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05-100375 CitybfFederal Way Mechanical Permit #: 05 - 100375 - 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) 835-305C Project Name: DIENST Project Address: 30128 3RD&pi 5 Parcel Number: 795450 0090 Project Description: Replacing gas log set Owner Applicant Contractor Alan J Dienst &Emily J Dienst Emily J Dienst GODFREY'S PLUMBING 30128 3RD PLS 30128 3RD PLS 15015 88TH ST E FEDERAL WAY WA FEDERAL WAY WA PUYALLUP WA 98372 98003-4077 98003-4077 (425)688-9888 Mechanical Valuation 852.75 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description IQuantity Gas Logs 1 PERMIT EXPIRES July 27,2005. Permit issued on January 28,2005 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: (z_ (0 1-- THIS CARD IS TO REMAIN ON-SITE CITY OF Community Development InspectionRecord Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-100375-00-ME Owner: ALAN J DIENST Address: 30128 3RD PL S FEDERAL WAY, WA 98003-4077 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) 0 Gas Piping(4125) 0 Final-Mechanical(4065) Approved Approved to release test Approved By Date By Date By Date J 3` a i � oF A CANED D 6- 1 D 0 3 �S -Fedetai WayRE pERMIT COMMUN17YDEVELOPMENT SERVICES SF MF CO EL PL DE EN FP 333256TMAVENUES011771•POBOXfJf1 2 8 2o0APPLICATIO N FEDERAL WAY,WA 93063-971 �V 7D / / 253-335-2607•FAX 253-835-2609 www cityoffederalwati com CITY OF FEDERAL WAY The ollowi • is re • 4I',Gaaain-an Inco .lete a••lication will not be acce.ted. Please •rint le.ibl (in in or IN PROPERTY INFORMATION SITE ADDRESS 3r)( L- ) arc, Y(' S SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - _ _ _ LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal desc iphon) ■ PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING JVIECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed de,scription of work included on this permit milli) Rem Jct_s lei ca-- rtel t.ce, &-n1/49u/tai PROJECT NAME(Name of Business or Owner Last Name) Di o1S PEOPLE INFORMATION PROPERTY NAME ff�/� U.-7 (,�J P y�( /yR��� (!I /' ( y lvl � J 3Y)PH `l'l - P37 OWNER MAID 0(Rz / s CITY STATE,ZIP L 9O3 CONTRACTOR PANY NAME CTOdf���1 _ yi?IV APPLICANT NAME - /rlJ/,/^ OFFICE PHONE ue . lOce (`ta5) 02-1 MAILING ADDRESS CITY ATE,ZIP CELL PHONE 1 `301 S Ur`' �- fu icor tram ( ) - CCIITY OF FEDERAL WAY BUSINESS LICENSE NUMBER7J�7EX IRATTIION DATE FAX NUMBER 2'Q-SJ.1-1o_ L� 7_ B L 4C� / Jl /os ( ) CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE APPLICANT COM N NAM APPLICANT NAME OFFICE PHONE MAILING ADDRESS ��/ (�//� CITY,STATE,ZIP `�'j'''�{ - CELL PHONE RE.Tt!H P PROJECT r( S / FAX NUM)ER ❑ Architect 0 Tenant ❑Agent 0 Other(Describe) ( ) - CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS ( ) - LENDER .er,. `.,:kW:.,• .v. Ayi NAME MAILING ADDRESS CITY,STATE,ZIP I DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WO• $q5.)\/)'16 ' "'1 SPRINKLERED BUILDING? ❑YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQ I. • - c r•5,. 0 NO WATER SERVICE PROVIDER ❑ LAICEHAVEN 0 IUGHLINE ❑TACOMA a PRIVATE(WELL) SEWER SERVICE PROVIDER a LAKEHAVEN 0 RTGHLINE 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 EXISTING SF TOTAL PROPOSED SF TOTAL SF 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 $ AIR HANDLING UNITS EVAPORATIVE COOLERS X _ GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(cammerc,at) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toile) MISC(Describe) DISHWASHERS SINKS _ DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS I.AVS(Bathroom Sinks) 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. NAME/TITLE / / DATE ! /dc-- /OSP— (Signature) (Title) RELATIONSHIP TO PROJECT ,wner ❑ Agent o Contractor 0 Architect ❑ Other ` aJ o ADDITION,;,'; o ALTERATION a REPAIR Y _ 3'TENANT IMPROVEMENT `= r i'r i .FiFiiNLY?;; •v '^'_;gyp YES,£o`NO , BASIC PLANVIONSW;=r= x: a YES • :•'o NO.^ - it,,t0;•ESIGMATIONm; ' '^ CHANGE a YES �DRESS=REQUIRED?• _ °a YES'=�NO`'`ter.. UP/SEPA/SU?.' r• `•'• '=_.~ --a YES ci NO .•' . Ot � D T .: ;°' ? � IC ^$34110_ :° ;^ .DEMO PERMIT*E9IJIRED? a YES ,i Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Pcrmit Application