04-101838Y
I
rCity of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:04 - 101838 - 00 - ME
Inspection request line: 253.835.3050
Project Name: ROKKE
Project Address: 827 S 319TH P�
Project Description: Install new gas fireplace insert with gas piping.
Parcel Number: 609400 0240
Owner
Applicant
Contractor
Calvin J Rokke
FIRESIDE DISTRICT OF OREGON
FIRESIDE DISTRICT OF OREGON
827 S 319TH Pi,
FIRESIDE DISTRICT OF OREGON
FIRESIDE DISTRICT OF OREGON
FEDERAL WAY WA
18862 72ND AVE S
18862 72ND AVE S
98003-5337
KENT WA 98032
(425) 251-3921
Mechanical Valuation..........................................2100 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description IQuantityl � Description Quantity Description 1Quantity
Fireplac_e Inserts ----�r 1 F as Piping
L _-1 L—_
PERMIT EXPIRES November 9, 2004.
Permit issued on May 13, 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 accordance with the laws, rules and regulations of the State of Washington and
the City of Federal Way. 11,
Owner or agent: f4 Date: S /3 —®0�
F `7-n-0y,coo
6� Clark UJ
1
11
RECEIVED
Federal way PERMIT RSCEIVK
COMMUNITY DEVELOPMENT SERVICES Q ( SF MF CO ME EL PL DE EN FP
33530 FIRST WAY SOUTH • 6 BOX 9718 �/ � P L I C AT I C ' 3
FEDERAL WAY, FAX
9806?-9718 ` 2004
253-6614115• FAX 253661412P9� �t p 1�
wurmdtvoffederdwaa.mm GIT F- 0.F: rDf�EnReAL,
g�) P' CITY OF FEDERAL AY
The following is require i>p iiiirttirir,tan incomplete applicatio$ MWpted. Please print legibiy (in inkl or tune_
SITE ADDRESSvC / �- JC� %��/ �L, �E/��'L IN J%r .. 9��3 SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # P - LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
lAttach sepamte page for lenohy Iegd d—iption/
PROJECT• 1 •
TYPE OF PERMIT ❑ BUILDING 0- PLUMBING P4 MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onluJ
/'A 97rT�1 GtY`Ji .��/ ✓t �S � t
PROJECT NAME (Name of Business or Owner Last Name) ":�IecaI
PEOPLEI • - •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
C RG.1/�nJ �Q/�&E (A5 9fe6 - 3
MAILING ADDRESS CITY, STATE, ZIP
COMPANY NAME
o- m� -Z
APPLICANT NAME
APPLICANT NAME
OFFICE PHONE
2.5� - f
MAILING ADDRESS
CELLPHONE
(
CITY, STATE, ZIP
CELLPHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
PRIMARY PHONE
E-MAIL ADDRESS
Per RCW 19.27.095: Lender information is ' `
required if project value exceeds $5,000
— --- — — — — —
B L
CITY, STATE, ZIP
CONTRACTOR 5 REGISTRATION NUMBER (copy of cud required with each application(
EXPIRATION DATE
'6'r6Ic ' QL50—
LL
l l
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
(
MAILING ADDRESS
CITY, STATE, ZIP
CELLPHONE
(
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( -
NAME
PRIMARY PHONE
E-MAIL ADDRESS
Per RCW 19.27.095: Lender information is ' `
required if project value exceeds $5,000
NAME
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
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 ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FANS
HOODS (commerriat)
WOODSTOVES
FIRST
FIREPLACE INSERTS
RANGES
MISC (Describe)
SECOND
FURNACES
GAS WATER HEATERS
CHANGE OF USE?
THIRD
GAS PIPE OUTLETS
NEW ADDRESS REQUIRED? o
YES o NO
FOURTH
o YES
o NO
PLATTED LOT? o YES ❑ NO
ADDITIONAL FLOORS (DESCRIBE)
o YES
o NO
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EXISTING
TOTAL. PROPOSED
TOTAL EXISTING AND PROPOSED
**NEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
number of each type of furture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
m�a,nn��.a.raa.
Value of Mechanical Work $Ji, �
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
REFRIG, SYSTEMS
BBQS
FANS
HOODS (commerriat)
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Describe)
COMPRESSORS
FURNACES
GAS WATER HEATERS
CHANGE OF USE?
DUCTS
GAS PIPE OUTLETS
NEW ADDRESS REQUIRED? o
YES o NO
BATHTUBS for Tub/Sho—Comw)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bathroom Sinks)
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
WATER CLOSETS (Toaeq
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
MISC (Describe)
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. n
NAME/TITLE
VIgnatvrs( C/ l (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
o NO
NEW ADDRESS REQUIRED? o
YES o NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT? o YES ❑ NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 —March 30, 2004 Page 2 of 4 k\Handouts — Revised\Permit Application
05/13/2024 22:13 4252518322
_<
FIRESIDE DIST
PAGE 02
VY '"cis A iM"
hfffi r 1t ,.fit r :it i7•';y :I Yi.;.,r+
t'•k�:'�I�. i5 '. �`f r�G'�„.I �ti �l t•: i''�;I '^ry � N, ;r..4:�',.ihh it•,r to{�
wi' .f IrIV F��,i
,tet i`, .-M,�`'
��,
• 'r.: !iyr•.-,t',T :f^ti:: ,�.. .,1 �!.�^ ,.oL' 'M;'tr.'r r,1, e,i: .. .
ia bio.;
,t4.....
AIGN. ;PR0FIT, .CORPORATION
,yRen,ewed:'by Authority of Secretary of State
0"ISTERED TRADE '-NAMES c
FAYR IDEW'--HEATING,AND.'COOLlNG
.
F �tES>CDE'; HEARTH,° AND :'HOME
�F��?�:IDEi;.b.ISTR'IBUTOi2S ...
'
'L'4'F.,,,, _M My. I •'7"! �tq ^ , '.�'(. t Y. �.1'.vV'�,1.�:!-+'I,1�,.N'+rykrir�� 1 �C �N .., ,bjy "jr "`,.
'I, \
71j'., . ?E` ,F" • r'' . , .., '•'t . ��.,< �f i x r�i �! � '' s
'�e;�;r��l�t S � �
+h 'JE'�`�'f� ,t y' � "moi Y ,�i
K�•.:, �lrl t IJ, „ _: •
IX
lift.
1.�
DEPARTMENT OF LA1301t AND 1Y1,')US*FRl1,5
REGISTER2D AS PROVIDED LY :GAW AS
CONST CONT SPECIALTY
REGIS C : SXV . DATE
CCEX' "FIRE510�50LE' 01/09/2005:?'r'``i
EFVECTTVE DATS 06/17/1985
FIRESIDE DIST OF OREGON INC
18389 HOONES FERRY RD
PORTLAND OR 97224
18.• ;+1! `. rrW1 1:1•`'171