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08-103186City of Federal Way lopmentS Mechanical Permit #: 08- 103186 -00 -ME Community 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: BARTOSE Project Address: 1649 S 359TH ST Project Description: Replacing existing gas furnace Parcel Number: 282104 9132 Owner Applicant Contractor ROBERT BARTOSE AFFORDABLE GAS SERVICE AFFORDABLE GAS SERVICE 1649 S 359TH ST 4864 NE SHELTERED BAY LN AFFORGS938D3 (3/23/09) FEDERAL WAY WA HANSVILLE WA 98340 4864 NE SHELTERED BAY LN 98003 -7450 HANSVILLE WA 98340 Y� THIS CARD IS TO REMAIN ON -SITE CITY OF n Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050 PERMIT #: 08- 103186 -00 -ME Owner: ROBERT BARTOSE Address: 1649 S 359TH ST FEDERAL WAY, WA 98003 -7450 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. 0 Mechanical Rough -in (4165) Gas Piping (4125) Final - Mechanical (4065) Approved Approved to release test Approved By Date By Date By P e,,- Date LqO�j For inspector reference only ❑ Rough Electrical ❑ FINAL - Electrical Approved Approved By Date By Date RECEIVE Federal Way � Y PERMIT SF MF CO L PL DE EN FP COAfMUM7YDEVELOPAlENTsrxCE�t L 0.2 2008 3332FEDRMNUY,WIIH•PO9718 1� APP ICATION FEDERAL WAY, WA 98063 -9718 r m —� -..F FEDERAL WA www.cltuolT rne.following is required rjo&tion - an incomplete application will not be accepted. Please print legibly (in ink) or type. PROPERTY • • SITE ADDRESS SUITE /UNIT # ASSESSOR'S TAX /PARCEL # $ © 4-- - 9— LOT SIZE (sfi LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Amxh s p—L- PWI- L-.gft bVW d —Od.,1 PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING A MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM DESCRIPT ION (Provide detailed description-af work included on PROJECT NAME (Name of or Ouwter Last :E Ar PEOPLE INFORMATION' PROPERTY OWNER CONTRACTOR PROJECT CONTACT LENDER EXISTING USE NAME PRIMARY PHONE ) a5b - 5al G AD C ,STATE, ZIP E -MAIL ADDRESS COMPANY NAME APPLICANT NAME OFFICE PHONE Af� G� �� ai#G71 1r. C� GAS. CITY, STATE, ZIP ( ) (p - 00R I LMT IIVG A, _ "' RESS Shea s �r#A Ck1it, STATE, ZIP v%l WA 91&1 CELL PHONE - ( ) CITY OF FEDERAL WAY BUSINESS LICENSE IWMMER EXPIRATION DATE FAX NUMBER Qo -ob-- loans a -W - L- e a U ) (038 - acouk. CONTRACTOR'S REGISTRATION NUMBER, Ein- RAnON DATE E- MAIL,ADDRESS ffo'R% a 3 COMPANY NAME APPLICANT NAME /OFFICE PHONE l ) - MAILING ADDRESS CITY, STATE, ZIP CELL PHONE RELATIONSHIP TO PROJECT ❑ Architect ❑ Tenant ❑ Agent ❑ Other FAX NUMBER NAME . PRIMARY PHONE E- MAII,ADDRESS \1 146 ( ) - NAME Per RCW 29.27.095: Lender I formation is required €f project value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP PHONE EXISTING ASSESSED /APPRAISED VALUE $, SPRINT IZRED BUILDING? ❑ YES ❑ NO PROPOSED USE VALUE OF PROPOSED WORK $ FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? O YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEKAVEN ❑ MGEMMM ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGEMANE ❑ PRIVATE (SEPTIC) N AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL SQ. FT. BASEMENT ❑ NEW D ADDITION D ALTERATION D REPAIR D TENANT IMPROVEMENT FIRST BUILDING SHELL ONLY? DYES ONO BASIC PLAN? SECOND D NO ZONING DESIGNATION THIRD CHANGE OF USE? ❑ YES D NO ADDITIONAL FLOORS (DESCRIBE) UP /SEPA/SU? D YES DECK (❑ COVERED OR ❑ UNCOVERED ?) PLATTED LOT? D YES D NO DEMO PERMIT REQUIRED? GARAGE ❑ CARPORT ❑ D NO NUMBER OF FLOORS UWALEM sroSr rvr�crsorae®OF rorAr.M "NEW HOMES ONLY"' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type of f fixture to be or r as part of this project Do not include existtng,Jiutures to remain. ANICAL of Mechanical Work $ (A F BID OR ESTIMAIE MUST BE INCLUDED VR H APPL(CA770M _ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVFS _ BBQS FANS GAS WATER HEATERS MISC (Describe) BOILERS FIREPLACE INSERTS HOODS (Commerd.0 _ COMPRESSORS _� FURNACES RANGES _ DUCTS GAS LOG SETS REFRIG. SYSTEMS BATHTUBS I-Tub /Shower Combo) DISHWASHERS DRINKING FOUNTAINS ELECTRIC WATER HEATERS HOSE BIBBS LAVS (Bathroom Sinks) RAINWATER SYST SHOWERS SINKS SUMPS URINALS MISC (Describe) VACUUM BREAKERS WATER CLOSETS ObueU WASHING MACHINES I certVy under penalty of perjury that I am the property owner or authorized agent of the property owner. I cerft that to the best of my knowledge, the igformation submitted in support of this permit application is true and correct. I eertVy that I will comply with all applicable City 4f Fod-M Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance Qf this permit does not remove the owner's responsibility for compliance with local, state, orfederal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim (including ousts, wipenses, and attorneys• fees incurred in the investigation and dgfense of such clamp, which may be made by any person, including the undersigned, and Jiled 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 (riformation supplied to the city as apart qJ this application. SIGNATURE: DATE _7 L s Property OwYier and /or Authorized Agent FOR OFFICE USE ONLY ❑ NEW D ADDITION D ALTERATION D REPAIR D TENANT IMPROVEMENT BUILDING SHELL ONLY? DYES ONO BASIC PLAN? D YES D NO ZONING DESIGNATION CHANGE OF USE? ❑ YES D NO NEW ADDRESS REQUIRED? D YES D NO UP /SEPA/SU? D YES D NO PLATTED LOT? D YES D NO DEMO PERMIT REQUIRED? D YES D NO Bulletin #100 — January 1, 2008 Page 2 of 4 k\llandouts\Permit Application