10-101651 • 0 Me° la>r�'�cal
City of Federal Way
illCommunity Development Services Permit #: 10-101651 -00-ME
P.O.Box 9718
Federal Way,WA 98063-9718 Ins ection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p Q
Project Name: ARSENAULT
Project Address: 30429 3RD PL S Parcel Number: 232960 0080
Project Description: 80% TO 80% furnace changeout
Owner Applicant Contractor
JERRY ARSENAULT CONVERGINT TECHNOLOGIES CONVERGINT TECHNOLOGIES
30429 3RD PL S 450 SHATTUCK AVE S SUITE 100 CONVETL995N9(8/29/10)
FEDERAL WAY WA 98003 RENTON WA 98055 450 SHATTUCK AVE S SUITE 100
RENTON WA 98055
�� '�%� pfs bM ..z.� • ', a.._ _ x_,., ,'... ? .3 `3as'.'., �._� . fir A , _« yq.
Mechanical Valuation 1850 Is this an Online or O.T.C.application? Yes
Furnaces 1
PERMIT EXPIRES Wednesday, October 20, 2010
Permit Issued on Friday,April 23, 2010
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 Ci f Federal Way. j
Owner or agent: G� Date: /7„ U
THIS CARD IS T MAIN ON-SITE , .
CRY OF 4 Construction I ection Record
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 10-101651-00-ME Address: 30429 3RD PL S
Owner: JERRY ARSENAULT FEDERAL WAY, WA 98003-4006
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) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By / Date ‘?".../01/
0 Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
ioct(1.' tip - U l_ sem% t
' A ' or A 0
Federal way PERMIT CO PL DE EN FP
COMMUNTIY DEVELOPMENT SERVICES E"°°'
APPLICATION
253-835-2607•FAX 253-835-2609
www.cittioffederalwau.com
APR 2 4 2010
SITE ADDRESS CITY OF FEDERAL WAY C
30 CG-D- 9 3 @_ oS CDS
PROJECT VALUATION ZONING ASSESSORS TAX/PARCEL s
TYPE OF PERMIT 0 BUILDING 0 PLUMBING CAL
0 DEMOLTTI 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT O ( (moi/"�/
(Tenant Nacre/Homeowner Last Name) I\ (�
0
V D
YO --- AAs-4c C.Le•-e o 9
PROJECT DESCRIPTION i
Detailed description of work to
be included on this permit only
NAMM
PROPERTY OWNER -Q.�in � r V
S ‘cc, ,1-k- '7FNioNs 5_ 114,6
EMAIL
rse_ciu.r.„. ( rii- 003
173 We,'f..v• IL ,t-( C4 AS SCL DdFRONSu -al q6
CONTRACTOR illunSTATE FAX
�T �W ( 5� � X
6,136 l e) S/1
li t-$i`, �,rl lii1A l'%*. ((9 v .-.2Sl -a-!v ri
bWr WA STATE e 2 CENSE D (a e,TTON/I 7 Fao0zv3c.-3y acts.
NAME � PHONE `-/
APPLICANT MAILING ADDRESS E-MAIL
CHT STATE ZIP FAX
PROJECT CONTACT NAME�— PHONE
(The tlldivbiunl to receive and L� c C N o i"
respondthis pZI
correspondence
MAILING ADDRESS "a r_ r��(Cc/y E-MAIL
CITY STATE P ( FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required value of$5.000 or more
(RCW 19.27.095) MAILING ADDRESS.CITY.STATE.ZIP PHONE
I cern/under penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the best
qf my knowledge,the all applicableof Federal Way regulations petion submitted in supportrtaining this permit
�t authorised is truehandcorrect.oc.I cpertly that I eaill understand that withh
issuance of this permit does not remove the owner'sby the issuance of a permit.I federallaws the
responsibility for compliance with local, state, or imps regulating
construction or environmental laws.
/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 clam),which may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information suppliedtrythg city asapartof this application.
SIGNATURE: {�^ ,, / DATE �s)i/a Ce)
PRINT NAME: 4d- /----r, - 3 . `CSL cS a 1. /
Bulletin#100-April 14,2010 Page 1 of 3 k:'.Handouts\Permit Application
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•
MECINICAL FIXTURES
VALUE OF afEcaANrcm,WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type offbcture to be installed or relocated as part of this project Do not Include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
ATR CONDITIONER FIREPLACE INSERTS HOODS(coo.atlA
BOILERS FURNACES HOT WATER TANKS tcao
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
Indicate how many of each type of f ixture to be Installed or relocated as part of this project. Do not Include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo) LAYS(Hand Shlka) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS 1t/utisto WATER HEATERS(Uresis)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF MISTING IMPROVEMENTS
8EE6TING/PREVIOUS USE LOT ST=(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes o No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
OTHER(describe)
Area Totals
--sew HOMES ONLY"
ESTIMATED SELLING PRICE$ I it OF BEDROOMS
COMMERCIAL-NEW/ADDITION
Area AREA DESCRIPTION Feet Occupancy Group(s) Construction TYPeSt y Additional Information
in SquareNaw Buxwmo
ADDITION
COMMERCIAL-REMODEL✓TENANT IMPROVEMENTS
AREA DESCRIPTION in 5q Feet Occupancy Group(s) Cion StoriesAdditional Information
TYPeTOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-April 14,2010 Page 2 of 3 k:\Handouts\Pemiit Application