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04-104572 City of Federal Way Mechanical Permit #: 04 - 104572 - 00 - ME Community Development Services P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050 Project Name: HOLMES pjJPi Project Address: 32225 27TH SW Parcel Number: 873180 0820 Project Description: Installing a new Lopi Answer wood-burning,fireplace insert into an existing chimney Owner Applicant Contractor Mike D Holmes Mike D Holmes Mike D Holmes 32225 27TH AVE SW 32225 27TH AVE SW 32225 27TH AVE SW FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA 98023-2273 98023-2273 Mechanical Valuation 800 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description Quantity Woodstoves 1 CONDITIONS: Manufacturer's installation instructions are to be on-site at time of inspection(s). PERMIT EXPIRES May 8,2005. Permit issued on November 9,2004 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 Way. Owner or agent: ,2f7 Date: Af/ l $7{ 6 THIS CARD IS TO REMAIN ON-SITE - CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE #(253) 835-3050 PERMIT#: 04-104572-00-ME Owner: MIKE D HOLMES Address: 32225 27TH AVE SW FEDERAL WAY, WA 98023-2273 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) 0 Gas Piping(4125) Final-Mechanical(4065) Approved Approved to release test Approved By Date By Date K2-/, Date.EZ,._s - f LI- OTT OF��N ! eV SYR Yom' • M Yi O 4 _ ( O 5 ( - , Fe .4•.A. eral Way PERMIT COMKUNITYDEVELOIMFNTSERVICES SF MF COmEL PL DE EN FP 3332FEDE�WAY,SOUTH .�-BOX 97Id Nov 0 2 PLI CATI O N TD 253-835.2607•FAX 253-835-2609 / / www ahloffederedwau com CITY OF FEDERAL WAY The ollowl ! is re• ired i;I.bEtai auDENinco •lete a••iicatlon will not be acce• -•. Please •rint le• -1_ n in or _)• . • PROPERTY INFORMATION SITE ADDRESS 2 22 S 2 711A A t^LA_ 5 W SUITE/UNIT# ASSESSOR'S TAX/PARCEL# L 2 3 7 _g o - O 2,1C) LOT SIZE(sQfl 7 35'0 LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 7-r c)11A e. GA ke s v' QJ ) Lo f AO Z (Attach sepomvpap.for Mwdw lewd deecnption) / • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 4 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)i / H S ef I ✓'Q-10 /C Ce /" S- i- -'C S'- I �e S S S-/-r o v�1 CA t wl vN.e� i(r1.¢.!t /K /'G /9(TA_ — •e._,(,S,>L I L'y ..67 v A d/C.. G2. PROJECT NAME(Name of Business or Owner Last Name) // 0 /01 S • PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER M e c‘44 .0-1 1). H.(„,,......s (2,53 7.fo - 3S0 y , MAILING ADDRESS CITY,STATE,ZIP 3222 5 271LN i4k)t- Sw f.acta...4QL w � ,, 84'2- 3 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 6 w ( ) MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER - - - B L / / ( ) CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE / / APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE ©(A)%••A--A ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) CONTACT N ME /� r PRIMARY PHONE E-MAIL ADDRESS Pi l G -Iii 0, /4 /vet e S (2r3 7io - .3S0Y LENDER Per RCW 19.27.093 Dander.Information le NAME required Vprgfect:value exceeds.$$r000, MAILING ADDRESS CITY,STATE,ZIP //�� n • DETAILED BUILDING INFORMATION EXISTING USE j' 5 i dC.2 ti-1-l crX PROPOSED USE 3;w`� EXISTING ASSESSED/APPRAISED VALUE $ ZOO/ o0•O VALUE OF PROPOSED WORK $ Ra 0 SPRINKLERED BUILDING? ❑ YES IF NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES Ille NO WATER SERVICE PROVIDER * LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 4 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE 0 CARPORT 0 EXISTING PROPOSED TOTAL TOTAL 1117a 11110 Sr TOTAL PDOIO1111A M TOTN,U NUMBER OF FLOORS • **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ far AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS Icommermal WOODSTOVES BOILERS X FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroomem►.) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK I certify 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 authorized 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,and filed 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 information supplied to the city as a part of this application. • `/K/ 3o NAME/TITLE 1 p Wim) DATE // y (Signature) (Title) RELATIONSHIP TO PROJECT Owner 0 Agent ❑ Contractor 0 Architect ❑ Other a NEW o ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES a NO BASIC PLAN? a YES .0 NO ZONING DESIGNATION CHANGE OP USE? a YES a NO _ NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES ci NO PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO Bulletin#100-August 19,2004 Page 2 of 4 k\Handouts\Permit Application