03-101414a
City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: GARCIA
Project Address: 621 SW 312TH $1'
Mechanical Permit #:03 -101414 - 00 - ME
Inspection request line: 253.835.3050
Project Description: Installing new zero -clearance gas fireplace and 48' of gas piping.
Parcel Number: 072104 9108
Owner
Applicant
Contractor
Simon Garcia
JOHNSON'S STOVE & PATIO INC
JOHNSON'S STOVE & PATIO INC
621 SW 312TH ST
602 AUBURN WAY N
602 AUBURN WAY N
FEDERAL WAY WA
AUBURN WA 98002
AUBURN WA 98002
98023-4613
(253)833-4246
Mechanical Valuation..........................................3968 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Fireplace Inserts 1 Gas Piping 48
PERMIT EXPIRES October 8, 2003.
Permit issued on April 11, 2003
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.
Owner or agent: Date:
Date:
FINALI
UPON COMPLETION OF WORK
Mechanical rough -in:
r
Gas pipe:
FINAL MECHANICAL:
4VIDay
` D to
Z los — U:,3
Date
A�k�1vEC) CONSTRUCTION PERMIT APPhICQNATRION
CITY OF �._./ ���✓ PLICATION NUMBER: - - �
Federal Way SPR � 12 03 PPLICA-HON NUMBER:
oERA`WAY PPLICATION NUMBER:
"The follo�v�' '4 L����Ij &TTiation - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: 6
ASSESSOR'S TAX/ PARCEL #: I -A
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT•• •
TYPE OF PROJECT (This application): o BUILDING o PLUMBING-f4ECHANICAL O DEMOLITION
❑ ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): 4�-!4 -V/V-jX_ pub N\Aq{ ,
PROJECT DIA E:
OWNER: NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
L
OR: NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
OF FEDERAL WAY BUSINESS LICENSE NUM
APPLICANT: I NAME:
REGISTRATION NUMBER:
ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
G74 S P � l/ ✓� � I r C7-
"vST 95l1�/VF
RELATIONSHIP TO PROJECT:
o ARCHITECT O TENANT ❑ OTHER ( DESCRIBE):
b►'�3-t
I
DAYTIME PHONE:
(Zs 3) 83}
EVENING PHONE:
i FAX NUMBER:
DAYTIME PHONE:
( )
EVENING PHONE:
( )
FAX NUMBER:
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT o CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: r� �q�y
SPRINKLERED BUILDING. ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPQSED/REQUIRED: o YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE o TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: O LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY" + '
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PRO3ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S) '
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S)
FAN(S) HOOD(S)
FIREPLACE INSERTS) RANGE(S)
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE:
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
REFRIG.SYSTEM(S)
WOODSTOVE(S)
MI,SC
CC i VtiCt,i {'
o ELECTRIC ❑ GAS
URINAL(S) _
VACUUM BREAKER(S) ❑
WASH MACHINE OUTLET
WATER CLOSET(S) _
]ISCLAIMER/SIGNATURE BLC
WATER HEATER(S)
ELECTRIC ❑ GAS
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 Cityof
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: � L�.�X--� _ DATE:
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES '33s30 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.253-661-4000 • FAX: 253-661-4129
www.ctvoffederalway.com