07-104088f a
Ciity De Federal pram y Mechanical Permit #• 07- 104088 -00 -M
;i�,rnmtinity Development Services •
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: EVERNHAM _
Project Address: 30052 MILITARY RD S larcel Number: 042104 9144
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Project Description: Installation of furnace and hot water tank
Owner
Applicant
Contractor
HAZEL EVERNHAM
NORPAC HEATING & A/C INC
NORPAC HEATING & A/C INC
30052 MILITARY RD S
3414 A ST SE SUITE 102
NORPAHA123M5 (9/13/07)
FEDERAL WAY WA
AUBURN WA 98002
3414 A ST SE SUITE 102
98063 -4230
AUBURN WA 98002
Additional Permit Information
Mechanical Valuation ................. ...........................4372 Over the Counter Permit? ...................................... Yes
Mechanical Fixtures'
Furnaces ...... ............................... 1 Hot Water Tank ............................. 1
PERMIT EXPIRES Friday, July 24, 2009
Permit Issued on Tuesday, July 24, 2007
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: `7 —ZS -Q'-7
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THIS CARD IS TO REMAIN ON- SITE
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CITY of Community Development Inspection record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104088 -00 -ME
Owner: HAZEL EYERNHAM
Address: 30052 MILITARY RD S
FEDERAL WAY, WA 98003 -4230
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 y ' Date
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
- By Date By Date
0" OF
Federal Way U- -
�0 PERMIT SF MF CO 1V p EL PL DE EN FP
COMMUNITY DEVELOPMENT.SE
333258* AVENUE SOUTH • PO 97 9 18 P�, L I CATION
FEDERAL WAY, WA 98063.9778 7D
.253-835-2607- uni1w. FAX 253- 10,alm 09 ` �P�` q
unyw,ntuulTedemhtra0.twm V V`4
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The following is requi a 'fW� - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS _c (NCO C5 . �. Ci;°�l C� � 1 SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # — _ - _ _ — _ LOT SIZE (sj
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for lengthy legal desv*fi n)
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ E NGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included o this permit only)
, ti % .-. tC- . r r-. \ b . _ " - n fi
PROJECT NAME (Name of Business or Owner Last Namel
PEOPLE •- •
PROPERTY
OWNER .
CONTRACTOR
COPY of acrd required
with eee ePP11.0doa
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAMEh �
PRIMARY PHONE
C PL V -V-.
(2,5-3) 15-3 - 3 Z
MAILING ADDRESS
CITY, STATE, ZIP
E -MAIL ADDRESS
SS
CELL PHONE
COMPANY NAME
PPLICANT NA
OFFICE PHONE
- I
�I
(Z. `-7J `i3)
MAILING ADDRESS
CITY, STATE, VAP
CELL PHONE
CITY OF FEDERAL..... BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
N 'l-- L -- p1 .. -SL —GG -
\;D---- -CS .
CONTRACTORS REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
NAME PRIMARY PHONE E -MAIL ADDRESS
NAME
Per RCW 19.27.095;
Lender information is required tf 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? O YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
i
AREA DESCRIPTION
EXISTING
S . FT.
ATE MUST BEINCLUDED W17H APPLICATION)
AIR HANDLING UNITS
PROPOSED
S% FT.
TOTAL
S . FT.
BASEMENT
FANS
GAS WATER. HEATERS MISC (Describe)
r
FIRST
HOODS (Commerd�n .
COMPRESSORS_
FURNACES
,SECOND
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
THIRD
PLATTED LOT?
o YES 'D NO
ADDITIONAL FLOORS (DESCRIBE)
o NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
raosrnto
rnorosso
MAL
MAL aysrnm er
TOML rsorosao Sr
TOTAL OF
" "NEW HOMES ONLY"" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of frxture be installed or re
AMC/IL
Do not include existing fixtures to remain.
Value of Mechanical Work S'
/ r (A fOPY OF BID
ATE MUST BEINCLUDED W17H APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER. HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (Commerd�n .
COMPRESSORS_
FURNACES
T RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS (or Tab /shower combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAVS (BUhroom sinks)
RAINWATER SYST
SHOWERS
SINKS
URINALS
VACUUM BREAKERS
WATER CLOSETS q n q
WASHING MACHINES
MISC (Describe)
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 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 of Federal Way" as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation attd defense of
such claim), which may be made by any person, including the-undersigned, and filed •against the City of Aideral 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 apart of
this application.
NAME /TITLE +1�' �� -� L �� DATE _ 7-c) -�
j5igriatu ) rritle)
RELATIONSHIP TO PROJECT a Owner Agent o -Contractor o Architect o Other
E) NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO .
BASIC PLAN? D YES
D NO
ZONING DESIGNATION
CHANGE OF .USE? q YES
ONO
NEW ADDRESS REQUIRED?
DYES o NO
UP /SEPA /SU? o YES
Cl NO
PLATTED LOT?
o YES 'D NO
DEMO PERMIT REQUIRED? d YES
o NO
Bulletin #100 —April 2, 2007. Page 2 of
k\Handouts\Permit Application