07-103369City of Fedor Way Mechanical ;� Community Development Permit # 07 -1 0336 0 E ent 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: GREEN
Project Address: 33513 11TH PL SW
Parcel Number: 926496 0190
Project Description: Remove /replace gas furnace -add outdoor heat pump and on- demand tankless water heater
Owner
Applicant
Contractor
ALAN R GREEN
BRENNAN HEATING & A/C LLC
BRENNAN HEATING & A/C LLC
33513 11TH PL SW
4601 S 134TH PL
BRENNHA971R9 12/29/07
FEDERAL WAY WA 98023
TUKWILA WA 98168
4601 S 134TH PL
TUKWILA WA 98168
ddit c�n�► emit formation
Mechanical Valuation ..................... .......................14455.65 Over the Counter Permit? ...................................... Yes
M�3C("18t1 pa X,ture
Furnaces ........... ............................... 1
Water Heater 11,. '. ' ..............
S
21 � tf
1, 2'007
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
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an t Cityc�of Federal Way. �(
Owner or agent: LSye °" "' �iCation Date:
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CITY OF
Federal Way
THIS CARD IS TO REMAIN ON -SITE
Community Development Inspection Record
IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 103369 -00 -ME
Owner: ALAN R GREEN
Address: 33513 11TH PL SW
FEDERAL WAY, WA 98023 -5310
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.
❑ Final - Mechanical (4065)
Approved
By Date fa
For rector reference only _
O Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
❑
Gas Piping (4125)
Mechanical Rough -in (4165)
Approved
Approved to release test
By
Date
By
Date
❑ Final - Mechanical (4065)
Approved
By Date fa
For rector reference only _
O Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
le .
4
RE
�IVED BY
COMMUNITY OPMENT DEPARTMENT
Federal.WN y -' .JUN 2
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The follo!gng is required f forination - an incomlpiete =Itcat'ton will not be dccepte4 Please print Ieg{biy ({R.{nk) or type.
8ITE ADDRESS _ ��� .� I -rzW �(_, SUITE /UNIT f .
ASSESSOR'S TAX /PARCEL f 9 o?- 4.1 —�LQ -1 (p - (� I Q d LOT SIZE (s�
LEGAL DESCRIPTION (e.g. Actne Estates, Lot 1) c� F
(A"°di *S—t. pawl - �wr►�r 4w► eeso{gran/
�rrmur�rei�r� –
TYPE flF °AERirIIT lc7 BUiLDiNQ ❑ .PLUMBING ' MECHANICAL
O DEMOLITION t7 ELECTRICAL la ENGINEERING • 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work irlcluded.on tht=�Iiermit onit�)
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PROTECT NAME (Name of Business or Owner Last Name) C-TK E E o
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PROPERTY
OWNER
.CONTRACTOR
APPLICANT
F
CONTACT
LENDER
RAMP.
ALA" �����
MAILING
PRIMARY PHONE
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ADD s
CITY, sTATE, ZIP
COMPANY HAMS
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MAILIN
APPLICANT NAME
21. A4- )K1eAKj
O FICE PHONE
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ADDR633
14o- oi
aft St , ZIP
SE NUMB [RATION ATE
b o + -. i d :. L o ate.. : .. /
AX NU ER
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CONTRACTORS REOISTRATiON NUMBER iooP,T or card required W Rh each apj+lloatloa)
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COMPANY NAME
MAILIN l - IE,A`t'it, l x A IC,
MAILING
MPUCANT NAME
$N ALx)1Q �t7,J
OFFICE PHONE
ADDRESS
�IaUI 8 l.34�n.1 'PL
CITY, STATE, ZIP —
"TUKWIt.�
CEU. Pro' NE
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RELATIONSHIP TO PROJECT
O Architect 0 Ten&nt 0 Agent O Other (Desa -ibe
FAX NUMBER
NAME
c�k6At1JNC��S l LU.
PRIMARY PHONE
ao6 a48 -71
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' 8- MIIILADDRESS
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EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE ,$ VALUE OF PROPOSED WORK $ e
SPRINKLER9D BUILDING? 0 YES O NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? O YES O NO
WATER SERVICE PROVIDER O LAID LIVEN 0 IIIGHLINE 0 TACOMA D PRIVATE (WELL).
SEWER SERVICE PROVIDER p LAKEHAVEN 0 MGBLM 0 PRIVATE SEPTIC)
i
1ndiCate number
or relocated as part
not
L?ECFJAMCAL
14.
T --
A4 557 &-zz
—
Value of Mechanical Work $
•
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOOS
REMO. SYSTEMS
BBQS
FANS
HOODS (Gmm.relaQ
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
�_ MISC (Describe)
COMPRESSORS
I
GAS WATER HEATERS
HIE AT `PVAA.t'
DUCTS
GAS PIPE OUTLETS
HATHTV8S (or Tub /snoM.rcomtol SHOWERS WATER CLOSETS iroo q MISC (Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
OAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS P sh—&4 VACUUM BREAKERS ELECTRIC WATER. HEATERS
I eenvy under penalty of perjury that the Wermation furbished by me is true and correct to the best of my knowledge, and further, that r
am authorised by the owner of the above premises to perform the work for which the permit application to Jnade. I further agree to hold
harmless the City of redsray .Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and dgfense of
such claim,►, which may be made by tiny person, including the undersigned, and; flied against the City of Federal Way, but only where such claim
arises out of the reliance of the Fitt', including its gMcers and employees, upon the accuracy g% the Wormation supplied to the city as a part of
this application.
NAME /TITLE DATE
(US ignatare� lam)
RELATI011SHIP TO PROJECT q Owner a Agent Contractor o Architect .O Other