05-104712 City of Federal Way Mechanical Permit#: 05 - 104712 - 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) 835-3u5€
Project Name: KLEIN
Project Address: 4107 SW 321ST St- Parcel Number: 873190 2240
Project Description: Install gas fireplace insert with gas piping
Owner Applicant Contractor
Michael R Klein &Linda H Klein WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
4107 SW 321ST ST 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA 98023-2414 SEATTLE WA 98199 SEATTLE WA 98199
(206)282-4700
Mechanical Valuation 2834 Over the Counter Permit Yes
Mechanical Fixtures
Description !Quantity , Description Quantity Description [Quantity
Fireplace Inserts 1 Gas Piping 1
PERMIT EXPIRES March 21,2006.
Permit issued on September 22,2005
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 acc ance with the laws,rules and regulations of the State of Washington and
the City of Federal W
Owner or agent: fie) Date:
�� d�
` THIS CARD IS TO REMAIN ON-SITE `
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104712-00-ME
Owner: MICHAEL R KLEIN
Address: 4107 SW 321ST ST
FEDERAL WAY, WA 98023-2414
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 As.`2, a6' By 4_4A...) Date/do ./ Z. Ds—
SEP-14-2005 11:08 FROM:PERMIT 4257756315 TO:12538352609 P.6
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coMM R YDEVEIAPM NI SERVICES PERMIT SF MF CO ? 3'-
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- 33530 FIRST WAY SOIJIH.PO BOX 9718FEDEAPPLICATION
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253-6614
3-66 411 5.• 53 67
FAX
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The ollowin• is re,uired in ormation—an ince •tete a••iication will not be acce•tad. Please .rine le.WI in t or
( � PROPERTY INFORMATION
SITE ADDRESS '7 /0 1 6'&) 3 Z( SV.- / SUITE/UNIT I'
ASSESSOR'S TAX/PARCEL i a 7 j 9 O - Z Z Z C LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
/Math wwwwe pagaJar Uwathil I.yd derotri-'
PROJECT INFORMATION
TYPE OF PERMIT O BUILDING O PLUMBING £ !ECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
--in f i I✓1 S 1)a,f /-t rf to 14 c-e -111..f-e- rIL w/2 d ' CY(
gas PIP/
1.15
PROJECT NAME(Name of Business or Owner Last Name) j( 1 el 1-1
PEOPLE INFORMATION
PROPERTY NAME'AAA� ��/,, / /, v7 PRIMARY PHONE_
OWNER Ivl 'cam'[.Qc( fl-G it 1 (Z, r7''/ 6gSa
MAILING- L 1 4 I ADDRESS S LC) 3 Z I jA' CITYVI(.(.,4:Z. _ e4A— % 2-2
CONTRACTOR COMPANY NAME.
yy�� 'J �j �Q/�[��j�� APPLICANT NAME OFFICE PHONE
�/-�,,�
WrISNIii -" J-I Y (z) 2 2 -it !W
MAILING ADDRES CITY.STATE,ZIP. CELL PHONE
42-Sob ` ►'ndy!�C Alue 4) S'e &-t w '[Q9 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER ...EXPIRATION DATE FAX NUMBER
CONTRACTORS REGISTRATION NUMBER(copy or card required with each application) EXPIRATION DATE
Ui f-S.ti /L r g71 0l_ 41 / -2-- / 41161
APPLICANT COMPANY NAME APPLICANT ME OFFICE PHONE
`Tit ?-orrl.tii- Craves 0' C!16 ( ) -
MAILING ADDRESS CITY.STATE,ZIP CEL PHONI
ePo 36X' 7.433c( ' e &4 �c-3 (Ilan 215-8 q5
RELATIONSHIP TO PROJECT -FAX NUMBER
❑Architect 0 Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT NAME/ PRI ARY PHONE E-MAIL ADDRESS
`fes or#1 d_c.AS-/- r _ 7S S1/57—LENDE ` -4--,, L
Per Rc W 19.T7 0 ,5:-Lertaer[i
Sa 11:08 FROM:PERMIT 4257756315 T0:12532352609 P.7
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
r BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL LriSIINO TOTAL PROPOSW TOTAL=ITvo ASR raor•oaw
•NEWFIOMES 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.
MECSAMCA.L G
Value of Mechanical Work $ O 3 r--- •
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQSFANS _ HOODS(c.meunlul WOODSTOVES
BOILERS l FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS r _ OAS PIPE OUTLETS
PLUMBING
BATHTUBS I.rTub/Sb.wcrC.mbol SHOWERS • WATER CLOSETS(Tao MISC(Describe)
DISHWASHERS _ SINKS ' DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES _ URINALS HOSE BLBBS
LAYS tvntluv.m 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 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 its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE ` �/L �- (Q0A DATE
(Sig[aturel (Titlel
RELATIONSHIP TO PROJECT 0 Owner Agent 0 Contractor O Architect 0 Other
°FORtOFICE USE ONT •!t)i'
a NEW ci ADDITION a ALTERATION a REPAIR b TENANT IMPROVEMENT
BUILDING SHELL ONLY'? o YES a NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OP USE? n YES a NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? a YES o NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? a YES o NO
PgcV-- 2 q/6 7 s w 3 '2.,y
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Reviscd\Permit Application