07-102833City of Federal Way
r oon4nunity Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) $35 -2607 Fax: (253) 835 -2609
Project Name: WALETTKO
Project Address: 28360 23RD AVE S
Project Description: Install furnace & a/c
0 y! ►
Mechanical Permit #: 07- 102833 -00 -VIE
Inspection Request Line: (253) 835 -3050
J , 4. Parcel Number: 326081 0360
I am L
Owner
Applicant
Contractor
BRUCE WALETZKO
DISCOUNT HEATING & AIR LLC
DISCOUNT HEATING & AIR LLC
28360 23RD AVE S
PO BOX 3207
DISCOHA00lL8 06/26/2008
FEDERAL WAY WA
FEDERAL WAY WA 98063
PO BOX 3207
98003 -2967
FEDERAL WAY WA 98063
Additional Permit Information
Mechanical Valuation ................. ...........................4700 Over the Counter Permit? ...................................... Yes
s
THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record.
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 102833 -00 -ME
Owner: BRUCE WALETZKO
Address: 28360 23RD AVE S
FEDERAL WAY, WA 98003 -2967
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 Q Date (e F _fl .-, By � Date
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CITY OF
Federal way RECEIVED PERMIT
— — _
COMMUNITYDEVELOPMENTSERVICES SF MF CO- E L PL DE EN FP
3332E ETN AVENUE SOUTH • 9718 MAY 2 3AP P L I C A T I O N TD
FEDERAL WAY, FAX 93063 63 971
253- 835 -2607• FAX 253.835 -260-260 9
u_v�L;,.ciho ederatwrnl.rvm
CITY OF Q��AL^�
FE WAY
The following is requiredgbVbB1NaJW21n incomplete application will not be accepted. Please print legibly (in ink) or type.,
PROPERTY , •. •
SITE ADDRESS 60 � �,p S SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # _ _ _ _ T _ - _ _ _ _ LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
TYPE OF PERMIT
(Attach separate page for lengthy legal description)
PROJECT • •
• BUILDING ❑ PLUMBING A MECHANICAL
• DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Pro
�ivide detailed description of work included on this permit only
/-• /lrh.r� e• P r% A— r
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE 0 •- •
PROPERTY
OWNER .
CONTRACTO
COPY of card regaired
with each application 1�
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NA 1 PRIMARY PHONE•� —•���
T` (aZ �
) � - � :31
MAILING ADDRESS CITY, STATE, ZIP E -MAIL ADDRESS
COMPANY NAME
et... ` A.. r Ll..�
APPLICANT NAME
E • � i1'1 �. �Sor1
OFFICE PHONE
(53) 5 - 7
ING ADDRESS
V. C� 3 ao
CITY, STATE, ZIP
" • U.. C1800
CELL PHONE
9 - 33 '26
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
( -
(PISS) ER `
CONTRACTORS REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL ADDRESS
DTsco H A co:t z-
6 lay acog
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( -
NAME w _ PRIMARY PHONE - ��� E -MAIL ADDRESS
{/p
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
F
. ....
AREA DESCRIPTION
.
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
o YES o NO .
BASIC PLAN?
FIRST
a NO
ZONING DESIGNATION
.SECOND
CHANGE OF.USE?
q YES
❑ NO
THIRD
DYES a NO
UP /SEPA /SU?
ADDITIONAL FLOORS (DESCRIBE)
o NO
PLATTED LOT?
o YES a NO
DECK. (0 COVERED OR ❑ UNCOVERED ?)
DEMO PERMIT REQUIRED?
o YES
o NO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
'c`1BMV:
PROPOSED
TOTAL
rOTAL ESrSM9 Sr
ROIAL PROPOSED Sr
TOTAL er'
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or re cated as art'of this pr 'e o r
of include existing fixtures to remain.
MECHAHICAL Jf ,
Value of Mechanical Work $ v (A COPY OF U Wl?`H APPLICATION)
AIR HANDLING UNITS
BBQS.
BOILERS
COMPRESSORS
DUCTS '
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
PLUMBING
BATHTUBS (or Tub /Shower combo) LAVS (Bathroom Sinks)
DISHWASHERS RAINWATER SYST
DRINKING FOUNTAINS SHOWERS
ELECTRIC WATER HEATERS SINKS
HOSE BIBBS SUMPS
GAS PIPE OUTLETS WOODSTOVES
GAS WATER- HEATERS MISC (Describe)
HOODS (Commercial)
RANGES
REFRIG. SYSTEMS
URINALS MISC (Describe)
VACUUM BREAKERS
WATER CLOSETS rroueq
WASHING MACHINES
I cert(%y under penalty of perjury that the information furnished by me is true and correct to the best of Tny 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 bf 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. l
NAME /TITLE DATE
(CT Sign ture) (Title)
RELATIONSHIP TO .1 E o Owner ❑ Agent iContractor O Architect O Other
a NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO .
BASIC PLAN?
o YES
a NO
ZONING DESIGNATION
CHANGE OF.USE?
q YES
❑ NO
NEW ADDRESS REQUIRED?
DYES a NO
UP /SEPA /SU?
o YES
o NO
PLATTED LOT?
o YES a NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 —April 2, 2007. Page 2 of
k\Handouts\Permit Application