02-105446City of Federal Way
Applicant
Mechanical Permit #: 02 -105446 - 00 - ME
Community Development Services
NORTHWEST PERMIT
WASHINGTON ENERGY SERVICES CO
33530 1st Way S
2320 1ST AVE SUITE 250
2800 THORNDYKE AVE W
Federal Way, WA 98003-6210
SEATTLE WA 98121
SEATTLE WA 98199
Ph: 253.661.4000 Fax: 253.661.4129
Inspection request line. 253.835.3050
Project Name: NICHOLS
Project Address: 420 SW 368TH yi' Parcel Number: 302104'9106
Project Description: MEC - Install fireplace insert & piping
Owner
Applicant
Contractor
SHARON NICHOLS
NORTHWEST PERMIT
WASHINGTON ENERGY SERVICES CO
420 SW 368TH ST
2320 1ST AVE SUITE 250
2800 THORNDYKE AVE W
FEDERAL WAY WA 98023
SEATTLE WA 98121
SEATTLE WA 98199
(206) 282-4700
Mechanical Valuation..........................................3132 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Q
ton,
G�ur4
1 tion .� .
Quark i
Fireplace Inserts
1�
Gas Piping
I
Number of Gas Outlets —1=
PERMIT EXPIRES June 7, 2003, IF NO WORK IS STARTED.
Permit issued on December 9, 2002
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 Z�i&�
% g
Owner or agent: Date:
12/03/2002 20:22 3609452091 NWPERMIT PAGE 02
REGE�vED
>
CONSTRUCTION PERMIT APPLICATION
�IZY 0F DING DEPT • Li£5A7'r=�V`3A1F3�:t':.'.:-:::'::::`
gU1L .
"Thafofiawfrrg is required inforwAWn — PIrme prfnt (in ink) ortYPa' *
Pieaae nates Efer, *24, fire Provtotion SyAtina and Englrmering parmMa mall require a separate appiir bn.
420 SW 388TH ST 98023 3 0 2 1 0 4
Siler llpi]RESSx AS&tSSDR's TAiC/PAitCEL #:
LEGAL, *t=RIPTION OF SUWECT PROPERTV (ATTACH SEPARATE DESCRIPTION IF LFNG`(HY)'-
INFORMATION
TYPE OF PROJECT (Thk appiiation): ❑ BIiILDIlNG - PLU148INQ a MECRANICAL B DEMOLITION
p EIECTRWAL = ENGINEIRING O FIRE PRf54dENTION SYSTEM
PROJECT DESCRIPTWH (Pr+'widesiets0ed deaarWloa):
INSTALL FIREPLACE INSERT 8 PIPING TO INSERT
PROJECT IiAmel
PROPERTY OWNER.
CONTIiACTM
NAMLt DAYTIME PHONE:
SHARON NICHOLS 253 ) 835 7380
MAIL %A0DRE58 MVEETAWRM gift; STA1T, ZtPa:
420 SW 368TH ST 98023
t4AME. DAYTNE PHOK:
WESCO (206 ) 282 4.7e0
KtILINGA"E 6 WWET ADDRBS, C[TY STATE, 2ID): EYENMG PHONE:
2800 THORNDYKE AVE lrli', SEATTLE WA 98199 � )
CITY OFFEDHIRLWAYBLME55LKEMENikti t: TAXi1iiFFBER:
CWTPXTOWS REQSTAT[ M N -MBR: — — — — — — EXPBLtTM DATE;
feW of rata rem&ert) W A S H I E 5 9 9 0 C W 02 { 28 /2003
APKWANT: '""'EVAYT[MEPHQK!
SHARON NIGHOLS
( 263 ) 836 7380
MAILBAGAT)MSS (S XEIADDR8 S: C[TY, b7ATE, ip): E1EAlm PWK,
420 SW 368TH ST 98023 ( )
PE! ATARI Kw M PRa;Krl NBEA
n ARCHUECT , TENANT 'I OTHER (AESCRI E); ( ) -
Ess
CONTACT PERSON FOR THIS PROJECT: a PROPERTY OWNER = APPLICANT p CONTRACTOR
EXISTING USE*
PROPOSED USE-
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER,
SEWER SERVICE PROVIDJER--
EXISTING BUILDING ASSESSEDIAPPRAISED VALUATION $... _ .._ ...- .....
. _--
_ PROPOSED VALI)ATION FOR EMPROVEMENTS: .3132.00
J YES LJ NO FIRE SUPPRESSION SYSTEM PROPOSEDjREQUIRED: L YES J NO
-+ LAKEHAVE14 iiWHLINE n TACOMA - PRIVATE (WELL)
m LAKEHAVEN =I HIG*KtNE LT PRIVATE(SEPTIC)
12/03/2002 20:22 3609452091 NWPERMIT PAGE 03
*7NENI R:ESIDErtTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROO"S:
ESTIMATED SELLING PRICE.
PRDJFC'T FI nOR APFA5
FLOOR
BAwF14kNT
E KL'FnNG SQ. Fr.
PROPOSED SQ. FT-
TOTAL ,
FIRST
FARM
HOOD(S)
WOODSTOVE(5)
SECOND
FlitEPIACE INSERT j
RANGgiS3
MISC. ( B
THIRD
FURNACE(S)
FOURTH
GAS PIPE OMET(S)
HEAT SOURCE:
Z) ELECTRIC o GAS
OTHER FLOORS (DESCRMF-)
DECK
PLUMBING
GARAGE
HOW MANY FLOORS? .�
LAVATMYM
URIfIAL(S)
WATER HEATER(S)
TOTAL-
RAM WATER SYS.
VACUUM BREAKER(S)
ELECTRIC ❑ GAS
Tndk4ft number of ears type of fixture
M€CHANXCAL
AIR HANDLING UNIT(S)
EVAPORATIVE COOLER(S)
QAS LQG(S)
REFRIG. SYSTEM(S)
BBQ(S)
FARM
HOOD(S)
WOODSTOVE(5)
001m(s) �-
FlitEPIACE INSERT j
RANGgiS3
MISC. ( B
COMPRES$OR(S)
FURNACE(S)
DUCTS)
GAS PIPE OMET(S)
HEAT SOURCE:
Z) ELECTRIC o GAS
PLUMBING
_ BATHTUB(S)
LAVATMYM
URIfIAL(S)
WATER HEATER(S)
DISHWASHER(S)
RAM WATER SYS.
VACUUM BREAKER(S)
ELECTRIC ❑ GAS
DRINKING FOUNTALN(S) _
SHOVIERM
WASH MACHINE OUTLET
GRAS PIPE OUTLET(S)
SMK[s)
NEATER CLOSET(S)
INTERCEPTOR($)
SUMPS)
K cwtify und$r pvssally aF p"Jusy ewt tlee 40acmation furpstsdsed by we is true and carredt to tbee best or rely Rarowledge, and
fudhec, that I am authorized by the ,oWner of the above premises to perfomt the work 1kF Nshfldr tine, w—it appiicatiam As made. F
further agree to hold hiirmbwa the C1tY of fedsra) Way as to rise cbl n (Inc siding ani, expensw, and attPMQVse fit" bumrred In the
lnvesUgation aqd 4efe. v of surb claim), which nary be ma" by any persons, indudinlg the undorsiowd, and fW against the Citi of
PMeral WRY, UkM ossfy WhFeM such c#abn B& -M out of the retfaam of the c1ty, intJudhV its offiecm and t."pfoy*ev's, open the acruracy
of the I nformatioR S41Rp)lV to the d" asp rt of "FTuation.
NAME/TITLE: c.(/� DATE1214/02
u PROPERTY OWNER J APPLLCAM' u CONTRACTOR
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