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16-102474r r City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Mechanical Permit #: 16 -102474 -00 -ME Inspection Request Line: (253) 835-3050 Project Name: ARBUCKLE Project Address: 31309 41ST -PL SW Parcel Number: 873199 0150 Project Description: Installation of gas pipe to 2 new fireplaces. Installation of Heat and Glo Cosmo gas insert in basement. Owne ARRlicant Contractor TODD & ELVIRA ARBUCKLE ALEXANDER'S HEATING INC ALEXANDER'S HEATING INC BRUCE & LINELL ARBUCKLE 11933124TH AVE NE ALEXAHI028M8 (8/15/16) 31309 41ST PL SW KIRKLAND WA 98034 11933 124TH AVE NE FEDERAL WAY WA 98023-2114 KIRKLAND WA 98034 Additional Permit Information Mechanical Work Valuation?.................................9000 Is this an Online or O.T.C. application? ................. Yes Mechanical Fixtures Fireplace Inserts ............................. 3 Gas Piping ...................................... X3 as P' Outlets............................. 3 PERMIT EXPIRES Satu Permit Issued on Mi I hereby certify that the above information is correct and that t5e46ns the occupancy and the use will be in accordance.with the I , rules _,?nd th# City o ederal W.: Owner or agent: a. 6 2016 he above described property and ions of the State of Washington Date: L'&- ' 4--7,A - THIS CARD IS TO REMAIN ON-SITE CITY" Construction Inspection Record Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 16 -102474 -00 -ME Address: 31309 41ST PL SW Project: TODD & ELVIRA ARBUCKLE FEDERAL WAY, WA 98023-2114 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 itis 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 Electrical Approved Final - Mechanical (4065) Approved By Approved to release test Approved By r Date By `_AA&j Date !; a b ' By Date Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date 4ik CITY OF Federal Way PERMIT NUMBER —16, �amgVIIT APPLICATION MAY 22016 TY OF FEDERAL WAY (9 Al e - _ CDS TARGET DATE SITE ADDRESS 3 13o %o/ C�4-v 1e"v471 9dWa3 SUITE/UNIT # PROJECT VALUATION $ .�&Vo, ao ZONING ASSESSOR'S TAR/PARC L # 'P 7 3 7 9' 9- o TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING XMECHANICAL []DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT 40 gf? /�' PROJECT DESCRIPTION Detailed description of work to be included on this permit only / _ J' �i7� Gl (�6/✓ NAME PRIMARY PHONE PROPERTY OWNER MAILING ADWMS (` . E-MAIL 1--7CPH ONE �51�6�� CONTRACTORc c3 CITY�FAR ZIPJ;o %�a7A WA TATE Q X-11 O TC7 OV11-3- FEDERAL4USINESS NSE #71 _ N0/i•�/1."" � / � �✓ /I/L� MAIIDREss APPLICANT CIT7Y STATE /� ZIcJ op©3 NAME' PRIMARY PHONE PROJECT CONTACT MAILING ADDRESS / EMAIL (The individual to receive and respond to all correspondence concerning this application) CITY U STATE ZIP FAX PROJECT FINANCING NAME ❑ OWNER -FINANCED When value is $5,000 or more (RCW 19.27.095) MAILING ADDRESS, CITY, STATE, ZIP PHONE 1 certify under penalty of perjury that 1 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 certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, 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 officers and employees, upon the accuracy of the information supplied to the city as a art of this application. SIGNATURE: '� DATE QA -1 PRINT NAME: Bulletin #100 – February 22, 2016 Page 1 of 2 k:\Handouts\Permit Application 10