08-103909c�of Federal Way Development Services
Com Mechanical Permit* 08- 103909 -00 -NEE
`munity
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: NISHIZAKI
Project Address: 2849 SW 340TH PL
Project Description: Remove & replace gas furnace
Parcel Number: 010920 0200
Owner
Applicant
Contractor
HENRY NISHIZAKI
A A A HEATING & AIR CONDITIONING INC
A A A HEATING & AIR CONDITIONING INC
2849 SW 340TH PL
(GENERAL)
(GENERAL)
FEDERAL WAY WA 98023
22653 83RD AVE NW
AAA1-ITRI971LW (6/19/09)
KENT WA 98032
22653 83RD AVE NW
KENT WA 98032
Additional Permit Information
Mechanical Valuation .................... ........................2880.78 Is this an Online or O.T.C. application? ................ Yes
Mechanical Fixtures
Furnaces......................................... 1
PERMIT EXPIRES Wednesday, February 11, 2009
Permit Issued on Friday, August 15, 2008
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
d the C' y of Federal Way. p'
Owner or agent: Date: D l.% a
f
THIS CARD IS TO MAIN ON -SITE -
CITY OF tommunity Developm t Inspection Record,
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 103909 -00 -ME
Owner: HENRY NISHIZAKI
Address: 2849 SW 340TH PL
FEDERAL WAY, WA 98023 -7734
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)
Approved
Approved to release test
By
Date
By
Date
Final - Mechanical (4065)
Approved
By Date llzie It,
a
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CIrY OR V Q —L_ SL O
Federal Wa� ECEI E '9u
PERMIT SF MF CO EEL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
333259- AVENUE SOU7H•PO BOX 971AUG 15 2APPLICATION
FEDERAL WAY, WA 98063 -9718
253 - 835 -2607• FAX 253 - 835 -2609
u+unn,rtU a ed I ,ra�
OF F
The following u required tf HrftEafi�+� .ari V�e�iplete application will not be accented. Please print leaiblu tin ink) or tune.
SITE ADDRESS "/ • d (i(� 37V V7 !L AGGleea 4VA- ?eV Z-3 SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # D / (/ [ ( - Q Q 0 LOT SIZE (s�
/ /�
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate pag. fm lengthy legal dewrlpttw
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING '*MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Permit onlu)
PROJECT NAME (Name of Business or Owner Last Name) (S • l / �C.�i(
PEOPLE •• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
NAME
�� i
OFFICE PHONE
2c 3) 4 &V
PRIMARY PHONE -
c?,�) 9
MAILING ADD
2 j s�i 3 q&A
C T TE. ZIP
Ue-
COMPANY NAME
10cIr 4 a+l n - - Arc
APPLICANT NAME
A l0.
OFFICE PHONE
2c 3) 4 &V
Ij 22-f
MAILING ADDRESS
Z2�53 93ek IBS
C117. STATE, ZIP
en4 'ulk. q -b37,
CELL PHONE
W(2 )'74S -Zi88
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
1 -1 0 -3 1? L 6- 0--B
EXPIRATION DATE
I2/ 31 / ®O O
FAX NUMBER
(X3)631D
- &Kif
L
CONTRACTOR'S REGISTRATION NUMBER (copy of cud required with each application)
&PX tir1�- z I i L � W
EXPIRATION DATE
6//1 109
COMPANY NAMF,
AAA ! A- A-/c,
APPLICANT NAME
A-n t-I a
OFFICE PHONE
Ur3) h30 I z2-1f
MAILING ADDRESS
U40'53 193 a S
CITY, STATE, ZIP
- - W4 8bS7-
CELL PHONE
C20 ) '7RS -2788
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
(ZS'3) b 3a - q J'4
CONTACT NAME PRIMARY PHONE E -MAIL ADDRESS
LENDER
EXISTING USE
Pt�CW9�l95 ,3:eniinarrtrnto NAME
MAILING ADDRESS CnY, 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)
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
BASIC PLAN?
o YES
❑ NO
FIRST
CHANGE OF USE?
❑ YES
SECOND
r YES n NO
UP SEPA /SU?
THIRD
r, NO
a YES ONO
ADDITIONAL FLOORS (DESCRIBE)
o YES
❑ NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
EXISTING
PROPOSED
TOTAL
TOTAL EJDSTIRO SF
TOTAL PROPOSED SF
TOTAL SF
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE S
numUer q) each type odJLnure LV Ue ULSLaueu Ur reuxuteu LIS Pw I UJ UEM, PIUjeu. w Iw< 11 11 1—••••�,r�••••• - -
Mechanical Work $ _2- 9 (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (r Tub /Sho 'Co b.)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVS (l3all,ronm Sklk-)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (cmumirt )
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS (T.1101
WASHING MACHINES
W OODS'I'OV ES
MISC (Describe)
MISC (Describe)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my
knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws.
1 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, 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 oft • plication.
SIGNATURE: A �4" DATE Jr6
Pr9ifertv Owner and /or Authorized Agent
o NEW o ADDITION
BUILDING SHELL ONLY?
ZONING DESIGNATION
NEW ADDRESS REQUII
PLATTED LOT?
o ALTERATION
E REPAIR 3 TENANT IMPROVEMENT
❑ YES c NO
BASIC PLAN?
o YES
❑ NO
CHANGE OF USE?
❑ YES
o NO
r YES n NO
UP SEPA /SU?
n YES
r, NO
a YES ONO
DEMO PERMIT REQUIRED?
o YES
❑ NO
Bulletin #100 -August 16, 2007 Page 2 of 4 k \Handouts \Permit Application