04-104906 ti
City of Federal Way Mechanical Permit #: 04 - 104906 - 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: VAN ALSTINE
Project Address: 33607 26TH SW Parcel Number: 255700 0880
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Project Description: Replace existing wood fireplace insert with a gas fireplace insert,including new gas piping.
Owner Applicant Contractor
Michael Vanalstine &Betty R Vanalstine Michael Vanalstine Michael Vanalstine
3217 S 296TH PL 3217 S 296TH PL 3217 S 296TH PL
AUBURN WA AUBURN WA AUBURN WA
98001-1467 98001-1467
Mechanical Valuation 2500 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description 1Quantity Description ,Quantity
Fireplace Inserts 1 Gas Piping 1
PERMIT EXPIRES June 1,2005.
Permit issued on December 3,2004
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: - _' •_. — `>♦ Date: I Z f 3/ O y
F 1NI\LED
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THIS CARD IS TO REMAIN ON-SITE
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CITY OF
Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104906-00-ME
Owner: MICHAEL VANALSTINE
Address: 33607 26TH CT SW
FEDERAL WAY, WA 98023-7708
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.
0 Mechanical Rough-in(4165) - Gas Piping(4125) Final-Mechanical(4065)
Approved Approved to release test Approved
By Date G 5 Date Z.---4,,,,c----, Dat is
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� ('CederalWay RGoVED PERMIT
COMMUNITY DEVELOPMENT SERVICES SF MF CO ME EL PL DE EN FP
33325 8Tu AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 DEC 0 3 APPLICATION /
253-835-2607•FAX 253-835-2609
www olgofjederalwaq con
Ilk The following is req t�t1r�eie EDERAL WAY
it 1 &;- 'a:'Li an incomplete ap•lication will not be acce•ted. Please print legibly(in ink)or type.
/ I PROPERTY INFORMATION
SITE ADDRESS -334 0 ? Z(21:14- Cr S'L) SUITE/UNIT# I
ASSESSOR'S TAX/PARCEL# Z- S S 7 D C) - Q s A V LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descnphon)
■ PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING ❑ MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
IE'faPLpCF P1r/57 &4 wco'b fr' fPligCE I..)SE41 LI eq 6.4s Ffrz pLACf "uSFWi,
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PROJECT NAME(Name of Business or Owner Last Name) VAN ALSrT/A J f
- • PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER Gat J i c.A0A f i fl kc Y ie. �a..d S'T/tif. (2 53 )'3. - 5>i>
MAILING ADDRESS CITY,STATE,ZIP -
33bo? Z641-4Cr Sw Pf , LJAy) WA 48023
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
S.o.,( YIS aW WER ( )
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
SiaME A S o w,.1E2 ( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT - FAX NUMBER
❑ Architect 0 Tenant 0 Agent 0 Other(Describe) ( )
CONTACT NAME PRIMARY PHONE
E-MAIL ADDRESS
-sia ti+E PS O witE 2 ( ) - Vo"/119 Co.-,to O.Ale-7
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000 0 A
MAILING ADDRESS CI ,STATE,ZIP
v, ■ DETAILED BUILDING INFORMATION -
EXISTING USE RES 11E 4,1i.w L PROPOSED USE IQE 5-/Dic..77 ,aL
.
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES P NO FIRE SUPPRESSI9N SYSTEM PROPOSED/REQUIRED? ❑ YES • NO
' WATER SERVICE PROVIDER I. LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ■LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
• FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
—
HOW MANY FLOORS? TOTAL STING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
uC
"NEW HOMES ONLY NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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 ,,, op
Value of Mechanical Work $ '5O- '
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
BBQS FANS HOODS(commero.y) W OODSTOV ES
BOILERS I FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS t GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Toh/Show<rCombo) SHOWERS WATER CLOSETS(rodoq MISC(Descnbe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
__-. __ : .-y'_ i.).;:a---:;::;_:;-:_:1:''': - '-'-''r,';-:_'''''' =DISCLA MER/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.
NAME/TITLE
�y� j 3 O t{
l'6 � "V DATE
(Signature) (Tttlel
RELATIONSHIP TO PROJECT o Owner ❑ Agent 0 Contractor 0 Architect 0 Other
( FOR OFFICE USE ONLY
o NEW o ADDITION a ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? D YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES D NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? D YES D NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? o YES ❑NO
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[Bulletin#100—March 30,2004 —
Page 2 of 4 k\Handouts—Revised\Permit Application