05-106126 CdeMechanical Permit #: 05-106126-00-M E
rornrn = p=ervices r
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: BELCOURT
Project Address: 2706 SW 315TH ST Parcel Number: 150310 0410
Project Description: Relocate gas line to new meter location.
Owner Applicant Contractor
PAUL BELCOURT NATURAL GAS SERVICES LLC NATURAL GAS SERVICES LLC
2706 S 315TH ST 38020 236TH AVE SE NATURGS971BC(1/3/07)
FEDERAL WAY WA 98003 ENUMCLAW WA 98022 38020 236TH AVE SE
ENUMCLAW WA 98022
Additional Permit Information
Mechanical Valuation 500.00 Over the Counter Permit Yes
Mechanical Fixtures
Gas Piping 1
CONDITIONS:
PERMIT EXPIRES Monday, May 29, 2006
Permit Issued on Wednesday, November 30, 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 accordan a with the laws, rules and regulations of the State of Washington
n•f'►,= Ci ederal Way.
Owner oragenCak..-.—�_ P - Date: 7/ /5.0 /OS
•
THIS CARD IS TO REMAIN ON-SITE ,.•-
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106126-00-ME
Owner: PAUL BELCOURT
Address: 2706 SW 315TH ST
FEDERAL WAY, WA 98023-7832
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 BSS Date /2 _.G y Date
I
A. . RECEIVED -
Federal Way Af 3 Z • _�
I 'COMMUNTY DEVELOPMENT SERVICES PERMIT NOV o V 0 2005.
IF MF C / �EL PL DE EN FP
99925 AVENUE WAY, ATH•!•O BOX APPLI CATIIIN t
FEDERAL 07.FAX 98063-97180 FEDERAL�/qy /
259J9ST6o7•FAXT59J359609 I DING DEP_ ��f
www.dtuoffederaiwaunem
The oilowl • is re• fired in ormation-an Inco •fete • • •lication will not be acce•ted. Please .rint le•ibl n or p .
■ PROPERTY INFORMATION
SITE ADDRESS a -20 tO SV✓ 3 /_s" 5 / SUITE/UNIT
•
ASSESSOR'S TAX/PARCEL$ - _ _ _ LOT SIZE(sf)
LEGAL DESCRIPTION fe.g.Acme Estates,Lot 1)
Which separate Per tier koWw ieyai description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING TA,PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
nn
r/'C-n_ Li/'✓ ./Q-c--L—,) f1--2 i-7-z-7-Lt--
i �c ,f--77 "--1
PROJECT NAME(Name of Business or Owner Last Name) l('C ( f"--T
U PEOPLE INFORMATION
PROPERTY NAME ?I/�'I, "�/ C O Id 2 i PRIMARY PHONE
OWNER (2c1,)3s-V - .9so
MAILING ADDRESS CITY,STATE,ZIP
9 -7 d to S w 3 /s- 5r `,-o ,-,-,47. L-„ i4.j 9s4,0 -3
CONTRACTOR COMPANY NAME APPLICANT NAME
V(2,„4-/ 6 45 S OFFICE PHONE
/Q
Pel/�.—�cA.._ (-2‘31 .31 - 5--y 79
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
3-SO O 23(0 Av Sc F��...,-,c ",1-1,✓ 9gaa (.v,5-3) 6,32 -90a 9
• CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE FAX NUMBER
.20--C Q-1 L. .2 (..:. c a -B L 1f/ _3( / 6 s t ) -
I
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
SI A — ✓ £ s 1 2 L L C o i 1 v 300o )
APPLICANT COMPANY NAME \
J\ APPLICANT NAME OFFICE PHONE
' MM LING ADDRESS CITY,STATE,ZIP – CELL PHONE
RELATIONSHIP TO PROJECT ( )
FAX NUMBER
0 Architect ❑Tenant o Agent 0 Other(Describe) ( ) _
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
iD4I fruc_i e,c._‹_. (?§-3) 4,3? - 9v; 9
LENDER ;< :
A'” ii;Ya� li�Y.inir: . • NAME
---:', a. .,^,,{.;. , 4,,,.,a•r,. 3:..,1,;,. Al'/A
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING
PR. L.•: • USE
EXISTING ASSESSED/APPRAISED • ,."•• VALUE OF PROPOSED WORK $ 5CC• DG
SPRINKLERED BUILDING? a • . NO F y • : D-. ION SYSTEM PROPOSED/REQUIRED? ❑YES a NO
WATER SERVICE PRO i• • t.
0 LAKEHAVEN a HIGHLINE ❑T «. . . ❑PRIVATE(WELL)
SEWER SERVIC •'" •VIDER o LAKEI1AVEN ❑HIGHLINE 0 PRIVATE(SEPTI
•
PROJECT FLOOR AREAS '
AREA DESCRIPTION EXISTING PROPOSED TOTAL
• ' SQ.FT. SQ.FT. SQ.FT.
BASEMENT
RST
SECOND
•
THIRD
FOURTH •
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS =STING PROPOSED TOTAL :,t<,_:, =s s;f? '• ' •"F,h: 1
"NEW HOMES ONL 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 �G�).co
of Mechanical Work $
•
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(eemmerel.y WOODSTOVES
BOILERS • FIREPLACE INSERTS RANGES MISC(Describe)
• COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS I OAS PIPE OUTLETS
PLUMBING
BATHTUBS(orTtb/Shower combo( SHOWERS WATER CLOSETS(roues MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(eachr.omsun) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
•I cert(fy 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,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of the city,including its offic and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLr . D L✓NA c— DATE / A / 5(Signatur,(7/
(Title)
RELATIONSHIP TO PROJECT a Owner a Agent 5iontractor a Architect 0 Other
t@✓1':(' .w D)E)E'r'(c)�f ;1 F'0a1;4•u0(01r1••. .. r 'i;b:Av.hW .. - - ..
:le;II,c)[kV., :i:S t,E C)S(R.,.? - ---- ,;(t3t
1e);. ._tt 1="0,aID1)"9a111;JD .t :i ;to) F def'' �/ �s nom- - ;re)
f'r: . < .(o; �tij;0*(4 1 ,¢Nr ".,t0i rle,. Te*,
•
•
4
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application