07-100246City of Federal Way Mechanical Permit #• 07- 100246 -00 -ME
Community Development Services •
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection Request Line: (253) 835 -3050
Project Name: ROGERS
Project Address: 5134 SW 326TH PL
Project Description: Remove and replace gas furnace.
Parcel Number: 189832 0030
Owner
Applicant
Contractor
RUDY M ROGERS
AAA HTG REFRIGERATION INC
AAA HTG REFRIGERATION INC
POLLYANNA G ROGERS
22653 83RD AVE NW
AAAHTRI97ILW 6/16/07
5134 SW 326TH PL
KENT WA 98032
22653 83RD AVE NW
FEDERAL WAY WA
KENT WA 98032
98023 -1941
Additional Permit Information
Mechanical Valuation ................. ...........................2100 Over the Counter Permit? .......... ...............: ............ Yes
Mechanical Fixtures
` THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record '
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 100246 -00 -ME
Owner: RUDY M ROGERS
Address: 5134 SW 326TH PL
FEDERAL WAY, WA 98023 -1941
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 By Date
9/,?Z/40
RECEIVED
clrroc JAN 1 7 2007
Federal way T E RM IT
COMMUNITY DEVELOPMENT SEIQt shy OF FEDERAL WA
33325 53r835 AVENUE 607 , WA 98 830-9 18 7� KP P LI CATI O N
FEDERAL WAY, WA 98063 -9118 UILDING D
Winnit Oat�Oedendwni� eon
SF MF CO fiVIE/ EL PL DE EN FP.
'ID
be accepted. Please print leoiblu fin ink) or tune.
SITE ADDRESS S1 3T SW 31444, (� OL "4%41Jkj Uk J SO ZJ SUITE /UNIT #
ASSESSOR'S TAX/PARCEL # 7f 3 2, - n W3 O LOT SIZE (sfl
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
Wf-h separate PageJur le,Wlhy legal descrfpttw)
PROJECT • ' • `
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING �1 /
MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Prov' a detailed description of work included on this permit onlu)
G� � n"e Imo% r gWjA6e,
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE • •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME �Q �' Zr
(RIMMY PHONE
lb'31 "4 2411
MAILING ADDRES
����
CI ATE, ZIP
ICUW WA. Z
COMPANY NAME
G
APPLICANT NAME
OFFICE PHONE
(20) 06 -1 Z-Y
MAILING ADD S
8a a hot, S.
CITY, STATE, ZIP
#-
CELL PHONE
C ) -
TY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
Z Q —0—S'1 0 I 2- ( -B L (2-/3
FAX NUMBER
-
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application) EXPIRATION DATE
L-A-a Lt �� ? 1 v✓ /1so /ate
COMPANY NAME
k
APPLICANT NAME
OFFI PHONE
fih -fit
MAILING ADDRESS
, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( ) -
NAM
Auk-46--,
PRIMARY PHONE
( ) ?k r - P S S'
E -MAIL ADDRESS
Per RCW 19.27.095: Lender information is
required if projectvalue exceeds $5,000
NAME
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
PROPOSED USE
VALUE OF PROPOSED WORK
N SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
• TACOMA ❑ PRIVATE (WELL)
• PRIVATE (SEPTIC)
� 1
number of each type of fixture to be installed or relocated as part of this project. Do not include existing f fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
BBQS
FANS
HOODS (comme, Aw)
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Describe)
COMPRESSORS
_�_ FURNACES
GAS WATER HEATERS
DUCTS
GAS PIPE OUTLETS
PLUMBING
BATHTUBS (orTLb /Shower Combo)
HOU RS
WATER CLOSETS (roneo
MISC (Describe)
DISHWASHERS
S
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUM
RAINWATER SYST
WASHING MACHINES
URINALS
HOSE BIBBS
LAVS (Bath— sink.)
VACUUM BREAKERS
ELECTRIC WATER HEATERS
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 4f 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, andfiled against the City of Federal Way, but only where such claim
arises out of the reliance of the city, including its q, jieers and employees, upon the accuracy of the Wormation supplied to the city as a part of
this application.
NAME /TITLE DATE / I6
a-;Lwiop�
(Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect o Other
Bulletin #100 — January 1, 2006 Page 2 of 4 MandoutsTenuit Application