04-104180 Citcof F'eaeral Way Mechanical Permit #: 04 - 104180 - 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: NGUYEN
Project Address: 202 S 330TH PI Parcel Number: 132140 0760
Project Description: Install 18"gas log set with associated gas piping.
Owner Applicant Contractor
Dung Tien Nguyen WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
202 S 330TH PL 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98003-5907 (206)282-4700
Mechanical Valuation 1585 Over the Counter Permit Yes
Mechanical Fixtures
Description iQuantity Description Quantity Description Quantity;
Gas Logs i! 1 Gas Piping 1
PERMIT EXPIRES April 12,2005.
Permit issued on October 14,2004
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. i
0°3k/de.
6((Y`GIC
Owner agent:orDate:
O‘
THIS CARD IS TO REMAIN ON-SITE ,
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-104180-00-ME
Owner: DUNG TIEN NGUYEN
Address: 202 S 330TH PL
FEDERAL WAY, WA 98003-5907
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) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By 4 Date By Date ByC[A..J Datee f../•.(3S""
OCT-12-2004 10:15 FROM: TO:12538352609 P.2
ciFdecal Way �`-
PERMIT SF MF CO aEL PL DE EN FP
COMMONTI9 DEVELOPMENT SERVICES
33325 D R L WA SWAIN•PO 63972 9711 APPLICATION — TO ___� �,
FEDERAL WAY,WA 9d06J•97Id
2S3-*3S-2607•FAX 253435.2609
unvw.d.o/leder&way.corn
The oilowing is re•uired information-an inco •Tete a••lieation win not be acce•ted. Please •rint le ibly(in in or • .
• PROPERTY INFORMATION
SITE ADDRESS 2 0 S 33 I / SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# L 3 z. i_ 4 Q i- 0 (^� () LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot I)
(Attach separate page fir lengthy doscrJptien)
■ PROJECT INFORMATION • ,
TYPE OF PERMIT 0 BUILDING 0 PLUMBING XMECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
0 ' I — �.e
PROJECT NAME(Name of Business or Owner Last Name) 1U91,1 (e
• - U PEOPLE INFORMATION
PROPERTY NAME Co`� PRIMARY PHONE
OWNER Y L /V9 U y..r (2 5---oq'<
MAILING ADDRESS Q ` ^STATE,ZIP
�z 3 3 P f-� £J4,/ f4 Vac_7
CONTRACTOR 1C S NINE J APPLICANT NA`M'E OFFICEPHONE
)
MAILING ADDRESS CITY,STATE Z P CELL PHONE
2-3b0 h rV L 524 C?)--/?7 ( ) -
CiTY OF FEDERAL WAY BUSINESS LICE E NUMBER EXPIRATION DATE FAX NUMBER
' - -
- B L / / ( ) -
CONTRACTOR'S REGISTRATION UMBER(copy of cud regnired with each application( EXPIRATION DATE
4-S E LES O 1 0T _ cl l y l or-
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
S.11--&. a, ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT - FAX NUMBER
a Architect a Tenant a Agent a Other(Describe) ( ) -
CONTACT NAMEY PHONE
Lt v c aYy1QUl P( f) 17o - 3241, E-MAIL ADDRESS
LENDER ,--Per RCW 19.271095: Lender information is NAME
regidre 4t pioJsci palui iiieeeds$5,000 _
MARINO ADDRESS CITY.STATE,ZIP
- ' ', ; • DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ r
SPRINKLERED BUILDING? O YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? O YES O NO
' WATER SERVICE PROVIDER CI LAKEHAVEN a BIGBLINE a TACOMA CI PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN O HIGIUdNE 0 PRIVATE(SEPTIC)
OCT-12-2004 10:15 FROM: TO:12538352609 P.3
•;;;. ./.;%.; ....:‘..-
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
TOTAL=STOIC TOTAL PROPOSED TOTAL=STOPS AIM PROPOSEDHOW MANY FLOORS?
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
_ -FIXTURES : i,....:.- •.. .
•
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 _........c
Value of Mechanical Work $ `�I
AIR HANDLING UNITS EVAPORATIVE COOLERS _ / GAS LOGS REFRIO.SYSTEMS
BBQS FANSHOODS(Cama Pat) WOODSTOV ES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES OAS WATER HEATERS
DUCTS / OAS PIPE OUTLETS
PLUMBINGMISC(Describe)
BATHTUBS(arty►/ShwerGobo) SHOWERS WATER CLOSETS tr.(kp
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS 10aDv..m sinks) mom•
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 permitr' applicationeurred is
sn investigation. Irhera agree
de to
hold
harmless the City of Federal Way as to any claim(including costs, expenses, ofFederalthebut onlywhere such claim
f
such claim, which may be made by arty person,including the undersigned,and filed against the City Way,
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.
(l /2i�v-
J
NAME/TITLEOlfriAjiCtift26Y-V)otc)v/ a 401-L-7S DATE
1 (Signature' (Title)
RELATIONSHIP TO PROJECT 0 Owner Agent 0 Contractor 0 Architect o Other
r �
•
( FOR OFFICE USE ONLY
a NEW o ADDITION a ALTERATION o REPAIR o TENANT IMPROVEMENT
{ BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
i ZONING DESIGNATION CHANGE OF USE? o YES o NO
t NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES 0 NO
412--3-7 7 2 a 32&
Bulletin M!00—March 30,2004 — Page 2 of 4
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k\Handouts—Revised\Pelmit Application