07-102682qty of Federal Way
Community Development Services Mechanical Permit #• 07- 102682 -00t=E
_
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: RUSSELL
Project Address: 1121 S 299TH PL �'� Parcel Number: 515160 0425
- L��M
Project Description: Adding heat pump & replacing furnfke
Owner
Applicant
Contractor
SYLVIA RUSSELL
ADVANCED FILTER & MECH INC
ADVANCED FILTER & MECH INC
1121 SW 299TH PL
418 VALLEY AVE NW UNIT B115
ADVANFMO44RD 12/28/08
FEDERAL WAY WA 98003 -3751
PUYALLUP WA 98371
418 VALLEY AVE NW UNIT B115
PUYALLUP WA 98371
Additional Permit Information
Mechanical Valuation .................. ..........................12138 Over the Counter Permit? ...................................... Yes
Mechanical fixtures
. ............................... 1 Furnaces.......... ............................... 1
-Ar -a Saturday, May 16, 20�'°
I her
the
Owner or agent:
of
THIS CARD IS TO REMAIN ON -SITE
Cliy of Community Development Inspection Record.
Federal Way IVR INSPECTION REQUEST PHONE # (253) 8353050
PERMIT #: 07- 102682 -00 -ME
Owner: SYLVIA RUSSELL
Address: 1121 S 299TH PL
FEDERAL WAY, WA 98003 -3751
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 d
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
OrY of .9
I! Federal Wa p - -
COMMUNITY DEVELOPMENT 5 qVV E PERMIT SF MF CO
-333251- AVENUE SOUTH • PO BOX 9718
A WA 298.63718
253- 835 -2 X .5 16
0 2007 A P P L I C A T I O N TD
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Y
a
EL PL DE EN FP
The following *•f'✓ 40fr�VfW!6 - an incomplete application will not be accepted. Please print legibly (in inkj or type.
gat ut nIN
SITE ADDRESS Z4 < <�y f SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # _ — _ - + _ LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
lAttach separate page for lengthy legal description)
TYPE OF PERMIT ❑ BUILDING O PLUI
❑ DEMOLITION t"LEI
PROJECT DESCRIPTION (Provide detailed description of work included
PROJECT NAME (Name of Business or Owner Last Name)
❑ FIRE PREVENTION SYSTEM
CONTRACTOR
CO" of evd repaired
with e e �pplieud..
APPLICANT
PROJECT
CONTACT
LENDER
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
M NG ADDRES
C ATE, ZIP
CE ONE
s _ zt,
CITY OF FEDERAL WAY BUSIN SS LICENSE NUMBER
EXPIRATION DATE
BER
CONTRACTOR5 REGISTRATION NUMBER
EXPIRATION
E -MAIL ADDRESS
/DATE
�
/ �✓�
COMPANY NAME
APPLICANT NAME
/ tOFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
( -
NAMA�-j 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
i ) -
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ Z- VALUE OF PROPOSED WORK $
eq
SPRINKLERED BUILDING? ❑ YES t-NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES "0
WATER SERVICE PROVIDER `!9- LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 00�-i.AKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
S ; FT:
PROPOSED
S . FT.
=T70TAL
BASEMENT
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
FIRST
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (foiled
SECOND
SINKS
WASHING MACHINES
HOSE BIBS
THIRD
ADDITIONAL FLOORS (DESCRIBE)
DECK (D COVERED OR -D UNCOVERED?)
GARAGE 0 CARPORT 11
NUMBER OF FLOORS
E7fISTIRO
PROPOSED
TOTAL
TbrAL XXISTRO sr
TOTAL PROPOSED Sr
TOTAL sr
"AFEW 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.
MECSAIUCAL -
VaIue of Mechanical Work t2 O ' r (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 (commercistl
COMPRESSORS i FURNACES RANGES
DUCTS. GAS LOO SETS REFRIG. SYSTEMS
PLUMBING
BATHTUBS ("Tub /Shomrcembo)
LAVS pith omsinks)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (foiled
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBS
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 1
am authorized by the owner of the above premises to perform a work for which the permit application is made. 1 further agree to hold
harmless the City of Federal Way as to any claim (tncludtng cost ,expenses, and attorneys' fees incurred in the investigation and defense of
such claim), which may be made b n person, incl g the and rsigned, and flied against the City of Federal Way, but only where such claim
arises out of the reliance oft ty, i cIuding it fficers and a ployees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME /TITLE DATE . 1 V /
Signature) (Title) '
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent contractor ❑ Architect ❑ Other
a NEW a ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT.
BUILDING SHELL ONLY? o YES ONO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? o YES ❑ NO UP /SEPA /SUP o YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO
Bulletin #100- January 1, 2007 Page 2 of MhandoutAPermit Application