08-102316&y of Federal Way
Community Development Services Mechanical Permt. 8
- 102316 -00 -ME
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: DOMINGUEZ
Project Address: 28256 27TH AVE S Parcel Number: 111700 0080
Project Description: Replace existing gas furnace with new.
Owner
Applicant
Contractor
GILBERT J DOMINGUEZ
AIR COMFORT ZONE INC
AIR COMFORT ZONE INC
28256 27TH AVE S
20825 SR 410 # SUITE 320
AIRCOCZ954DB (3/02/09)
FEDERAL WAY WA
BONNEY LAKE WA 98391
20825 SR 410 # SUITE 320
98003 -3306
BONNEY LAKE WA 98391
Additional Permit Information
Mechanical Valuation ................. ...........................5155 Is this an Online or O.T.C. application? ................ Yes
Mechanical Fixtures
- ` THIS CARD IS TO AIN ON -SITE
CITY OF tOMMUnity Develo m t Inspection n Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 102316 -00 -ME
Owner: GILBERT J DOMINGUEZ
Address: 28256 27TH AVE S
FEDERAL WAY, WA 98003 -3306
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 By Date j 3
For inspector reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
Federal Way, ..�_ � a. ! � PERMIT /� �.�
COMW1MDBVSLOPMENTSERVICBS U SF MF CO EL PL DE EN FP
333Z5 8a AVBNUB SWATH • 9 f.
FADERM WAY, 98063-9718 ;
253435-2607• PAX 253435.260 9 ,
APPLICATION
--
�.dtuoifed(er'atm�au'.�a(m � Q�� , p I n v
The follouQ is reg ref t� r f► I &— ttJ AYomplete application will not be accepted. Please print legibly (in irdq or type.
SITE ADDRESS _(�,� / I/'%'(� SUITE /UNIT Ii
ASSESSOR'S TAX /PARCEL ii _ _ _ _ _ , _ - _ _ _ _ LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Mmoh separate pgwjbr kn0W legal cf—dpff-1
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING .MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
O
PROJECT NAME (Name of Business or Owner Last Name) LQjae::� f y% 1•L.Q -7--
0 PEOPLE INFORMATION
PROPERTY
OWNER
N E
rt(.B2j"T (Q ®VVN l...Gi, e- 2
PRIMARY PHONE
t'04 ) 93 2
T
MAILING ADDRESS
q 2 l-f S
CITY, Sj ATE, ZIP
r�
E -MAIL ADDRESS
CITY, STATE, ZIP
S�
U
Ck-t,"'G1 C t-1" I Lf
RATION D TE
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
T
av-✓1 ! -1
- oe oL
MAILING ADDRESS `
0 3e O
CITY, STATE, ZIP
S�
CELL PHONE
fob 9S - 6 ®2 t
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
RATION D TE
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER
MA IION DATE
EMAIL ADDRESS
Q z < ,6
CT31 0 C 10 o
COM NY NAM
APPLICANT NAME
OFFICE PHONE
MAILING AD RESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
NAME PRIMARY PHONE E -MAIL ADDRESS
o � e �� -y3�� ( '2aG ) 44t - boo � i
NAME
Per RCIV 19.27.095.
Lender ir1formation is required ff 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? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
SO. FT.
TOTAL
80. FT.
BASEMENT
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
FIRST
COMPRESSORS
FURNACES
RANGES '
SECOND
GAS LOG SETS
REFRIG. SYSTEMS
a NO
THIRD
o YES o NO
UP /SEPA /SU?
ADDITIONAL FLOORS (DESCRIBE)
a NO
PLATTED LOT?
a YES o NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
DEMO PERMIT REQUIRED?
o YES
a NO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
ZUNPIfe
NWPOE M
TOTAL
rarnt ssa+rrso sr
7"M
M"
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate. number of each type of future to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work
V-- (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS iCommerd�q
COMPRESSORS
FURNACES
RANGES '
DUCTS.
GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS (orlub /shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAVS (Bathroom sh*4
URINALS MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS (roueq
SINKS
WASHING MACHINES
SUMPS
o NO
I eert(fy under penalty of perfury that I am the property owner or authorised agent of the property owner. I certify that to the beat of my
knowledge, the information submitted in support of this permit application is true and correaL I cart(& that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorised 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.
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 elaing, 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 of this application.
SIGNATURE:
<:;'r 10- r i2q
a NEW o ADDITION
o ALTERATION
a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY?
a YES o NO
BASIC PLAN?
a YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
a NO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU?
o YES
a NO
PLATTED LOT?
a YES o NO
DEMO PERMIT REQUIRED?
o YES
a NO
Bulletin #100 — January 1, 2008 Page 2 of 4 k\HandoutsV?ennit Application