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