07-100062go
city of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: PISTOLE
Project Address: 30536 6TH AVE SW
Project Description: Gas furnace replacement
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Mechanical Permit #: 07- 100062 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 178880 0840
Owner
Applicant
Contractor
JUDY D PISTOLE
RITE -WAY GAS SERVICE
RITE -WAY GAS SERVICE
30536 6TH AVE SW
PO BOX 7003
RITEWGS236JG 2/1/07
FEDERAL WAY WA
COVINGTON WA 98042 -0040
PO BOX 7003
98023 -3919
COVINGTON WA 98042 -0040
Additional Permit Information
Mechanical Valuation ................. ...........................2800 Over the Counter Permit ? ...................................... Yes
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THIS CARD IS TO REMAIN ON -SITE
DIY OF Community Development Inspection Record
'l Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 100062 -00 -ME
Owner: JUDY D PISTOLS
Address: 30536 6TH AVE SW
FEDERAL WAY, WA 98023 -3919
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.
❑ Mechanical Rough -in (4165) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By Date By Date Bye Date2. -t
RECEIVE® CONSTRUCTION P MIT A %I TION/
CITY OF .... PPLICATION NUMBER: - _ 0- %7 -
_ t
Federal Way AN 4 2007 PPLICATION NUMBER:
PPLICATION NUMBER: - -
* *T a D�KE)gAf7R -ad information — Please print (in ink) or type **
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
��1 • • •
SITE ADDRESS: s D S� .14 y S w• ASSESSOR'S TAX /PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT • •
TYPE OF PROJECT (This application): o BUILDING o PLUMBING X MECHANICAL o DEMOLITION
o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): & p1••W -g 6 145 ru R/Yn e-&
PROJECT NAME: s -rn L t
WPEOPLE INFO • •
PROPERTYOWNER: ! NAME: DAYTIME PHONE'
CONTRACTOR: NAME:
DAYTIME PHONE:
17-P-Way 6AS 6E RV j W 'X0153) 431 -
MAILING ADDRESS (STREET ADDRESS: CITY, STATE. ZIP): EVENING PHONE:
�-P- C, Bax '7003 gR'61:2 1 ( >
I CI Y OF FEDERAL WAY BUSINESS LICENSE UMBER: FAX NUMBER:
a - -
CONTRACTOR'S REGISTRATION NUMBER:
�Y ', r �• a I i EXPIRATION DATE:
(ropy of card required) Q 1 L (�J LS i OX l 0 1
APPLICANT:
NAMt:
DAYTIME PHONE:
( )
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: i FAX NUMBER:
o ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): ( )
I
I
E-MAIL ADDRESS: I
I
CONTACT PERSON FOR THIS PROJECT: C) PROPERTY OWNER ❑APPLICANT .W CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED /APPRAISED VALUATION ;
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: o YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA o PRIVATE (WELL) '
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
AIR HANDLING UNITS)
FIRST
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
SECOND
HOOD(S)
WOODSTOVE(S)
BOILERS)
THIRD
RANGE(S)
MISC. ( )
COMPRESSOR(S)
FOURTH
DUCT(S)
OTHER FLOORS (DESCRIBE)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
DECK
BATHTUB(S)
GARAGE
HOW MANY FLOORS?
URINAL(S)
WATER HEATER(S)
DISHWASHER(S)
TOTAL:
VACUUM BREAKER(S)
❑'ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S)
)TSCLATMFR /STC,NATHRF RLC
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 rhay be ma an erson, including the undersigned, and filed against the City of
Federal Way, but only where such claim arises out of rel'an the city, including its officers and employees, upon the accuracy
of the information supplied to the d part s
NAM E /TITLE: DATS
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063 -9718 • 253 - 661-4000 • FAX: 253- 661 -4129
www.ctvoffederalway.com
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNITS)
EVAPORATIVE COOLER(S)
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
FAN(S)
HOOD(S)
WOODSTOVE(S)
BOILERS)
FIREPLACE INSERTS)
RANGE(S)
MISC. ( )
COMPRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
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)
SINKS)
WATER CLOSET(S)
MISC. ( )
INTERCEPTORS)
SUMP(S)
)TSCLATMFR /STC,NATHRF RLC
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 rhay be ma an erson, including the undersigned, and filed against the City of
Federal Way, but only where such claim arises out of rel'an the city, including its officers and employees, upon the accuracy
of the information supplied to the d part s
NAM E /TITLE: DATS
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063 -9718 • 253 - 661-4000 • FAX: 253- 661 -4129
www.ctvoffederalway.com