October 5, 2004. Permit issued on April 8, AN I hereby certify that the above information is correct and that the constructionon 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, (�/�i Owner or agent:XDate: ` l I I�- by FINALED � / APR -5-2004 18:11 FROM: RECEIVE® TO:12536614129 'P.10 APR V 6 2004 COMMUNITY DEVELOPMENT SERVICES - _ 33530FIR5r WAY50LITH •POBOX9718 FEDERAL WAY, Vlvlay PFS G LICATION )415sa p�r cMty' 1 0- L 1 2 Y- D 0 FW File Number: k' / / The following is reoulred information -an itwomolete aonllcatlon will not be accented. Please Print legibly (in Ink) or type. SITE ADDRESS: f2 r 3 w Z _r T_ M3SUITE/APT GJ # ASSESSOR'S TAX/PARCEL #: / 2 � —1,Q- L, L Z V SQUARE FOOTAGE OF LOT. LEGAL DESCRIPTION (e.g.: Acme Estates. Lot 1) ttach separate page for lengthy legal desrriptlorV TYPE OF PERMIT (This application: ? E ? PLUMBING (:t MECHAINICAE ? DEMOLITION ? ELECTRIC ? ENGINEERING ? NTION SYSTEM PROJECT ES RIPTION (P vide dei ed descrtprlo of work J uded a permit au1lv): l�I I-LVIR —9 �t4ee �� I 0 to Iv�� k_i •S - y7 -Q V T� • i 1 Lr v� S 1� U i F Lam'`. PROJECT NAME (Name of Business/Owner Lost Name): PROPERTY OWNER: CONTRACTOR: LENDER: 6r P—P.w V.1— > 26.000) APPLICANT: NAME: �L4 'bPRIMARY�v L LINC ADDRESS (STREET ADDRESS;): 21P NAME COMPANY OFFICE PHONE: 2l (-I- n4 A1G D S�/ � ff ADDRESS:),,'AP _Lttoo �% %�� LLP HO _ E _ �WAY BUSINESSUCEN-� � EXPIRATION DATE! J FAX NUMBER: - R'S RE ON N ^ A (copy of card �egvlred with each application) ��I� J Y -7 (Q R ( £XPiR'? DAT r 2— / G[� / J CONTACT PERSON FOR THIS PROJECT: ? Property Owner . Contractor ? Applicant ADDRESS! EXISTING USE: PROPOSED USE: EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: S SPRINKLERED BUII.DING? ? YES ? NO FIRE SUPPRESSION SYS'T'EM PROPOSED/REQUIRED?: ? YES ? NO WATER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? TACOMA ? PRIVATE (WELL) SEWER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? PRIVATE (SEPTIC) DAYTIME • MAILING ADDRESS ( ET ADDRESS,): FCRY. AIE. ZIP CONTACT PERSON FOR THIS PROJECT: ? Property Owner . Contractor ? Applicant ADDRESS! EXISTING USE: PROPOSED USE: EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: S SPRINKLERED BUII.DING? ? YES ? NO FIRE SUPPRESSION SYS'T'EM PROPOSED/REQUIRED?: ? YES ? NO WATER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? TACOMA ? PRIVATE (WELL) SEWER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? PRIVATE (SEPTIC) tOPPANY OFFICE PHONE: MAILING AD ( ET ADD ): A . Z[P EVENING) HONE: - LA11 RO Cf:FAX ? Architect ? Tenant Other (Describe): NUMBER. CONTACT PERSON FOR THIS PROJECT: ? Property Owner . Contractor ? Applicant ADDRESS! EXISTING USE: PROPOSED USE: EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: S SPRINKLERED BUII.DING? ? YES ? NO FIRE SUPPRESSION SYS'T'EM PROPOSED/REQUIRED?: ? YES ? NO WATER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? TACOMA ? PRIVATE (WELL) SEWER SERVICE PROVIDER: ? LAKEHAVEN ? HIGHLINE ? PRIVATE (SEPTIC) APR -5-2004 18:12 FROM: TO:12536614129 " ' 'P.12 �-0,BG�TS 5'Z3 S�✓ 32l'� AREA DESCRIPTION WASTING SO, FT. I PROPOSED SO. FT. TOTAL BASEMENT WOODSTOVES FIREPLACE INSERTS RANGES FIRST FURNACES GAS WATER HEATERS 7 NO SECOND CHANGE OF USE? 7 YES SHOWERS THIRD M1SC (Describe) SINKS DRINKING POUNTAINS FOURTH SUMPS RAINWATER SYS ? NO ADDITIONAL FLOORS (DESCRIBE) HOSE BIBBS VACUUM BREAKERS DECK (COVERED?) GARAGE/CARPORT HOW MANY FLOORS? TMA1 EXLMKe TMAt PRO KAED TMAL EUMaG PN0 PaoPOSM RCTMAATPn CRU-ING PRICE: S J—r-NEW tYVM— CJ LJJVLZlvurvir3mm yr pcynvv+vs..a. --- ----- each type of fixture that Is to be Installed or A&CNANICAL jYJ "7 Value of Mechanical Work 3� _ AIR HANDLING UNITS BBQS BOILERS COMPRRSSORS DUCTS PLUMBING BATHTUBS (-Tub/5f.w ,C-1* l DISHWASHERS GAS PIPE OU11.E'TS WASHING MACHINES LAVS VJ a WM. baa as part of this protect. Do not include existing fixtures to remain. EVAPORATIVE COOLERS CAS LOGS REFRIG. SYSTEMS FANS HOODS (Cam mwn WOODSTOVES FIREPLACE INSERTS RANGES MISC (Describe) FURNACES GAS WATER HEATERS 7 NO GAS PIPE OUTLETS CHANGE OF USE? 7 YES SHOWERS WATER CLOSETS arAlm M1SC (Describe) SINKS DRINKING POUNTAINS NEW ADDRESS REQUIRED? SUMPS RAINWATER SYS ? NO URINALS HOSE BIBBS VACUUM BREAKERS ELECTRIC WATER HEATERS 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 clairr;l, which may be made by any person, including the undersigned, and Med against the City of Federal We , but only where such claim arises out of the reliance of the city, Including Its olilcers and employees, upon a aocura the nformatlon supplISSL to the city as a oarvr this applIcatioq. / i LAI) NAME/TITLE: RELATIONSHIP TO PROJECT: '?Property Owner V Applicant ?Contractor ?Architect ? q0 FOR OFFICE USE ONLY: ? NEW ? ADDITION 7 ALTERATION 7 REPAIR ?TENANT IMPROVEMENT BUILDING SHELL ONLY? ?YES ?NO BASIC PLAN? ? YES 7 NO CHANGE OF USE? 7 YES ? NO ZONING DESIGNATION: UP/SEPA/SU? ? YES ? NO NEW ADDRESS REQUIRED? ?YES ?NO DEMO PERMIT REQUIRED? ? YES ? NO PLATTED LOT? ?YES ?NO Bulletin #100 - January 13, 2004 Page 2 of 4 k.\Handouts - Rcvised\Permit Application