05-103364 r ,
City of Federal Way Mechanical Permit #: 05 - 103364 - 00 - ME
Community Development Services s
PO Box 9718
Federal Way,WA 98063-9718
Ph.(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305C
Project Name: NANTZ FOG
Project Address: 31402 36THISW Parcel Number: 873198 0540
Project Description: Install fireplace insert
Owner Applicant Contractor
Robert G Nantz &Guadalupe Nantz Robert G Nantz Robert G Nantz
31402 36TH AVE SW 31402 36TH AVE SW 31402 36TH AVE SW
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-2103 98023-2103
Mechanical Valuation 500 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description LQuantity Description Quantity
Fireplace Inserts 1
PERMIT EXPIRES January 8,2006.
Permit issued on July 12,2005
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: ?�J/pS
,
THIS CARD IS TO REMAIN ON-SITE
,CITY Community Development Inspection Record.
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-103364-00-ME
Owner: ROBERT G NANTZ
Address: 31402 36TH AVE SW
FEDERAL WAY, WA 98023-2103
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 G„(,%. Date.7 f'-( By et. 63 Date • /siet.`�
r . .
RECEIVED
•
Federal Way JUL 1 2 2005 PERMIT 0 a - ,z4.3:5__�
coMARlNnrDEYELOPI(BM SF MF C!l! rj k L DE EN FP
333ss3 ERAL W Y.WA 1T•631BY ILF FNG /
FEDERALWAY, X 063BUILDING APPLICATION
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1 •
25335 2607•FAX29583-83:574:9
The ollowi • is iced in ormation-an in;• •tete . ••lication will not be acce•ted Please •rint Ie• •I in or p
(� 11 PROPERTY INFORMATION,
/
SITE ADDRESS 3/ C� .3Z . /f7,--e--e -SC✓J /amu/ bU y�j SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ _ J LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
cth naa for krodwlegal deaA+Ptio.4 _
all PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING rA MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
PROJECT NAME(Name of Business or Owner Last ante) /JWt'ft..
{ I i PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHOHE_„„
OWNER b (' ) d-3 b )L!
MAILING ADD CITY, ATE,ZIP
3 i Yo .3‘a ,¢v.4 SW ,fir.,.( Uc/u7 ?z)
CONTRACTOR COMPANY NAME APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER r
- - -B. L / / ( )
CONTRACTORS REGISTRATION NUMBER(copy of card required with each appUcatioa) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME� APPLICANT NAME OFFICE PHONE
Cl.vyl,ei ( )
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
a Architect a Tenant a Agent ❑ Other(Describe) ( ) -
fCONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER :>n- : NAME
,,.:r, Y.1,C r, 4,1- - i)-'i';,.
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTIN r USE PRO'0 SED USE
EXISTING SESSED/ : 'RAISED VALUE 'ALUE OF PROPOSED W• • $
SPRINKLERE• :UILD I'0? ❑ YES ❑ N• FIRE SUPP 7.3%SION SYSTEM PROPOSED/REQ I i• • . • IN- ❑ NO
WATER SERVICE - •VIDER ❑ LAKEHAVEN ❑ :1 :, INE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE a PRIVATE(SEPTIC)
. ft •
- PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
_ SQ.FT. SQ.FT. SQ.FT.__
BASEMENT
FIRST '--- ---"-- --.--7.--- .•.,: -
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE) J
DECK(COVERED?) /
GARAGE 0 RT❑
NUMB ROF RS s�asTuo eaorosso torn - •F i.:,.' ;
**NEW HOMES ONLY** NUMBER OF BEDROOMS (► I ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each - o s.,, • to be installe."' r-'..ted as part of this project. Do not include existing fixtures to remain.
MECHANICAL 5P '-
Value of Me. . ' . ork $ v
•
AIR HANDLI . u ' ' EVAPORATIVE COOLERS GAS LOOS REFRIG.SYSTEMS
BBQS FANS HOODS(cm. ..ass WOODSTOVES
BOILERS I••,. FIREPLACE INSERTS RANGES " . MISC(Describe)
- - COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or iub/snowercombo) SHOWERS WATER CLOSETS crones MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS pot.=stoles 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 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.
NAME/TITLE DATE 74 //_c
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑Agent ❑ Contractor ❑ Architect ❑ Other
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Bulletin#100-January 7,2005 Page 2 of 4 Mandouts\Permit Application