12-104837S
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: HAMLING
0
Project Address: 30223 6TH AVE SW
Project Description: Install ductless beat pump
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f
A echanical
Permit #: 12- 104837 -00 -ME
Inspection Request Line: (253) 835 -3050
Parcel Number: 039580 0300
Owne
ARRI11can t
Contractor
JOHN R HAMLING
MOUNTAIN VALLEY HEATING & A/C INC
MOUNTAIN VALLEY HEATING & A/C INC
30223 6TH AVE SW
(GENERAL)
(GENERAL)
FEDERAL WAY WA
13407 SE 339TH ST
MOUNTVH970N2 (3/5/14)
98023 -3916
AUBURN WA 98092
13407 SE 339TH ST
AUBURN WA 98092
Mechanical Valuation .................... ........................5264.00 Is this an Online or O.T.C. application? ................. Yes
Mechanical Fixtures
Compressors / Heat Pumps............ 1
PERMIT EXPIRES Sunday, April 21, 2013
Permit Issued on Tuesday, October 23, 2012
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 b in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: // -2
FfNAl1,4D 10INPIlz
CITY OF 14A
Federal Way
PERMIT #:
Project:
THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQU TS: (253) 835 -3050
12- 104837 -00 -ME Address: 30223 6TH AVE SW
JOHN R HAMLING FEDERAL WAY, WA 98023 -3916
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 21�j -1Z—.
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
y
CITY Fe PERMIT
Federal wa ECEIVE
COMMUNITY DEVELOPMENT SERVICES P P L I C A'T I O N
253 - 835 -2607• FAX 253- 835 -26041 C T 2 3 20
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CITY OF FEDERAL WAY
MF C ME PL DE EN FP
�I $tt'(
SITE ADDRESS CDS
SUITE /UNIT #
30 2-2-3 A Je SO FeJe� l Wu 5"00-,)3
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAX /PARCEL #
n 9S o- 0 0a
,4,6yw
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeowner Last Name)
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r i% O a m 1 l
4) O 111
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
jd 4 It- C 0 i•1 S,� j ti
PRIMARY PHONE G
�" $ 3 ! r
MAILING ADDRESS
fit" r��e SI..J
E-MAIL
CITY re J erti l C.�G
Ll%A
ZIP 1% o ? 3
NAME
✓� vu �/e c ew
PHONE
�/o
000A 0
MAILING ADDRESS I if
Y d St 3 jCT`r' 'S}
E-MAIL
CONTRACTOR
CITY
iMA1 tl.AL
STATE
WA
ZIP /�
97 652
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
SL
0 2-
3 i s- i /Y
20 0 S71 QQ
NAME K Vl k Q
Pn U _[ '- 60
MAILING ADDRESS
E -MAIL
APPLICANT
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NPR k— S
P2a6
(The individual to receive and
MAILING ADDRESS
EMAIL
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
EMAIL
PROJECT FINANCING
NAME
OWNER - FINANCED
Required value of $5,000 or more
(RCW 19.27.095 )
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that 1 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.
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 claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such c1pirn arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information sup 1 the city as apart of this application.
' 3 �`
SIGNATU DATE//) G 2
�
PRINT NAME: D�/ J7 . + � !fin E-A 0L)
Bulletin #100 —January 1, 2011 Page] of 3 kAHandoutsTermit Application
VALUE OF MECHAMCAL WORK $ 5,
2 (0 `
(a copy of bid or estimate must be provided) �S
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (comercial)
m
C. -Iles S
BOILERS
FURNACES
HOT WATER TANKS (Gas)
Ak-dd mn
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
Indicate how many of each type
BATHTUBS (or Tub /shower combo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
'fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
LAVS (Hand Sinks) TOILETS WATER PIPING
RAINWATER SYSTEMS URINALS OTHER (Describe)
SHOWERS VACUUM BREAKERS
SINKS (Kitchm /utitity) WATER HEATERS (Electric)
SUMPS WASHING MACHINES - -�C
CRITICAL AREAS ON PROPERTY? I WATER PURVEYOR ) SEWER PURVEYOR I VALUE OF EXISTING IMPROVEMENTS .
EXISTING /PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? I PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
Bulletin #100— January 1, 2011 Page 2 of 3 k:\Handouts \Permit Application