07-105942IA�ofity D Federal Way Mechanical Permit*. 07-105942-00-M t
Commifiity Development Services •
"P.O. Box 9718
Federal Way, WA 98063-9718
Ph. (253) 835-2607 Fax: (253) 835-2609 a3 Inspection Request Line: (253) 8`35-3050
Project Name: RUSSELL
Project Address: 31428 13TH AVE SW Parcel Number: 416810 0070
Project Description: Install gas fireplace insert
Owner
Applicant
Contractor
BENJAMIN RUSSELL
BENJAMIN RUSSELL
BENJAMIN RUSSELL
31428 13TH AVE SW
31428 13TH AVE SW
31428 13TH AVE SW
FEDERAL WAY WA
FEDERAL WAY WA
FEDERAL WAY WA
98023-4507
98023-4507
98023-4507
Additional Permit Information
Mechanical Valuation............................................450 Over the Counter Permit? ...................................... Yes
MechanicalFixtures
Fireplace Inserts ............................. 1
PERMIT EXPIRES Monday, October 26, 2009
Permit Issued on Friday, October 26, 2007
1 hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will ben accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO AIN ON-SITE .
r
CITY OF . fommunity Developm nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07-105942-00-ME
Owner: BENJAMIN RUSSELL
Address: 31428 13TH AVE SW
FEDERAL WAY, WA 98023-4507
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 Date /Z
For inspector reference only__._
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
arra
�ra I W, by
COMWNITY DEVELOPAWff SBRVFCSS
39326 0 AV$NUS SOUTH • PO BOX 9710
FEDB'BAL WAY, WA 98069.9718
759898•2607• FAX 753435.7609
REcEIvEDPERMIT
OCI 2 APPLICATION
SF MF C DEEL PL DE EN F
CITY of FaaERAL WAY
The following is r+equiredW&A"PEPir"compkte application will not be accepted. Please print. kgibty (in irtk) or type.
PROPERTY INFORMATION
SITE ADDRESS ( �"� �l✓t jo ,�r SUITE/UNIT tk
ASSESSORIS TAR/PARCEL ti — — — — _ — — _ — LOT SIZE (sJ)
LEGAL DESCRIPTION (e.g. Acme.Estates, Lot 1)
PROJECT•- •
TYPE OF PERMIT XUILDING O PLUMBING. ❑ MECHANICAL
❑ DEMOLITION O ELECTRICAL ❑ ENGINEERING ❑ .FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this hermit only)
7
PROJECT. NAME (Name of Business or Owner Last Namel >
PEOPLE• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
E%IOTING USE
NAME PRIMARY PHONE
ri ( ,
M -UUNO AD S , ATE, ZIP EMAIL ADDRESS
e, 11VIS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
C7PY, STATE, ZIP
CLL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REGISTRATION NU ER MM TION DATE
E MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
_
NAME PRIMARY PHONIC E-MAILADDRESS
NAME
Per=W 19.Z7.098t
Lender information is required i j project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP /PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? D YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 13 PRIVATE ISEPTICI
PROJECT ••
AREA DESCRIPTION -EXISTING
SO. FT.
PROPOSED
SQ. FT.
TOTAL
80. FT.
BASEMENT
EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQ3
BASIC PLAN?
FIRST
BOILERS
FIREPLACE INSERTS HOODS ico�ud,q
COMPRESSORS
SECOND
FURNACES RANGES
DUCTS
NEW ADDRESS REQUIRED?
THIRD
UP/SEPA/SU?
o YES
o NO
ADDITIONAL FLOORS (DESCRIBE)
a YES a NO
DEMO PERMIT REQUIRED?
a YES
DECK (O COVERED OR O UNCOVERED?)
GARAGE 0 CARPORT 11
NUMBER OF FLOORS
rsO eD
TOTAL
rerazaeroasr
'ror"cmor°esasr
rarmer
"NEWHOMES ONLY"., NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of f cture to a installed or relocated as part of this project. Do not include existing furfures to remain.
w�wann�a.r,..
Value of Mechanical Work
`i SU : '
(A PY OF BID OR ESTIMATE MUST • BE 1NCLUDAD WITH APPLIC,ATTOIT
AIR HANDLING UNITS
EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQ3
BASIC PLAN?
FANS GAS WATER HEATERS T_ MISC (Describe)
BOILERS
FIREPLACE INSERTS HOODS ico�ud,q
COMPRESSORS
CHANGE OF USE?
FURNACES RANGES
DUCTS
NEW ADDRESS REQUIRED?
GAS LOG SETS REFRIG. SYSTEMS.
BATHTUBS (-T b/ahow.rc.mb.) LAVS (B■&. shA.) URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS rres.q
ELECTRIC WATER HEATERSSINKS WASHING MACHINES
HOSE BIBBS SUMPS
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my
knowledge, the information submitted in support of this permit application is true and correct. I eer ft that l will comply with all applicable
City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with focal, state, or federal laws regulating construction or environmental laws.
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, but only
where such claim arises out of the reliance of the city, including Its gpicers and employees, upon the accuracy of the information supplied to
the city as a part of this application.
SIGNATURE:
Owner
a NEW a ADDITION
o ALTERATION
a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES. o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
a NO
NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT?
a YES a NO
DEMO PERMIT REQUIRED?
a YES
a NO.
Bulletin #100 -August 16, 2007 Page 2 of 4 . MHandoutsTermit Application