07-104296r '
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: BACKMAN
Project Address: 29617 2ND PL S
Project Description: Replace gas furnace
Mechanical Permit #: 07- 104296 -00 -ME
Inspection Request Line: (253) 835 -3650
Parcel Number: 718300 0120
Owner
Applicant
Contractor
JOYCE BACKMAN
PERFORMANCE HEATING & A/C INC
PERFORMANCE HEATING & A/C INC
29617 2ND PL S
25500 74TH AVE S
PERFOHA15ORT 4/29/09
FEDERAL WAY WA 98003 -3617
KENT WA 98168
25500 74TH AVE S
KENT WA 98168
Additional Permit Information
Mechanical Valuation .................... ........................6415.79 Over the Counter Permit ? ...................................... Yes
Mechanical Fixtures
Furnaces ......................................... 1
PERMIT EXPIRES Sunday, August 2, 2009
Permit Issued on Thursday, August 2, 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:
a
• THIS CARD IS TO REMAIN ON -SITE `
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104296 -00 -ME
Owner: JOYCE BACKMAN
Address: 29617 2ND PL S
FEDERAL WAY, WA 98003 -3617
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 r s� test Approved q
By Date By Date //nom By Date / 07
For inspector reference only _
O Rough Electrical O FINAL - Electrical
Approved Approved
By Date By Date
RECEIVED 2108 -07 r _
? -Y - � � ��.
Federal WaYUG 0 2 zoo PERMIT
COMMUMNDEVEL.OPAWM SERVICES SF MF C ME L PL DE EN FP
333258- w F .83 DING DEPT. ,IPPLICATION
uatnc. cituo /(ederalurau. com
r-
Thefollowing is required Wormation - an incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY
SITE ADDRESS 29617 2nd PI S, Federal Way WA 98003 SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # 7 1 8 3 0 0 - 0 1 2 On LOT SIZE (sp 11,070
LEGAL DESCRIPTION (e.g. Acnw Estates, Lot 1) 12 Ray -Dia Terrace Addition
44f e.h -p—t. Pj�.Ior Lengtlty kwW desci ,V
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 13 MECHANICAL
O DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of uwrk included on dds perm-it onlu)
Replace Gas Furnace
PROJECT NAME (Name of Business or Owner Last Name) Backman
PEOPLE INFORMATION
PROPERTY
OWNER
CONTRACTOR
COPT of cud tega4ed _r,
WMd -b aPPI� 1*
APPLICI;� L /
PROJECT
CONTACT
LENDER
NAME
PRIMARY PHONE
Joyce Backman
( 253 ) 813 - 1785
MAILING ADDRESS
CITY, STATE, ZIP
E -MALI. ADDRESS
29617 2nd PIS
Federal Way, WA 98003
25500 74th Ave S
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Performance Heating & AC
Charles Day
(425 ) 251 - 0356
MAHA NG ADDRESS
CITY, STATE. ZIP
CELL PHONE
25500 74th Ave S
Kent, WA 98032
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
19 -85- 000042 -00 -BL
12/31/07
(253 ) 867 - 5775
CONTRACTOR'S REGISTRATION NUMBER
/- IRATION rUITE
E-MAIL ADDRESS
PERFORA15ORT
4/29/07 j
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
t ) -
MAMING ADDRESS
CITY, STATE, ZIP
CELL PHONE
t ) -
REIATTONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
( ) -
NAME PRIMARY PHONE E -MAIL ADDRESS
Charles Day 1( 425 ) 251 - 0356 charleeaperfor nceheating. corn
NAME
Per RCW 19.27.095:
Lender igformation is required {fprRject value exceeds $5,000
MAILING ADDRESS
CPIY, STATE, DP
PHONE
t ) -
EXISTING USE Residential PROPOSED USE Res
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED
SPRINKLERED BUMDING? ❑ YES IN NO FIRE SUPPRESSION SYSTEM
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ BIGBLINE ❑ TACOMA ❑
SEWER SERVICE PROVIDER ❑ LAKE_waVEN ❑ iIIGBLINE ❑ PRIVATE (SEP
ial
K $ 6,415.79 f'
�UIRED? ❑ YES! / X NO
r�
(WELT.)
PROJECT FLOOR
AREA DESCRIPTION
AREAS
EXISTING
89. FT.
PROPOSED
SQ. FT.
TOTAL
89. FT.
BASEMENT
SHOWERS
ELECTRIC WATER HEATERS
SINKS
FIRST
SUMPS
BASIC PLAN? o YES
❑ NO
SECOND
CHANGE OF USE? o YES
THIRD
NEW ADDRESS REQUIRED? o YES o NO
UP /SEPA/SU? o YES
ADDITIONAL FLOORS (DESCRIBE)
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED? a YES
DECK (❑ COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
EMM'O
PROFOB®
TMAL
mrv. Rio ar
70rv.rr"08008+
TOrALel
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate nwnber Rf each type of f fixture to be installed or relocated as part of this project. Do not include existing fudwes to remain.
of Mechanical Work $ 6,415.79 (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WrM APPLiCA770M
AIR HANDLING UNITS EVAPORATIVE COOLERS
BBQS FANS
BOILERS FIREPLACE INSERTS
COMPRESSORS 1 FURNACES
DUCTS GAS LOG SETS
BATHTUBS (or Tub /Shower Combo)
LAVS (Bathroom Sinks)
DISHWASHERS
RAINWATER SYST
DRINKING FOUNTAINS
SHOWERS
ELECTRIC WATER HEATERS
SINKS
HOSE BIBBS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (cammaxtaD
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS (r.&q
WASHING MACHINES
WOODSTOVES
MISC (Describe)
MISC (Describe)
I cer#* under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and jitrther, 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 and defense of
such clainy, which may be made by any person, including the undersigned, andjUed against the City gfFederW Way, but only where such claim
arises out of the reliance of the city, including its o- 07cers and employees, upon the accuracy of the irRormation supplied to the city as a part of
this application
g
NAME /TITLE _•/ Manager DATE 7/27/2007
RELATIONSHIP TO PROJECT ❑ Owner o Agent 9 Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
❑ NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IA PROVEMENT
BUILDING SHELL ONLY? o YES ❑ NO
BASIC PLAN? o YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE? o YES
o NO
NEW ADDRESS REQUIRED? o YES o NO
UP /SEPA/SU? o YES
o NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED? a YES
o NO
Bulletin #100 — January 1, 2007
Page 2 of 4
Mliandouts\Permit Application