04-100188City iu Federal Way
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Comnity Development Services Mechanical Permit #: 04 - 100188 - 00 - ME
33530 1 st Way S
Federal Way, WA 98003-6210
Pb: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: BECK �Jv
Project Address: 31232 12TH SW Parcel Number: 416800 0050
Project Description: Fireplace insert
Owner
Applicant
Contractor
Betty Beck
ADVANCED FILTER & MECH INC
ADVANCED FILTER & MECH INC
PO Box 25136
418 VALLEY AVE NW UNIT B115
418 VALLEY AVE NW UNIT B115
PUYALLUP WA 98371
PUYALLUP WA 98371
PO Box 25136 !Federal Way, WA 98093-2136
(253) 770-2440
Mechanical Valuation..........................................2951 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description QuantityE Description Quant Description Quantity
Fireplace Inserts 1
PERMIT EXPIRES July 19, 2004.
Pertrait issued on January 21, 2004
I hereby certify that the above information is correct anti 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: Date:
+erlOOGV vFedays 1 ti0�4
For OIIi— Use
The foiiowirla is
�k�c �
COMMUNITY DEVELOPMENT SERV! ES
33530 FIRST WAY SOUTH • PO BOX 9718
FEDERAL WAY, WA 98063-9718
�P� PERMIT APPLICATION Y53uwwditm e��wau6nlm129
le Number: fes//-_(�/}//✓/ � �
information -an incomplete application will not be accepted. Please print legibly (in ink) or time.
SITE ADDRESS: 3 (a r�— 1� ��� S I p O SUITE/APT #
ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ - _ _ _ _ SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (eg: Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
PROJECT•- •
TYPE OF PERMIT (This application): ❑ BUILDING ❑ PLUMBING 6 MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only). -:7,\
PROJECT NAME (Name Of Business/Owner Last
PROPERTY
OWNER:
CONTRACTOR:
LENDER:
(if rmp—d Vsi e > =s,0001
APPLICANT.
NAME: - PRIMARY PHONE:
3
MAILING ADDRESS (STREET ADDRESS;): CITY, STATE, ZIP
NAME
COMPANY
OFFICE PHONE:
(Z53 Y7210
Z
MAILING ADDRESS (STREET ADDRESS;):
CITY, STATE, ZIP
CELL PHONE:
❑ Architect ❑ Tenant ❑ Other (Describer
_
100(
-
CITY OF FEDERAL WAY BUSINESS LIENSE NUMBEREXPIRATION
DATE:
FAX NUMBER:
'------ - --
/ l
(Z3) 70
?,&3
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of cad required with ach application) —
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS;): TZITY, STATE, ZIP
NAME:
COMPANY
OFFICE PHONE:
WAILING ADDRESS (STREET ADDRESS):
CITY, STATE, ZIP
EVENING PHONE:
RELATIONSHIP TO PROJECT:
FAX NUMBER:
❑ Architect ❑ Tenant ❑ Other (Describer
( -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner ❑ Contractor ❑ Applicant E-MAIL ADDRESS:
DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE. n
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
vrrT
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER- 0 LAKEHAVEN 0 HIGHLINE 11 PRIVATE (SEPTIC)
R
■ PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
a YES.:a NO
BASIC PLAN? a YES
a NO
FIRST
CHANGE OF USE? a YES
a NO
SECOND
o YES o NO
UP/SEPA/SU? o YES
a NO
THIRD
o YES a NO
DEMO PERMIT REQUIRED?: a YES
a NO
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL. EXISTING
TOTAL PROPOSED
TOTAL EXISTING 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.
MECSAMCAL
Value of Mechanical Work $
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (or Tub/Shower combo)
DISHWASHERS
_ GAS PIPE OUTLETS
_ WASHING MACHINES
LAVS (Bathroom sink
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
QAS LOGS REFRIG. SYSTEMS
HOODS (cam ciao WOODSTOVES
RANGES MISC (Describe)
G/�S WATER HEATERS
WATER CLOSETS (r ilea MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYS
HOSE BIBBS
ELECTRIC WATER HEATERS
7TSCT.ATMF.R/STGNATURF SLC
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 accuracy of the information supplied to the city as apart of this application.
NAME/TITLE: DATE:
RELATIONSHIP TO
. ❑ Property Owner ❑ Applicant ❑ Contractor ❑ Architect ❑
.0 NEW ❑ ADDITION
o ALTERATIONa
REPAIR ! a TENANT IMPROVEMENT .
BUILDING: SHELLONLY? ;,
a YES.:a NO
BASIC PLAN? a YES
a NO
ZONING DESIGNATION:
CHANGE OF USE? a YES
a NO
NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU? o YES
a NO
PLATTED LOT?
o YES a NO
DEMO PERMIT REQUIRED?: a YES
a NO
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