07-101647uni of Federal Way
Community Development Services Mechanical Permit #• • 07- 101647 -00 -ME
! 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: HOLM
Project Address: 30017 10TH AVE SW Parcel Number: 515320 0409
Project Description: Replace a 4 -ton heat pump
Owner
Applicant
Contractor
MATTHEW S HOLM
NORTHWEST PERMIT INC
WASHINGTON ENERGY SERVICES CO
NATALIE D HOLM
1345 GULF ROAD
(WESCO)
30017 10TH AVE SW
POINT ROBERTS WA 98281
WASHIES9710B 9/2/07
FEDERAL WAY WA
2800 THORNDYKE AVE W
98023 -8207
SEATTLE WA 98199
T
I hereby certify that�the above lnformabon is correct and that the,constructipp n
the occupancy and the use will be in accordance with the laws, rules and reg
_ &nd the City of Federal Way.
Owner or agent:
"— a, AS-4 to - -?) - _'C"--,
C vl*'�
THIS CARD IS TO REMAIN ON -SITE
CITY Of Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 101647 -00 -ME
Owner: MATTHEW S HOLM
Address: 30017 10TH AVE SW
FEDERAL WAY, WA 98023 -8207
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 Of L By DateA,r —�
DECEIVED
cliff CPA
� -=
Federal Way MAR ® 2007 nsvalorTrsNr sCRvrces PERMIT
CaVMUM'r SF MF CO CMMEL PL DE EN FP
�FB'TMRA A'L B w07w 4H06s 6P PEDERMLICATION
UILDING D
2U is — an bwompbee avvUeadon evils not be awwwd. Plalse mint kalbW an bw or
WM ADDRE" 30017 10th Ave SW surrEAmn s
AssESSOR.s TAY/PARCEL # 5 1 5 3 2 0- 0 4 0 9 MW sm (sfi
LEGAL DBRCRIITTION feg. Acme Estates. Lot I)
wmnesnro�J�* rydd�roowu
TYPE OF PERMIT 0 BUIIAIING ❑ PI M OG o(MEC iANICAL
❑ DEMOLITION ❑ ELECTRICAL O ENGINEERING ❑FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION [Prootde dakWed descry t[on of Work kwk ded on d* DerrW on(ul
Replace 4 ton Heat Pump
CONTRACTOR
■ PI;OPLI; INTORNIA110N
NAME pRi VXV MOM
Natalie Holm 1 (263 } 941 - 8900
gly= ZIP
3001710th Ave SW Federal Way, WA 98023
COMMY NAME
WESCO
APPUCAMNAM
0FF=PW1hM
(206 ) 378 6608
MAUMG ADDRESS
aff. $TATS. EF
cesu.
2800 Thomdyi(e Ave W
SeatOe WA 98199
( } -
CTY OF FEDE W WM BAISM S 14CZNW NUMBER EXi'IIwnaN DATE
12 /31 /07
PAXNUMMR
( } "
2 Q- 9-3-1942 3 -4-s
RE"On-flow
/
COMRWMRS OISTRATM NUMBER (copy of cad Tow � OMIL 77:07:1
W A S H _I _E _ S_ 9_ 7 1 0 B 09 02
COMP M NAME
Northwest Permit Inc
NAME
Melissa Cmd-@--
D PIM
( 360 ) 945 -2787
MARMO ADDRess
ter, STAT L Z'
CEU MCM
1345 Gulf Road
Point Roberts, WA 98281
Q PRGJ=
EMNUUM
❑ Architect o Tenant Agent o Other
CONTACT l R- MALAnDRR68
xAm Melissa Cmda (360 ) 945 - 2787 I m cxRrl
.3
RUF
"-lip]
E=STWQ USE SFR PROPOSED USE
NXM- MG ASSESSED /APPRAISED VAS $ VALUE OF PROPO= WORK $
SPRIItgLERED BUILDING? o YES ❑ NO FIRE SUPPRE88ION WSTEM PROPOSED /REQUIRED? a YES ❑ NO
WATER 8ERVICE PROVIDER o LAKXIIAVEN o WOHLINE ❑ TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDER O LAKEBAVEN o MOM MM a PRIVATE (SEPTIC)
AREA DESCRUPIWN
ram" WO
SQ. FT.
PROPOSED
1rT.
TOTAL
FT.
BASEMENT
FIRST
SECOND
nURD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE ❑ CAMRrO
NUMBER OF FLOORS
""NW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE S
k0kate number of each type ofjbdure to W installed or reheated as pad qf this Project Do not kwkwk edst&Vftdures io remain.
MaCCUMICAL, 11183.00
Value of Medianical, Work li
MR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCM
BATHTUBS (w TwPao*er cwAo
DISHWASHERS
GAS PIPE ounzrs
WASHING MACHINES
EVAPORATIVE COOLERS
PASS
FIREPLACE INSERTS
FURNACES
C.XS PIPE Ourim
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS REF14G. SYSTEMS
HOODStc.mftvW WOODSTOVES,
RANGES MISC (Describe)
Q" WATER HEATERS Heat Pump
WATER CLOSETS mwl _ ML13C Pescribe)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
RLRCTRW WATER HEATERS
I cert(fo under Penalty qfPed-v that the ftfarmatImfuralmhed by me is true, and oerroct to the best qfaty knowledge. amdArthAr, that I
am autharleed by the owner ctr the abe" premises to perform the work jar which the peratit application is made. I jkwther a#nw to held
harmless the city of Federal Way as to any clam flachulliV costs, exPen0w, and attwnqp'fe fmcurrod, in the b"BeIgatins and dq#base qf
such clainkL which may be made by any person, Including the underv4pned, and flied against the Cky qfFederal Wag. but only where such claim
arises out of the reliance of the eft. laclading Its q8kers and employees, upon the accuraelp 0 the ftformation supplied to the eft as a part of
thL qppacat[WL
NAMB/nTLB ---PATE
MWaiure) frd"
RRIATIONGH TO PROJECT ❑ Owner XAge-t 0 Contractor ❑ Architect ❑Other
Bulletin #100 — January 1. 2006 Pap 2 of 4 Mandouts)Pwnft Application