06-1002484
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: SIMPSON
Project Address: 30310 6TH AVE S
Project Description: Install of fireplace insert
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Mechanical Permit #: 06 -100248 -00 -ME
Inspection Request Line: (253) 836-3050
Parcel Number: 064310 0210
Owner
Applicant
Contractor
KATHY SIMPSON
WASHINGTON ENERGY SERVICES CO
WASHINGTON ENERGY SERVICES CO
30310 6TH AVE S
2800 THORNDYKE AVE W
WASHIES9710B (9/2/06)
FEDERAL WAY WA 98003
SEATTLE WA 98199
2800 THORNDYKE AVE W
SEATTLE WA 98199
PERMIT EXPIRES Tuesday, July 18, 2006 _.
Permit Issued on Thursday, January 19, 2006
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 a rdance with the laws, rules and regulations of the State of Washington
and he City of Federal Way. I
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Owner or agent: Date:
N'# THIS CARD IS TO REMAIN ON-SITE e It
CITY OF Commulrio-�Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -100248 -00 -ME
Owner: KATHY SIMPSON
Address: 30310 6TH AVE S
FEDERAL WAY, WA 98003-4014
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 By C t Date Z,. f (o
JAN -18-2006 10:21 FROM:PERMIT 4257756315 TO:12538352609 P.2
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Federal Way
COMMUNM DEVELOPMENr SERVIC83
3332S Vw AVENUE SOUTH - PO BOX 9718
FEDERAL WAY, WA 98063.9716
453-035.4607- FAX 453435.2609
11I.Mm
SITE ADDRESS
PERMIT,SF MF CO EL PL DE EN FP
APPLICATION9, °
ASSESSOR'S TAX/PARCEL M D
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
SUITE/UNIT If
LOT SIZE (s])
PROJECT• •
TYPE OF PERMIT 0 BUILDING 0 PLUMBINGMECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING D FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION ftuide detailed description of work included on tilis r7nit onlul
PROJECT NAME (Name of Business or Oumer Last Name) --,,Vi ✓ �' �at/ ' `
PEOPLE•- •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
NAMt j� PRI¢AARY PHONE
S
t 1753) Y-79-
MAILI NO A�DRESS �ry CITY. STATIC. ZIP � �Ix
COMPANY N E
APPUCANT NAME
OFFICE PHONE
( J`
��
TY, SEAT 1
(' ) -
MAILING �E9S t ,V
,STAT .
CELL PHONE -
CITY OF FEDE `L A BUSINESS ENSE NUMBF.R EXPIRATION DATE
FAX NUMBER
CONTORIS REGISSTTRAATTION NUMBER
BER (copT of card raquf"d with .4a1 applleatloaf FXPIRATION DATE
1VJ /^l
COMPANY NAME C -
APPLICANT NAME
OPPICE PHONE
MMUNO ADDRE3
TY, SEAT 1
CELL PHONE'
/
RELATIONSHIP TO PROJECT
FAX NUMBER
0 Architect ❑ Tenant 0 Agent o Other (Describe)
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ r
SPRINKLERED BUILDING? 0 YES a NO FIRE SUPPRESSION SYSTEM PROPOSED%REQUIRED? O YES 0 NO
WATER SERVICE PROVIDER O LAKEHAVEN 0 HIGHLINE O TACOMA 0 PRIVATE (WELL)
JAN -18-2006 10:21 FROM:PERMIT
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4257756315 TO:12538352609 P.3
AREA DESCRIPTION
EXISTING PROPOSED TOTAL
so. FT.. SO. FT. SQ. FT.
BASEMENT
WOODSTOVES
FIRST
MISC (Describe)
SECOND
THIRD
MISC (Describe)
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT D
NUMBER OF FLOORSO 'ro""
"NEW HOMES ONLY*" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE
number of each type of f bdure to be installed or relocated as part
MECILANZCAL O
Value of Mechanical Work $
AIR HANDLING, UNITS
BBQS
BOILERS
COMPRESSORS
DUCT3
PLUMBING
BATHTUBS (errub/shover combo)
DISHWASHERS
OAS PIPE OUTLETS
WASHING MACHINES
LAVE jDatbroom mm4
EVAPORATIVE COOLERS
FANS
-�f--- FIREPLACE INSERTS
FURNACES
OAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
not inclade existing
OAS IROS
REFRIG. SYSTEMS
HOODS (eommere[YJ
WOODSTOVES
RANGES
MISC (Describe)
GAS WATER HEATERS
WATER CLOSETS troueq
MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
I certVy under penalty of perAry that the trVormation 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 de(/ense of
such claim) which may be made by tiny person, including the undersigned, andfled against the City of Federal Way, but only where such claim
arises out of the reliance of the yity, in ding its officers and employees, upon the accuracy of the tr{jormation supplied to the city as apart of
this application.
NAME/TITLE G%Z/LCA �C� �v V DATE
(signature) mue)
RELATIONSHIP TO PROJECT Q Owner Agent O Contractor p Architect t] Other
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