07-100930..or
City of Federal Way Mechanical Permit #• 07- 100930 -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) 836 -3050
Project Name: ZIEGELMAN
Project Address: 31324 31ST AVE SW
Project Description: Remove and replace gas furnace.
Parcel Number: 438801 0040
Owner
Applicant
Contractor
WILMA M ZIEGELMAN
AAA HEATING AND REFRIGERATION INC
AAA HEATING AND REFRIGERATION INC
31324 31ST AVE SW
22653 83RD AVE NW
AAAHTR1971LW 6/16/07
FEDERAL WAY WA
KENT WA 98032
22653 83RD AVE NW
98023 -7838
KENT WA 98032
Additional Permit Information
Mechanical Valuation ..................... .......................1738.86 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- 100930 -00 -ME
Owner: WILMA M BEGELMAN
Address: 31324 31 ST AVE SW
FEDERAL WAY, WA 98023 -7838
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' t.3 Date,;?-26- Q�
RECEIVED
CRY OF �! C
Federal way FEB 2 1 2ooPERMIT
COMMUNITY DEVELOPMENT SERVICES SF MF CO L PL DE EN FP
33315 AVENUE SOUTH • BOX 9718 E CATION
FEDERAL WAY, 98063 63 -9718 OF FE
2538351607•FAX 153- 835 -2609 SU,(LDN
wuu.eituoi3ideraluau rorn
The following is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type.
--?132-q (
PROPERTY
SITE ADDRESS J .,4- /J Q r'�G /�� SUITE /UNIT #
ASSESSOR'S TAR /PARCEL # ® L - Q Y- O LOT SIZE (Sfi
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
Otlach .sepmwc page ( 1-glhy legal dc— iplion)
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING �CMECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work inclu tod on this permit onlu)
iL
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE •• •
PROPERTY
NAME PRIMARY PHONE
OWNER
CONTRACTOR
COPY of card regoi�e
with each app.=:
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
EXISTING ASSESSED /APPRAISED VALUE $'
SPRINKLERED BUILDING? ❑ YES ❑ NO F SUPPI
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLI
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
PROPOSED USE
VALUE OF PROPOSED WORK $
N SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
• TACOMA ❑ PRIVATE (WELL)
• PRIVATE (SEPTIC)
MAILING ADDRESS — � � � � w
F, -MATT. ADDRESS
COMPANY NAME
t
APPLICANT NAME
-
OFFICE PHONE
( ) 630 1 zL
"LING ADDRES S �� L �.
C TATS. ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
- rd3uz��oo L2 � 07
CONTRACTOR'S REGISTRATION NUMBER t,�CPT AT10N DATE
i "6,q -f AU -7I f-q,1 4A-7/"7
FAX NUMBER
(�53rb3o - 7
E -MAIL. ADDRESS
COMPANY NAM .
mg A G
APP CANT NAME
- a tk-
OFFICE PHONE
(26-34 b a -Zi
MA N ADDRESS
,
2-7-& f5 --yj el At t,
CI STATE, ZIP
4&ft Alk 1 Pd3A-
CELL PHONE
(2A (o ) 7 f — 2-788
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
W-3 ) 3
NAME
PRIMARY PHONE
E -MAIL ADDRESS
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5.000
MAILING ADDRESS
CITY. STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE $'
SPRINKLERED BUILDING? ❑ YES ❑ NO F SUPPI
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLI
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
PROPOSED USE
VALUE OF PROPOSED WORK $
N SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
• TACOMA ❑ PRIVATE (WELL)
• PRIVATE (SEPTIC)
K
PROJECT '
AREA DESCRIPTION
AREAS
EXISTING
S . FT.
PR SED
S . FT.
TOTAL
5 . FT.
BASEMENT
_ BOILERS FIREPLACE INSERTS
HOODS (Cnmmerc.iap
_ COMPRESSORS FURNACES
FIRST
_ DUCTS GAS LOG SETS
REFRIG. SYSTEMS
SECOND
❑ NO
NEW ADDRESS REQUIRED?
c YES ❑ NO
THIRD
UP /SEPA /SU? ❑ YES
❑ NO
PLATTED LOT?
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED? a YES
u NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
Ex�srnvc
m
TOTAL
TOTAL S=rm'csr
TOTAL FaoPOSMSF
TOTAL
"NEW HOMES ONLY" NUMBER OF BE OOMS ESTIMATED SELLING PRICE $
FIXTURES
—1--m7--- lumber of each type of fixture to be installed or relocated as part of this project. Do not include existing fLxtures to remain.
I0+*ZIL-1211d
of Mechanical Work $ 8 $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
_ BBQS FANS
GAS WATER HEATERS MISC (Describe)
_ BOILERS FIREPLACE INSERTS
HOODS (Cnmmerc.iap
_ COMPRESSORS FURNACES
RANGES
_ DUCTS GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS J-1T,b /Shoo rC—bnl LAVS atbm ,Sink) URINALS MISC (Describe)
DISHWASHERS RAiIVWA SYST VACUUM BREAKERS
DRINKING FOUNTAINS O u WATER CLOSETS (Taie ELECTRIC WATER HEATERS KS WASHING MACHINES
HOSE BIBBS SUMPS
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 may be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME /TITLE DATE d-)4;V1i2
(Si�+nature( ('title)
RELATIONSHIP TO PROJECT o Owner gent ❑ Contractor ❑ Architect ❑ Other
F1 NEW n ADDITION
n ALTERATION
r REPAIR i TENANT IMPROVEMENT
BUILDING SHELL ONLY?
❑ YES ❑ NO
BASIC PLAN? ❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE? o YES
❑ NO
NEW ADDRESS REQUIRED?
c YES ❑ NO
UP /SEPA /SU? ❑ YES
❑ NO
PLATTED LOT?
u YES u NO
DEMO PERMIT REQUIRED? a YES
u NO
Bulletin #100 — January I, 2007 Page 2 of 4 k \Handouts \Permit Application