01-101952 City of Federal Way
Community Development Services Mechanical Permit #:01 - 101952 - 00 - ME
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: WELLS Q\
Project Address: 29938 2ND'SW Parcel Number: 720530 0040
Project Description: MEC-Install fireplace insert in existing chiminey w/gas piping
Owner Applicant Contractor
Janice Wells NONE ADVANCED FILTER AND MECHANICAL
29938 2ND PL SW 418 VALLEY AVE NE
FEDERAL WAY WA PUYALLUP WA 98372
98023-3571 NONE (253)770-2440
Mechanical Valuation 2775 Over the Counter Permit Yes
Mechanical Fixtures
f.. ... : "kl401151 n11, ;,IQuantityl - { DescrptiOni,�F . JQuantty Description IQuaiitity
Fireplace Inserts 1 Gas Piping 20
PERMIT EXPIRES November 12,2001,IF NO WORK IS STARTED.
Permit issued on May 16,2001
I hereby certify that the above info 'on is co t and that the construction on the above described property and
the occupancy and the use wi.e in • corda ' the law 't"es and regulations of the State of Washington and
the City of Federal Way. ✓ /
Owner or agent: L ' G �' Date:
'lit,�Gh. ' % tel 0 6_ C- o / G -
W
clTYo G CONSTRUCTION PERMIT APPLICATION
• EDS P LICATION NUMBER: OI O L Cs 2 -/4&
uv FEY '-•fit= r-rr , ty .
-" • ' APP ICATION NUMBER: - -
APPLICATION NUMBER: - -
MAY 16 Pr
**The following is required information-Please print(in ink)or type**
Please note: Electrical, Fire Prevention*'§ fif$pkt 'ig permits may require a separate application.
-•
q, • PROPERTY INFORMATION
SITE ADDRESS: <}58' Ns). P( 5 f,m ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING gYMECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
��a_� -w ---- ._t; A.-- min N
NIIII
PROJECT NAME: wP__k. _S
• PEOPLE INFORMATION
PRQPERTY OWNER: NAME: DAYTIME PHONE:
.� Lem � � ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
2-99 3 g' 2— . (_ f...,.,.
CONTRACTOR: NAME: (' ? Y\� . DAYTIME P")HOOON`NE: -..,e4/
MAILINGADDRESS(STREET ADDRESS;CITY,STATE, EVENINGPHONE: ���O
'ft(e UAk�\.�'- e� ( ) -
OF FEDERAL WAY B LICENSE NUMBER: FAX NUMBER:
_ _ - 76 71 _ - _ _ 0770 -A,itis
CON CT 'S REGISTRA N NUMBER: EXPIRATION DATE:
(copy of card required) "C�v -E f — _ _ / /
APPLICANT: NAM . DAYTIME PHONE:
�\ - 7:Zg (3) 770 - 01D
MAILING ADDRESS(STREET ADDRESS;CITY,SIAit,)IP): EVENING PHONE:
4l� 0-.-� t0..-c. ( ) -
RELATIO IP TO PROJECT: ' � (c\ � FAX NUMBER: CH
❑ ARCHITECT ❑ T T L#'OTHER(DESCRIBE): �t .P.1-12 c3-4,3) 770 - - 3
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ x
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ i
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• • PRO3ECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ 'FIXTURES
•
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) ,IAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) V FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GA3
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
• 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 defen - • -uch clai ,which ay be made by any person,including the undersigned,and filed against the City of
Federal Way,but o where .uch lm arises • .t of the reliance of the city,including its officers and employees,upon the accuracy
of the informatio+fsupplied • th city .s a •., of this application.
NAME/TITLE: i _ i/ice cr2,_R7 - DATE: 5, 11�
❑ PROPERTY OWNER ❑ APPLICANT /ONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? Cl YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX-253-661-4129