04-101468Cimn Federal Wamunity Development Services
Community
Mechanical Permit #: 04 - 101468 - 00 - ME
• 33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: LESMEISTER
Project Address: 202 SW 324TH ri- Parcel Number: 926490 1650
Project Description: Install fireplace insert and gas piping.
Owner
Applicant
Contractor
Michael Lesmeister & Theresa Lesmeister
ADVANCED FILTER & MECH INC
ADVANCED FILTER & MECH INC
202 SW 324TH CT
418 VALLEY AVE NW UNIT B115
418 VALLEY AVE NW UNIT B115
FEDERAL WAY WA
PUYALLUP WA 98371
PUYALLUP WA 98371
98023-5634
(253)770-2440
PERMIT EXPIRES October 17, 2004.
Permit issued on > April 20, 2004
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 accor ance with the laws, rules and regulations of the State of Washington and
the City of Federal y.
Owner or agent: Date:
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RECEIVEDCOMMfJM7Y DEVELOPMENT SERVICES
33530 fIRST WAY SOU7TI • PO BoX 9718
ctrY of FEDERAL WAY, WA 98063-9718
Federal way APR PAWIT APPLICATION 253-661-4115- FAX253-661-4129
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Far OOice U -Only: FW TD:
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The following is required information -an incomplete application will not be accepted. Please print legibly (in ink) or tune
SITE ADDRESS: cI(f) ,D - s(Q:) 3 a7 iv' CSI SUITE/APT # _
ASSESSOR'S TAX/PARCEL #: '� _ - Q 16 5gQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (e.g.: Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
PROJECTINFORMATION
TYPE OF PERMIT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM �Q5
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlyF --l-ate, "U 11
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PROJECT NAME (Name of Business/Owner Last Name): 96a� L42 on e. ins
PEOPLEI • - •
PROPERTY
OWNER
CONTRACTOR--
LENDER.
ONTRACTOR:
LENDER:
(If Pmp—d Value > $5,0001
APPLICANT:
NAME: PRIMARY PHONE:
\.< me e ( )V4
-O
MAILING ADDRESS (STREET ADDRESS;): CITY, STATE, ZIP
i�e
NAME
COMPANY
MAILING ADDRESS (STREET ADDRESS;):
OFFICE PHONE:
NAME:
COMPANY
OFFICE PHONE:
MAILING ADDRESS (STREET ADDRESS;):
CITY, STATE, ZIP
PHONE:
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/CELL
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CITY OF FEDERAL WtA BUSINESS LICENSE NUMBER:
F EXPIRATI N DATE:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card regaired with cath application)
NAME:
(DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS;):
CITY, STATE, ZIP
NAME:
COMPANY
OFFICE PHONE:
MAILING ADDRESS (STREET ADDRESS):
CITY, STATE, ZIP
/EVENING PHONE:
t � -
RELATIONSHIP TO PROJECT:
❑ Architect ❑ Tenant ❑ Other (Describe$.
FAX NUMBER:
( -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner ❑ Contractor ❑ Applicant E-MAIL ADDRESS:
DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $
VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED?: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
■ PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING S!2. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
❑ ALTERATION
❑ REPAIR o TENANT IMPROVEMENT
FIRST
o YES o NO
BASIC PLAN? o YES
a NO
SECOND
CHANGE OF USE? a YES
a NO
THIRD
o YES o NO
UP/SEPA/SU? a YES
a NO
FOURTH
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EXISTING
TOTAL PROPOSED
TOTAL MSTING AND PROPOSED
•`NEW HOMES ONLY"` NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value eMechanical Work $
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (-T„b/Sh—C.-bo(
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (B,Ihr—Sink
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS REFRIG. SYSTEMS
HOODS (co—dat( WOODSTOVES
RANGES MISC (Describe)
GAS WATER HEATERS
WATER CLOSETS (Tact) MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYS
HOSE BIBBS
ELECTRIC WATER HEATERS
]ISCLAIMER/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 offirs and employees, pan the accuracy of the information supplied to the city as apart of this application.
NAME/TITLE: DATE: q1,
/
(Signature( (Titie(
RELATIONSHIP
❑ Property Owner ❑ Applicant ❑ Contractor ❑ Architect ❑
FOR OFFICE USE ONLY:
o NEW o ADDITION
❑ ALTERATION
❑ REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN? o YES
a NO
ZONING DESIGNATION:
CHANGE OF USE? a YES
a NO
_NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU? a YES
a NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
I kI _ei irI i (I;% ;.i: t Page 2
1`625-05'_ 000 (;/117)
NOT TRANSFERABLE
BUS. NUMBER
930260
DATE PAID
3/12/2004
LICENSE YEAR
2004
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST. # EXP DATE
CC01 ADVANFM044RD 12/19/2004
EFFECTIVE DATE 12/04/1996
ADVANCED FILTER & MECH INC
418 VALLEY AVE NW
BLDG B STE 115
PUYALLUP WA 98372-2503
CITY OF PUYALLUP POST IN CONSPICUOUS PLACE
BUSINESS REGISTRATION CERTIFICATE
The person, fine or corporation named below is granted this business certificate pursuant to the provisions of the City Business
License Ordinances to engage In, carry on or conduct the business, trade, calling. Profession, exhibition or occupation described
below. Issuance of the certificate Is not an endorsement, nor certification of compliance with other Ordinances or laws. This license
Is Issued without verification that the licensee Is subject to or exempt from licensing by the Stale of Washington.
BUSINESS TYPE: Sub -Contractor
NOTES:
BUSINESS LOCATION 418 VALLEY AVE NW STE B-115
IN PUYALLUP
BUSINESS NAME ADVANCED FILTER 8t MECHANICAL
ATTENTION DAVID ROSS
MAILING ADDRESS 418 VALLEY AVE NW STE B-115
CITY AND STATE PUYALLUP, WA, 98371-3312
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EXPIRATION DATE
8/31/2004
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