05-104989 `ito.
City of Federal Way Mechanical Permit #: 05 - 104989 - 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: ERNIE'S FUEL STOP
Project Address: 33101 PACIFIC S Parcel Number: 172104 9100
Project Description: Installing one new gas water heater and associated gas piping and moving one gas water heater&
associated gas piping to final permit#02-103558 that previously expired.
Owner Applicant Contractor
ERNIE'S FUEL STOPS BLUE MOUNTAIN MECHANICAL INC*DAT BLUE MOUNTAIN MECHANICAL INC*DAT
ERNIE'S FUEL STOPS PO BOX 220 PO BOX 220
33101 PACIFIC HWY S EAST OLYMPIA WA 98540 EAST OLYMPIA WA 98540
FEDERAL WAY WA 98003 (360)459-4498
Mechanical Valuation 1500 Over the Counter Permit .. Yes
PERMIT EXPIRES March 27,2006.
Permit issued on September 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 W- ..
porilork
Owner or agent: wo Date: 4p, 0S—
THIS CARD IS TO REMAIN ON-SITE ---
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104989-00-ME
Owner: ERNIE'S FUEL STOPS
Address: 33101 PACIFIC HWY S
FEDERAL WAY, WA 98003
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 yGas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved 09/ar
By Date By Date By /� Date
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FPCOMMUNIYDEVELOPJB,lSERVICEs
33323 doAVENUE NO BOX 971d
FEDERAL WAY.WA 98063-9718 SEP 2 � LICATION
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CITY OF FEDERAL WAY ,.�— IF
The oilowi • is re• fired i ' • . `. Q g ih , •fete a,•licatton will not be acce•ted. Please •tint le.ib or ,
114 PROPERTY INFORMATION
SITE ADDRESS ,3 3 t 01 'lir, h A,, S'. SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separaIePage for kr"legal deeviPtion)
/A PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
7.---A1s LA--PO rif I)j= Z 649-c .41-5-e— i :;. in
/a,..( L L t1�A Gig-- P i Pj / , 0,2?-/03 --S--8
PROJECT NAME(Name of Business or Owner Last •
ILA PEOPLE INFORMATION
PROPERTYVi r PRIMARY PHONEOWNER NAME ��_}]1 ] 1`Z.1 :- `STD(' ( )
-
MAILING ADDRESS CITY,STATE,ZIP -
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
(.vim -r 41 t) b i9 ZIP� l.9w, .AP, (36o) '13-7 - y 0ADD 91;,y7.,/c, CEL,PHONE
er 0. 13,7•' 2 _c 4r Qi-y$16,4 i.,,4- (,Sfe, ) z39 - 03 7/
• CITY OF FEDERAL WAY SINESS LCENSE NUMBER EXPIRATION DATE //�� FAX NUMBER
71) --0" -10 B L lZi31 / 0c ( )
CONTRACTORS REGISTRATION NUMBER(copy of easel regairol with each application! EXPIRATION DATE
.3 t- u e- i�l 8i-� 1 r (2 k-i1 l L / 31 / oS
APPLICANT COMPANY NAME APPUCANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect a Tenant a Agent ❑Other(Describe) ( )
CONTACTPRIMARY PHONE E-MAIL ADDRESS
NA1)47,1 1 fit. LA, 3e;g:/- (341, ) 73i - 0-3-7 I
LENDER ;a: . el.•:Z „r.er t'ltYiri(r7i:I T $ NAME
WAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
TING USE • • *POSED USE
EXIS ANG ASSES '/APPRAISED • UE $ VAL - OF PROPOSED WORK $ ��
SP ERE I :UILDING? o YES a NO t• SUPPRESSION SYST ,, • :OPOSED/• . . I• D? a YES 0 0 -.
WATER SERVICE PROVIDER O •4D4:. '• 0 HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC) a
- PROJECT FLOOR AREAS
-t
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT. -
BASEMENT
FIRST -
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
< ::::::1: -.,
GARAGE 0 CARPORT 0
NUMBER OF F co .. I stnrrut° I "°roes° TOTAL .
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of e o fixture to be installed % - ... ed as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Wor $ )O
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS , FANS HOODS(coameml.q WOODSTOVES
BOILERS FIREPLACE INSERTS . RANGES ' MISC(Describe)
• COMPRESSORS FURNACES 'ice OAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or74b/Shower Combo, SHOWERS WATER CLOSETS
(roileq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
,..
LAVS(sosnooa sures VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the / o •• • n 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,incl if
, its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
AP 1
NAME TITLE �..01211�� '•r ` DATE
(Signature) ride) {
RELATIONSHIP TO PROJECT 0 Owner 0 Agent XContractor 0 Architect ❑ Other
4:',','.'t .WOE)t't`(&)i ,VI,:0.-,,,a,tp.`(04 7,4:>):.M.V8;4.. .,1}�,,p.V;t,I. 1„_I:);Yet•= l,t:.0,1l`
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Bulletin#100—January 7,2005 Page 2 of 4 k\HandoutssPermit Application