10-104000 ' I chanical
City of Federal Way
Community Development Services
Permit #: 10-104000-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718 Ins ection Re uest Line: 253 835-3050
Ph (253)835-2607 Fax (253)835-2609 p a
Project Name: MARSHALL FILE
Project Address: 29808 6TH AVE S Parcel Number: 515190 0320
Project Description: Change out gas furnace
Owner Applicant Contractor
MARY JANE MARSHALL A HAYES HEATING&R COOLING LLC A HAYES HEATING&COOLING LLC
29808 6TH AVE S 276 SW 43RD ST HAYESHC939JR(4/19/11)
FEDERAL WAY WA 98003-3624 RENTON WA 98057 276 SW 43RD ST
RENTON WA 98057
•
Mechanical Valuation 4464 Is this an Online or O.T.C.applications Yes
� .
Furnaces.
PERMIT I
EXPIRES Saturday, March 19, 2011
Permit Issued on Monday,September 20,2010
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: _AO' Date:2G' err 74 /0
f9MMLLbtO°
1
• . • THIS CARD IS TO AIN ON-SITE ,-
CITY OF Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-104000-00-ME Address: 29808 6TH AVE S
Owner: MARY JANE MARSHALL FEDERAL WAY, WA 98003-3624
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.
El Mechanical Rough-in(4165) - -❑ Gas Piping(4125) - 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By 7/ � Date OZ/0
0 Rough Electrical Final Electrical Right of Way
Approved Appmved Approved
By Date By Date By Date
cmros , .,, o - d ( eDi
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PERMIT SFMFC MEELPLDEENFP
COMMUNITY DEVELOPMENT SERVICES
33325 8111 AVENUE SOUTH*PO BOX 9718
253-835-2607*PAX253��2609 APPLICATION
Joww.tituoffederalwau.com
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
MI PROPERTY INFORMATION
SITE ADDRESS 0/8O ES t 1 i'91/1= 5 1 T•_
T
ASSESSOR'S TAX/PARCEL# �� �� �' 0 - (�`7 � ® G SEp LO I (4)1
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) City 2O 2010
( P ib. 1 Op F
• _
NI PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING II MECHANICAL
r
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onitt)
C/j `
i 4197 cc.f-/— 1-t i✓et 4rC L
PROJECT NAME(Name of Business or Owner Last Name) iii ?Y i11ci//
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER nick ' 72;14 c Pnci-S lied i (2 )&3 ' -qt &/
MAILING ADDRESS t Li 41"c° S CITY,STATE,ZIP E-MAIL ADDRESS
f Li/af Wee %m,0 3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
4 //q)/ /Ifa tis r e��„g Ii/(c 4-1;7r/e. e, (aci )DWI/ - 432.e
MAILING ADDRESS ., CITY,STATE,ZIP CELL PHONE
V74, .50( 4V 3` --51. Re.”,4.-r ewe 7,90S7 (w6.)370 -c.2.2
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
D-0v— 10.7:7 (5 --c)e,"01- /2//0 ( )
CONTRACTOR'S REGISTRATION NUMBER EXPIATION DATE E-MAIL ADDRESS
CC /441/2-1 11iC 3yTZ I////
APPLICANT COMPANY NAME / APPLICANT NAME OFFICE PHONE
-Sirr/e Ce.5 c�belet ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT f FAX NUMBER
❑ Architect ❑Tenant ❑Agent •Other /s-57c/J-L— ( ) -
PROJECT NAME PRIMARY PHONE
E-MAIL ADDRESS
CONTACT ( ) -
1 LENDER NAME Per RCW 19.27.095:
ILender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? O YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES a NO
' WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
' SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
•
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST •
SECOND •
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS TAMING PROPOSi) I TOTAL TOTAL=STOP sr TOTAL PSOPoeso sr TOTAL er
•
•
"*NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL „ g e
Value of Mechanical Work$L�4/r,L j (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 pomwmy:so
COMPRESSORS I FURNACES RANGES
DUCTS • GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS 0,r7tib/shower combo LAYS pat.=nuts) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roues •
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that I am the property owner or authorised 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 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 claim), which may be made by any person, including the undersigned, and filed against the city, but only
where such claim arises out the reliance of the city, including its officers sus a employees,j $b 9 jIi mploy es, upon the accuracy of thn information supplied to
the city as a part of this application. •
SIGNATURE:` C ' DATE VC,' �n F /Gr
Property Owner and/or Authorized Agent
a NEW a ADDITION o ALTERATION o REPAIR a,TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application