05-106352 VI
City of Federal Way Mechanical Permit #: 05-106352-00-ME
Community Development Services
P.O Box 9718
Federal Way,WA 98063-9718
Ph (253)835-2607 Fax:(253)835-2609 1Inspection Request Line: (253)835-3050
Project Name: REINICK
Project Address: 32507 42ND PL SW Parcel Number: 873201 0480
Project Description: Installing a new gas fireplace insert and up to 20 lineal feet of gas piping
,
Owner Applicant Contractor
HENRY R REINICK AQUA REC INC AQUA REC INC
32507 42ND PL SW 1221 REGENTS BLVD QUA' 110RA 2/19/07
FEDERAL WAY WA FIRCREST WA 98466 e 22 ' GENTS BLVD
98023-2649 \(.._ 'CREST WA 98466
Additional Permit Informa 'on /
Mechanical Valuation 2763.51 Ove the C r P- ' it? Yes
Mechanical Fixt res
Fireplace Inserts 1 Gas Piping ¢ i 20
CO IT
\.i) /
• • PERMIT XPIR S onday, June 12, 2006
Permit Issue. 6n e,/esday, December 14, 2005
(I hereby certify that the above information 's Q, , ct and that the construction on the above described property and
the occupancy and the use will be in - .•;:'• ,ce with the laws, rules and regulations of the State of Washington
ity of Federal Way.
Owner or age �_ Tioor
tWair Date: /Z /`` /--
dillir ' 'r
1
4
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPI CTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106352-00-ME
Owner: HENRY R REINICK
Address: 32507 42ND PL SW
FEDERAL WAY, WA 98023-2649
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 • Approvedppto release test Approved
By G>� Date/2 . (4 e d By C_W Date/2. 4.og— By Date
. l
i
ciA RECEIVED
Federalway PERMIT — L- ��
COMMUM7YDEVELOPMENT SERVICES DEC 1 4Op w i SF MF CO ME EL PL DE EN FP
333QSt"ERAL WA so07N.poBox 9718LI C AT I O N
FEDERAL WAY,WA 98063-9718 p OTC
953 Sw. o�derdll ca, CITY OF F DERAL WAYr-- �
BUILDING DEPT, I
The ollowi • is fired in ormation-an Inco •fete • ••Uication will not be acce•ted. Please 'runt le•ibl in in or
■ PROPERTY INFORMATION
SITE ADDRESS '2 7 yZ ND ILS e SVV F �^
K7 --:00-...1 SUITE/UNIT#
TAX/PARCEL# 11 7 3 2 O / — Q 4/ 1 LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
/Aaadh aeparaiePace far 10,9thv legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 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)
R At 4M1tiKr GM' ti/ 76. An,AleE . f 4 ,/"6- 5 //UJ T-i . .
PROJECT NAME(Name of Business or Owner Last Name) -
111 PEOPLE INFORMATION
PROPERTY NAME '(�,p,, r n PRIMARY PHONE
OWNER 6((/tD 4 V• '�•`rC T- l(`/�) icK-- I ( zr3 )77Y - ..w
MAILING ADDRESS CITY,STATE,ZIP
3z-S-67 YZ ND �i so/ I v t 4 -y ��a z 3-
CONTRACTOR COMPANY NAME ILS,�! APPLICANT NAME OFFICE PHONE
AtkikA°t (� c3t'+ S{ I AlAi f (zs3 )6.3-Z- -(79 2-
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(22 l ,C-C7e.,-5' n/t'.1/ ) 207- Z 6
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER �2er (•
[RATION DATE FAX NUMBER
CONTRACTORS REGISTRATION NUMBER(copy of card Knired with each application( / ( )
EXPIRATION DATE
Q Lt 14 g T t L 1 _1g 4 z / 1q / a7
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant a Agent ❑ Other(Describe) ( ) _
CONTACT NAME
4.&o.. .FLS PRIMARY PHONE
( ) J z - 119Z, E-MAIL ADDRESS
LENDER
i : ;lc a., ;.,,y::., ,.{,",fr,: !"l;Livi�ft%%F;,. i NAME
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES ❑ NO
WATER SERVICE PROVIDER a LAKEHAVEN a/IMMUNE ❑TACOMA []PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
•
PROJEt3T FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
t 4 SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0 i
NUMBER OF FLOORS ExurDto PROPOSED Tom k ioroeED it -
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL -7
Value of Mechanical Work $ 2 !�P 3
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(emmeret.q WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES - MISC(Describe)
• COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS ZL'S' GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower combo( SHOWERS WATER CLOSETS(roues MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(SNhrom Stilts) 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 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,includ •• er d employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE I Z//`V g.S�
(Signature) (Title)
RELATIONSHIP1 o• •ROJECT ❑ Owner ❑ t ❑ Contractor 0 Architect ❑ Other
t0900e)4 Wird Y,V a } i_....V1Y 1 ' i1' 1,41Pic), S1W,
}eli1100\ft, :);e €4. c��E .f� � } 1�,. ' '4,:q•1(€
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Bulletin#100—January 7,2005 Page 2 of 4 lAHandouts\Permit Application