06-105570City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
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Mechanical Permit #: 06 -105570 -00 -ME
Project Name: DE BORD >
Project Address: 28441 15TH PL S
Project Description: Installation of new gas fireplace with gas piping.
Inspection Request Line: (253) 835-3050
kz Parcel Number: 720300 0055
Owner
Applicant
Contractor
MICHAEL J DEBORD
AQUA REC INC
AQUA REC INC
ANNA M DEBORD
1221 REGENTS BLVD
AQUARI*110RA 2/19/07
28441 15TH PL S
FIRCREST WA 98466
1221 REGENTS BLVD
FEDERAL WAY WA
FIRCREST WA 98466
98003-3168
Additional Permit Information
Mechanical Valuation............................................2939.01 Over the Counter Permit? ...................................... Yes
Mechanical Fixtures
Fireplace Inserts ............................. 1, Gas Pipe Outlets............................. 1
Owner or agent:
PERMIT EXPIRES Friday, October 31, 2008
P rni#Iss'o6d on Tuesday, October 31, 2006
informationo t and that the construction on the above 'descrl; arc e[ty and
will be in accordance with the laws, rules and regulations of the State Washington
andity of deral Way.
Date: l0 3 Zoo
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -105570 -00 -ME
Owner: MICHAEL J DEBORD
Address: 28441 15TH PL S
FEDERAL WAY, WA 98003-3168
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 W f Approved
By Date By Date ////3 ld& By ""�D ate 1 /
err of RECEIVEC
Federal Way OC ► 31 2006 PERMIT
COM MUNIN DEVELOPUENr SERVICES
33375 am AVENUE SOUTH 980 O BOX 99I8 )PLICATION
FEDERAL WAY, WA 98063-971aCITY OF FEDE
253-aass6°r'PAX ssaa35-ate BUILDING
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SF MF COME L PL DE EN FP
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Ited. Please print katbir/ An ink) or tripe.
SITE ADDRESS 2g `i` (� 1 t!,, i3A SUITE/UNIT #
ASSESSOR'S TAIL/PARCELZ # LOT SIZE (sf3
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
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ROJECT INFOMIATION
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TYPE OF PERMIT ❑ BUILDING . ❑ PLUMBING WfiECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide/detailed description of work included on this vermit ow
h V, et— rF -' *- e,
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE•• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME nn PRIMARY PHONE
i 0.1- �� Qo,-d
MAILING ADDRESS CITY, STATE, ZIP
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
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MAILING ADDRESS
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MAILINCRADDRESS
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CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAYfBUSINESSILICENSE NUMBER
EXPIRATION DATE
PAX NUMBER
❑ Architect ❑: Tenant 0 Agent
❑ Other (Describe)
(
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with e}ch application)
EXPIRATION DATE
A f � R # d
►� �
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COMPANY NAME
APPLICANT NAME
OFFICE PHONE '
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MAILING ADDRESS
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CITY, STATE, ZIP
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CELL PHONE '
(L�"3) �, = f�Gir�
RELATIONSHIP TO PR ECT
FAX NUMBER
❑ Architect ❑: Tenant 0 Agent
❑ Other (Describe)
(
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 ❑ LAMIAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN . ❑ HIGHLINE ❑ PRIVATE (SEPTIC) ( r
I
AREA DESCRIPTION
EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
AIR HANDLING UNITS
FIRST
BBQS
SECOND
BOILERS_
THIRD
COMPRESSORS
FOURTH
.DUCTS
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT ❑
sasraa reoroeso rata.
NUMBER OF FLOORS
"NEW HOMES ONLY""' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
to
MECHANICAL
Value Mechanical Work $ ZJ 131.61 '
of
AIR HANDLING UNITS
EVAPORATIVE COOLERS
BBQS
FANS _
BOILERS_
FIREPLACE INSERTS
COMPRESSORS
FURNACES
.DUCTS
_
GAS PIPE OUTLETS
BATH7VBS (ornub/shoowcombo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVE Bothmom 9tnlril
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
is project. Do not include existing fixtures to remain.
GAS LO REFRIG. SYSTEMS
HOODS (commmo. q WOODSTOVES
RANGES MISC (Describe)
GAS WATER HEATERS
WATER CLOSETS (roseq _I
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
MISC (Describe)
Z certVg 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 authorised 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, andJiled 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 the accuracy of the ir{formation supplied to the city as a part of
this application.
NAME/TITLE DATE
(Signaturel fntie)
RELATIONSHIP TO PROJECT to Owner ❑ Agent O Contractor O Architect I7 Other
A1111ptin #1(1) — .Innllwv 1. 2006 Page 2 of 4 Mandouts\Permit Application