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04-105163 at City of Federal Way Mechanical Permit #: 04 - 105163 - 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: DIENST Q\ Project Address: 30128 3RDIS Parcel Number: 795450 0090 Project Description: Installing new gas logs and associated piping Owner Applicant Contractor Alan J Dienst &Emily J Dienst Emily J Dienst Emily J Dienst 30128 3RD PLS 30128 3RD PLS 30128 3RD PL S FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA 98003-4077 98003-4077 Mechanical Valuation 750 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description Quantity Gas Logs I PERMIT EXPIRES June'20,2005. Permit issued on December 22,2004 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: g'e_f , I Date: I l/�VOL/ FINALED 1214 PU1 l 0141 1-91 N - Cb D5 . /ji THIS CARD IS TO REMAIN ON-SITE • CITY OF101:114Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 04-105163-00-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. ❑ Mechanical Rough-in(4165) Gas Piping(4125) Final-Mechanical(4065) Approved Approved to release test Approved By Date B Date /J ����y Date / ��, .��'' RECEIVED 6 - / 0 5 f 6 3 Federal Way PERMIT COMMUNITY DEVELOPMENT SERV(C $_„ 2 2 o o S F M F CO L PL D E E N FP 3332FDRLWA ,VENUE WA OUTH 980PO 63-9718 AVi LL 1l." FiPPLICATION FEDERAL WAY,WA 98063-9778ITD /253-835-2607•FAX 253-835-2609 mono nonoffederalu'an CITY O���FnngIrdrtlFEDERAL WAY / The following is regtt'i����Yigtf - dn-an incomplete ap.lication will not be accepted. Please print legibly(in ink)or type. . y PROPERTY INFORMATION SITE SITE ADDRESS 3o 1 Z e) 3 y7W` `)( `_h� ( ',(iQ i ll.et ��3SUITE/UNIT# ASSESSOR'S TAX/PARCEL N _— "") LOT SIZE(sf7 LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal desenpnon) ■ PROJECT INFORMATION - - TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) u- 9ZS �105 s � -e. c s--k_r� I t J; (15 at 0-) --r-Li-re_-emc.. PROJECT NAME(Name of Business or Owner Last Name) Dl e4 St - - - - ' - -- II PEOPLE INFORMATION . PROPERTY NAM Dl PRIMARYr� PHONE OWNER I - lam(,-it_ giS3) qLe' - 79.37 MAILING ADDRESS CITY STATE,ZIP 3©tvai 3`- �t CONTRACTOR COMPANY NAME APPLICANT NAME T�.�1�({•��1��^lY,�/' ���,y��; OFFICE PHONE C:ITVSTATE,ZIp l kMI&Y�t&& CE-LL ON c(( iI MAILING ADDRESS _ E( CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER B L / / ( CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each applications EXPIRATION DATE / / APPLICANT COMPANY NAME ALICANT NAME OFFICE PHONE /1 MAILING ADDRESSCITY, V�j�.�'�I�`'�l CITY,STATE,ZIP CELL PHONE j\t7,�J (/��/Q let RELATIONSHIP RELATIONSHIP TO PROJECT L���,, (zc ) 3'" 'T �,�,/�,, /' FAX NUMBER ❑ Architect 0 Tenant 0 Agent (Other(Describe) CI I e ( ) _ CONTACT NAME PRIMARY PHONE E-MAIL ADDRE,SS LENDER Per RCW 19.27.095: Lender information is NAME required if project valueJ exceeds$5,000 MAILING ADDRESS �,l,.I CITY,STATE,ZIP - - .■ DETAILED BUILDING INFORMATION - - EXISTING USE PROPOSED USE -�] � • EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ G V V' SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? o YES ❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 IIIGHLINE 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 EXISTING TOTAL.PROPOSED TOTAL EXISTING AND PROPOSED •'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 Value of Mechanical Work $ MR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS BBQS FANS HOODS(commrc,m) W OODSTOV ES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or r.bishou<rcombo) SHOWERS WATER CLOSETS(Torleq MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom Sulks) VACUUM BREAKERS ELECTRIC WATER HEATERS , - '.r -=r_ �> .�:-' :1 C SIGNATURE BLOCK- -.'__ _=;- _.- •: u-.>z..-_ms'=s-.. - _• _ -- - r•yl��/ , 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. i /�.� NAME/TITLE q/....) DATE l9 Z/ 1{ (Signature ���tik�/v�� (TL[lc) ` 1 I RELATIONSHIP TO PROJECT ❑ Owner 0 Agent 0 Contractor ❑ Architect o Other E FOR OFFICE USE ONLY I o NEW a ADDITION a ALTERATION ❑REPAIR a TENANT IMPROVEMENT l BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? ❑YES o NO 1 ZONING DESIGNATION CHANGE OF USE? a YES o NO t NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? ❑YES o NO PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100—March 30,2004 — * Page 2 of 4 k\Handouts—Rcvised\Permit Application