04-102346Ci of kederal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: MURPHY
Project Address: 1412 SW 351ST s -f -
Mechanical Permit #:04 -102346 - 00 - ME
Inspection request line: 253.835.3050
Project Description: Install gas fireplace insert, exterior gas fire pit and gas piping.
Parcel Number: 502860 0590
Owner
Applicant
Contractor
MICHAEL AND JOAN MURPHY
FIRESIDE DISTRICT OF OREGON
FIRESIDE DISTRICT OF OREGON
1412 SW 351ST ST
FIRESIDE DISTRICT OF OREGON
FIRESIDE DISTRICT OF OREGON
FEDERAL WAY WA 98023
18862 72ND AVE S
18862 72ND AVE S
KENT WA 98032
(425) 251-3921
Mechanical Valuation..........................................3800 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Quantity DescriptionQuantity I Description Quanti
BBQs �� Fireplace Inserts �L Number of Gas Outlets 2
PERMIT EXPIRES December 8, 2004.
Permit issued on June 11, 2004
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us5fvill be in accordance with the laws, rules and regulations of the State of Washington and
the City of Federal Way// „ A
Owner or agent:
Date: /,,
N
THIS CARD IS TO REMAIN ON-SITE. .
CITY OF Community Development Inspection ecord
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102346 -00 -ME
Owner: FIRESIDE DISTRICT OF OREGON
Address: 1412 SW 351 ST ST
FEDERAL WAY, WA 98023-6943
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
❑ Mechanical Rough -in (4165) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date /� L% By �Zf= Date
QfY. ` F
FederalWay�- PERMIT
G�DMMUM7Y DEVEIAPMEW SERVICES
33530 FIRST WAY SOUTH • BOX 9718`j � I',�`.' �
3 APPLICATION
FEDERAL WAY, WA 98066 3-9718 e
253-6614715• FAX 2536614129
www. dluoffederalway.com
The following is requirWii" f(rtjoiti urabji r an incomplete application will not be(
04 0 3
. YL
SF MF CO ME EL PL DE EN FP
D
ted. Please print legibly (in inkl or tune_
SITE ADDRESS 3W2- (SI.k-�) G'S'- St SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # C) z- $ �n A�) O
LOT SIZE (,j)�
LEGAL DESCRIPTION (e.g. Acme Estates, Lot I ) � Mlp.�-�� W�SF}®� �S
(Attach separate page for lengthy legal desenption)
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed descrintion nfumrk inrhirlorl nn this „o.-r.,;r „n1,n
PROJECT NAME (Name of Business or Owner Last Name) NI a V
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME
Vku pu>
PRIMARY P NE
3 )'
- S i
MAILING ADDRESS
�q Q_
I CITY STATE, ZIP
COMPANYNAME `\l c
1 1 v` J�
APPLICANT NAM,E�7��y
1 l
OFFICE PHONE
(Cjoc
/(J/
MAILING ADDRESS
t8`�o2.
CITY, STATE, ZIP
-t W14 $ 3Z
CELL PHONE
(21�) 'G
- U �3
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
1 a-4 a --L Q 5 �L 5 q -B
L 1 �L / 3a /o4
(Lk --) 00SI��-
�f2Z
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application(
EXPIRATION DATE
E_RE5DQ1 5 oLP
3 lot
/05
COMPANY NAME
F e..:Es i�!k-
APPLICANT NAME
OFFICE PHONE
)- t
?�I Z
MAILING ADDRESS �p
CITnY, �S/TAT-E-,. ZIP
CELLPHONE
RELATIONSHIP TO PROJECT ,�..,(� �,� ,,
❑ Architect ❑ Tenant ❑ Agent � Other (Describe)C� /1�y s \ \
FAX NUMBER
(LVICSLOS6
NAME
7
PRIMARY PHONE
- a
E-MAIL ADDRESS
Per RCW 19.27.095: Lender information is
NAME
required ifproject value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED/APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
❑ TACOMA ❑ PRIVATE (WELL)
❑ PRIVATE (SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
RAINWATER SYST
URINALS
HOSE BIBBS
FIRST
ELECTRIC WATER HEATERS
BASIC PLAN?
❑ YES
SECOND
ZONING DESIGNATION
CHANGE OF USE?
THIRD
❑ NO
NEW ADDRESS REQUIRED? ❑ YES o NO
UP/SEPA/SU?
FOURTH
o NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
ADDITIONAL FLOORS (DESCRIBE)
❑ NO
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EXISTUM
TOTAL PROPOSED
TOTAL ERISTIFG AND PROPOSED
"NEWHOMES ONLY`* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each
Value of Mechanical Work
AIR HANDLING 1
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (-Tub/Shower Combo
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS raachroom s.*.i
ixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
EVAPORATIVE COOLERS GAS LOGS REFRIG. SYSTEMS
FANS HOODS (c --ii) WOODSTOVES
FIREPLACE INSERTS RANGES —� MISC (Descri )
FURNACES GAS WATER HEATERS 11 V 41 Ql
GAS PIPE OUTLETS
SHOWERS
WATER CLOSETS paiteq MISC (Describe)
SINKS
DRINKING FOUNTAINS
SUMPS
RAINWATER SYST
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 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 �Archite�cto
DA
(Signat e)
RELATIONSHIP TO PR ❑ Owner �Agc.t��eC�..tracto�ro Other
X10
FOR OFFICE USE ONLY
❑ NEW ❑ ADDITION
❑ ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
BASIC PLAN?
❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES o NO
UP/SEPA/SU?
❑ YES
o NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
❑ NO
Bulletin #100 — March 30, 2004 Page 2 of 4 k\handouts — Revised\Permit Application
J."..,,_
MASTER LICENSE 'ARNA(T
"R PO Box 9034 • Olynipia, WA 9R ,()7 ((;1- 11100
' REGISTRATIONS AND HCENSES
STATE OF
WASHINGTON
FIRESIDE DISTRIBUTORS OF OREGON INC.
18862 72ND AVE S
KENT WA 98032
FUREIGN PROFIT CORPORATION
Renewed by Authority or ss-cre troy or S ti to
REGISTERED TRADE NAMES:
FIRESIDE HEATING AND COOLING
FIRESIDE HEARTH AND HOME
FIRESIDE DISTRIBUTORS
Unified Business ID #: 600 577 880
Business ID #: 1
Expires: 03-31-2005
The licensee rtnned abovo Irn. b()en i4511011 1110 bu Jl reap Ir llmnr; c,r
licertsos listed, t3y a ceptinq this document tl w licollsoo cru lily! s the in(ot rnalion
provided on theapplication for thn3e licensef. wa , c,ompletr , litin, and accuiat(,
to the best of his or her know) dgn, and that business, will Ivy conduclyd in
compliance with all applionble W ishin(Iton ,^,tote, county. and oily rv(vjlnliow-. I )imr.tot, Ucp,utment c.l ginl,imi
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PPOV I I)l 11Y l,A 1 n:,
REGTS'C. li EXP.
X FTRI'sSDOL501,P 01/09/2005
FFFECTIVC I)A'Cul, 06/ 17/_1955
t" WESITJE DISI' OU (WHGOtl CN('
1 A3l39 fiOONES FI?RPY I'l-)
I'OR�I'L11R11) OR 97224
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