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05-103282 r w `:ity of Federal Way Mechanical Permit #: 05 - 103282 - 00 - ME Community Development Services P.O Box 9;18 Federal Way,WA 98063-9718 Ph:(253)835-7000 Fax.(253)835-2609 Inspection request line: (253) 835-3054 Project Name: TERRY pg' Project Address: 32514 36THISW Parcel Number: 873195 0920 Project Description: Installing a new gas insert& associated gas piping Owner Applicant Contractor Robert L Terry &Normandie M Terry Robert L Terry Robert L Terry 32514 36TH AVE SW 32514 36TH AVE SW 32514 36TH AVE SW FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA 98023-2601 98023-2601 Mechanical Valuation 3200 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description Quantity) Fireplace Inserts 1 PERMIT EXPIRES January 4,2006. Permit issued on July 8,2005 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 Way. Owner or agent: Date: \XL) U 81 �.CQg 1 THIS CARD IS TO REMAIN ON-SITE • CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-103282-00-ME Owner: ROBERT L TERRY Address: 32514 36TH AVE SW FEDERAL WAY, WA 98023-2601 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 abort 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) 0 Final-Mechanical (4065) Approved Approved to release test Z/ P5I Approved By Date By r —/ Date 070s- By priC Date "AZ/CS-- I 1 } C2 C. - _l_Q3. I a Federal • i M oow<uunn7Yosvecorwem � g 2005 .L "` SF MF CO �L PL DE EN FP 33375tH AVENUE SOUTH l7� 4PPLJ 53435FEDERAL WAY,WA 91063.9711 C AT I O N TD / I . 753-135.2607•FAX 753435.2609 mwd&a.ede•eI•opOd'1i F FEDERAL WA BUILDING DEPT. The oiiowi • is • #red in ormatton-an c .fete • ••licatlon will not be acce•ted. Please •rint le• •1 in or p . Xi PROPERTY INFORMATION SITE ADDRESS 3 2.S l i+ 3�. p v`.., S'. ,I rod "vi i WA, 9 A�023 SUITE/UNIT# TAX ACC¢x.)NIT Nm. 8 1._ I -L.9_ S_- -Q_ .9._ Sz__— OZ LOT SIZE(sl e)2.e,o LEGAL DESCRIPTION(e.g.Acme Estates,Lot I) So_a_ a Ho c1 pA s k 1 f nods oeparatepage for kngehy legaldescriptiW - ' Oa PROJECT INFORMATION 1 TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DRIPTION(Provide detailed description of work included on this permit only) /y)Qehav►lcaA „utnvic -1,-t, it•►aati t• 9c:e iY,sewl- .. ..IA, ,. P.Y.Ich.v 43 Mayo.1rLi t IrIpfact +O iv,acid. Yulel elI.1 a caa ( t1'114. #O 44,x_ x1 4 pia cl.a a v, d t in S+-ei/.4!171 4-6� 1 h ce -f _ E La.efv,a aA to co Or_ 4.r, •Iry I..- a v, Q.IQ ohncaA i 1.7.1t., •1-•t, Ca-lo.-7g w,N, +4,113 o.��, . _ .... . -. C •. ._ —_- - - - PROJECT NAME(Name of Business or Owner Last Name) Tt ta.R� —--- -=___ U PEOPLE INFORMATION • 1 PROPERTY NAME PRIMARY PONE OWNER RebavA- L. of r.4 N.ovlh()4,d1 fv!. Texr-(.4 (x-53 ) 952 - ZG,CXa MAILING ADDRESS CITY,STATE,ZIP 3 2S 14 bCo4i'1.1v.1t_, 5 w, F•ecit.4adt W a.I,( 1 1.1.1A 9 Pi 0 2 3 CONTRACTOR COMPANY NAME AP. CANT NAME OFFICE PHONE I , ( ) - MAILINO ADDRESS it (` 1 Titan,ZIP CELL PONE - • CITY OF FEDERAL Y [MEN lI/ ta�4 EXPIRATION DATE FAX NUMBER �► / / - ,.L� B L ( ) CONTRACTORS REQISTRATION NUM' • + •f cant required with each application) EXPIRATION DATE I I / 44ew,,,QQ APPLICANT COMPANY NAME APPLICANT NAME &PPIM&PHME RotTA.v}- L, Te.vr (153) (ISL.- '-GO(,, MAILING ADDRESS CITY,STATE,ZIP 1 - CELL PHONE 3 2 5 14 342414 A.lQ•.s,W. F-od e4-aJl W oc� , W ( 1 - RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect 0 Tenant 0 Agent 01,Other(Describe) 15e43 nv,te- ( ) - CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS Ro 6.9.44 L, 'rev(' (153) 0152 - 7CaQLe LENDER MAILING ADDRESS CITY,STATE,ZIP ■ DETAILED BUILDING INFORMATION p +STING USE -1- -."— • •SED USE 4 STING ASSESSED/APP• .1--ED V. "•: VALUE • . •RO•• • SP. • E• • : . I • 0 •? o YES ❑NO IRE SUPP• D. • ' SYSTEM PROPOSED/REQUIRE- • . • • ' • • • • PROVIDER a LAKEHAVEN a HEMLINE ❑TACOMA ❑PRIVATE(WELL) SEWER SERVICE PROVIDER a LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) • PROJI.I.. AREA DESCRIPTION 4 STING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT BASEMENT FIRST • SECOND THIRD FOURTH - ' ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE 0 CARPORT 0 NUMBER OF F e•• =STOW raotas= TOTALi -fr w�F • **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ • FIXTURES Indicate number of e• ,.,, re to be installed or relocated as part of this project. Do not include existing fixtures to remain. CAL Valuef Mechanical ork $ .3 Z.©O.— • AIR HANDLIN. • - EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(commercial) WOODSTOVES BOILERS .. FIREPLACE INSERTS RANGES MISC(Describe) - • COMPRESSORS FURNACES GAS WATER HEATERS DUCTS 1 GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(mks MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK • I certify under penalty of perjury that the o • on 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 officers and employees,upon the accuracy of the information supplied to the city as a part of this application. e t{ NAME/TITLE DATE U I 7 I `21)405S (Signature) (Title( RELATIONSHIP TO PROJECT Owner �/Agent ❑ Contractor 0 Architect 0 Other 1I-)YI , -- --- - u C)t)!f (c)�F .. --- ,Vl/)� Cd.tu-t ) ' �(, , ,•'-0*D)4K",11 •'tti 1 0,•. t't•.I1It)(Ytb•f 1,Q)41.`• -_... .. • (0 A (0)4 — _ e 'i,� op Jo �; Gt. .. 4 ,'ai.l );d�: i :�o)t(i;y o)r7 :_rc i - fo _ ;f j5,4:} )sfr Fi` � 70) - Y � -4-e) - - - -•. .,, EIII5P,.tc,)i j;rtN r a:i,r.'r�i i:• � + - �� t • Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application