08-104831 . , Mechanical
City of Federal Way #: Q
Community Development Services Permit 08-104831 -00-M E
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p Q
Project Name: PUGERUDE
Project Address: 29612 21ST AVE S Parcel Number: 931510 0150
Project Description: Replacing gas furnace
Owner Applicant Contractor
RAY&KATHY PUGERUDE GRIFFIS HEATING INC GRIFFIS HEATING INC
29612 21ST AVE S 402 E MAIN ST SUITE 130 GRIFFHI088DZ(12/27/08)
FEDERAL WAY WA 98003-4245 AUBURN WA 98002 402 E MAIN ST SUITE 130
AUBURN WA 98002
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Mechanical Valuation 4476 Is this an Online or O.T.C.application Yes
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Furnaces.... 1 Gas Piping 1
PERMIT EXPIRES Saturday, April 11, 2009
Permit Issued on Monday, October 13, 2008
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:
See Application
,OCT 10 2000
a
THIS CARD IS TO MAIN ON-SITE
CITY OF itommuni y Develo m Inspection Record
P
Federal Way tY p t IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-104831-00-ME
Owner: RAY & KATHY PUGERUDE
Address: 29612 21ST AVE S
FEDERAL WAY, WA 98003-4245
•
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.
0 Mechanical Rough-in(4165) CI Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date 1 Cl..,4.4\qt
For inspector reference only_
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
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tt PERMIT SF MFCO� LPLDEENFP
99325 8'r A7111101)800771.PO BOX 9718 S
mum WAY,WA 98069.9718 1 1 p
2534354607o PAX 283435-2609
1,L ,/I CATION / /
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The foiiowi 1011;10.itlfcriljon-an incomplete application will not be accepted. Please print legibly(in ink)or type.
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• PROPERTY INFORMATION
SITE•ADDRESS ^d-91 UP V)-- a...k. t`}tJ L s SUITE/UNIT i
ASSESSOR'S TAX/PARCEL 0 Ci. ) t .V - () j,._ __..0__ LOT SIZE(sjj
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
raid.Warms PEW fr.uwwtlegal d ml/+donl
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING D44F.CHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this aermit only) •
g., ,,,,,..e......_ `�„_,. c-�fL►J Arc-Q,_
PROJECT NAME(Name of Business or Owner Last Name) •
U PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER Q.2u.k • (X )-317 - 6(1199
MAILING ADDRESS STATE,ZIP E-MAILI ADDRESS
J- ( - 'a--t. - Xi S :(,u t {,..4_. _g1)03 I
CONTRACTOR COMPANY N NAME OFFICE PHONE
�RR.Vs la
. -L � ��'A03 .k�CCs (ate-3)',3X' -3FrFs® .
MAILING ADDRESS CITY STA ZIP CELL PHONE
Loa. 11,6 -r l) SQL 13 �„ urz..) LOk. ( ) _
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
0-0 - C, '- lb3 l % et. [a._ 3 ( - ®Fr (? ).'7 -9 4142.
CO 8'S REGISTRATION NUMBER EXPIRATION DATE EMAIL ADDRESS
IZT\--N-- t-.l On-b``Z. 12_- -`'—coT.
APPLICANT COMPANY NAME APP 914 fN NAME OFFICE PHONE
MAILING ADDRESSSilS-"N%-itlik-s CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect o Tenant 0 Agent 0 Other ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT viativp 0,48cas (2> ) X33 -3 EC)
LENDER NAME Per RCW I9.27.095t
Lender information is required((project value exceeds$5,000
MARINO ADDRESS CITY.STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
•
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? O YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE:PROVIDER o LAKEHAVEN HIGRLINE 0 TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER aLAKEHAVEN ao HIGHLINE
0 PRIVATE(SEPTIC)
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS nouns* rsorons TOTAL ?OM MIM>IYSer cer4Lnmramser a»SALsr
`!NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ •
• FIXTURES
Indicate,number of each ,,•- of fixture to >=installed or relocated as part of this project. Do not include existing fixtures to remain.
M SCHAMCAL
Value of Mechanical Work (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS OAS PIPE OUTLETS WOODSTOVES
•
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS( •9
COMPRESSORS • F FURNACES RANGES •
DUCTS. • GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(sr Tub/showercemeel LAVS(a.u.o.msbeml URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(ramp
ELECTRIC WATER HEATERS SINKS WASHING MACHINES .
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that 1 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 amply 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 of the reliance • the city,including its officers and employees,upon the accuracy of the information supplied to
• the city as a application.
SIGNATURE: 1117.74.1DATE
�7'--3o-0S(
7jy� and/or Authorized Agent
o NEW o ADDITION a ALTERATION o REPAIR oTENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a,YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SII? o YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO
•
Bulletin#100—January 1,2008 Page 2 of 4 k\HandoutssPernrit Application