07-1010821�
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fqx: (253) 835 -2609
Mechanical Permit #: 07- 101082 -00 -ME �
Project Name: LENO � �
Project Address: 30404 11TH AVE S
Project Description: Replace gas furnace
Inspection Request Line: (253) 835 -3050
Parcel Number: 091900 0240
Owner
Applicant
Contractor
VIOLET LENO
ALL SEASONS, INC.
ALL SEASONS, INC.
30404 11 TH AVE S
4851 S WASHINGTON ST
ALLSEI *03055 12/17/07
FEDERAL WAY WA
TACOMA WA 98407
4851 S WASHINGTON ST
98003 -4120
TACOMA WA 98407
Additional Permit Information
Mechanical Valuation ................. ...........................1650 Over the Counter Permit ? ...................................... Yes
Owner or agent: /41L
6A
Date: /0( 191
THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 101082 -00 -ME
Owner: VIOLET LENO
Address: 30404 11TH AVE S
FEDERAL WAY, WA 98003 -4120
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 3.
200 p�_�OI
• Federal Way MAR r 20
Y �W/jj 07
COMMUNJIYDEVBLOPMENT SERVICES _ V��n— °''cam` SF MF CO EL PL DE EN FP
33325 BTU AVENUE SOUTH • PO BOX 97j� �'
FEDERAL WAY, WA 98063-9718 V �� ` '6 p LI 0 qY
253- 835 -2607• FAX 253 - 8352609
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-Tihe-f-b-Ikudna is a
Mu fired i orrreation - an in fete lication will not 6e awe Fqed . Please nt (in Ink) or
PROPERTY •
SITE ADDRESS 11v Ave S SUITE /UNIT #
ASSESSOR'S TAR /PARCEL # _SQL _._L L + A- 0 LOT SIZE (sn
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
rntt-n -p-.w pWf Irgftj &aW dew+$tloN
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Prow' a detailed description of work included on this permit on(u)
I - ?Gi.S a�.YtGC.CC
PROJECT NAME (Name of Business or Owner Last Name) _0 r
PEOPLE •• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
NAME PRIMARY PHONE
(Z5)
MAILING ADtote,+
v ' 4� ` ^ CITY STATE, Z� O
COMPANY
A I ( SC��
APPLICANT NAME
....... .. ONE
' I �
(P63)8-761
�I
MAILING ADDRESS
-qwl 50 St
CITY, STATE. ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LT SE NUMBER EXPIRATION DATE FAX NUMBER
C B L �a ' I 16 -7 s�s�a3a
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application) EXPIRATION DATE
8t L L SE,
1 W O Q 12-' 1'7 ' 0-7
C MPANY NAME
5AMe
APPLICANT NAME
OFFICE PHONE
( ) -
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
Taclo Vt \ of -�I�OS PRIMARY PHONE E -MAIL ADDRESS
(253 )$7R -T4 iiwaws waWail e f
Per Rm 19.27.m. iant14T'fjorllkfttiDR l- NAME
reauiradt »rni®etns�tv�..';.wree�;nn..
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORN $ I(O
SPRINELERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAFt W_RAVEN ❑ HIGH LINE ❑TACOMA ❑PRIVATE (WELL)
SEWER SERVICE PROVIDER 11 LAKEHAVEN ❑ MGHLINE ❑ PRIVATE (SEPTIC)
AKEA DESCRIPTION
BASEMENT
FIRST
EXISTING
S . FT.
PROPOSED
S • FT.
TOTAL
3 . FT.
GAS PIPE OUTLETS
SUMPS
SECOND
URINALS
IAVS (Baduoom Si k.)
VACUUM BREAKERS
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
11OPOB°n
SO1"
sorwi+trrsroas
sorer tieorostsar
rorecW
"YEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
NECILANICAL
Value of Mechanical Work $
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
BATHTUBS for Tub /Shower combo)
SHOWERS
DISHWASHERS
SINKS
GAS PIPE OUTLETS
SUMPS
WASHING MACHINES
URINALS
IAVS (Baduoom Si k.)
VACUUM BREAKERS
GAS LOGS
HOODS (comwm1w)
RANGES
GAS WATER HEATERS
WATER CLOSETS jfaleq _
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
I cert(fY under penalty of peduril that the ii{formation furnished by me is true and correct to the best of my knowledge and further, that I
am authorised 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 4f 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 4f 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. l
NAME /TITLE Ci�l�ty !_ j, DATE Va ( A J
(SI ature "� mde)
RELATIONSE11P TO PROJECT 0 Owner ❑ Agent O Contractor ❑ Architect O Other
o ALTERATION a REP.
o YES a NO
I YES ONO
YES ❑ Nd
❑ TSNA
AS 1C. P1.Alli9
• YES ❑ NO
• YES
o NO
• YES
❑ NO
• YES
o NO
Bulletin # 1 W —January 7, 2005 Page 2 of 4 k\Handouts\Permit Application