10-100963 •
Mechanical
I t City of Federal Way
Community Development Services Perrit #: 10-100963-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718
Inspection Request Line: 25
Ph:(253)835-2607 Fax (253)835-2609 p q ( 3)835-3050
Project Name: GORETSKI
Project Address: 29854 1ST AVE S Parcel Number: 052104 9040
Project Description: Installation of furnace& heat pump.
Owner Applicant Contractor
CARL&FRANCES GORETSKI ADVANCED FILTER&MECHANICAL INC ADVANCED FILTER&MECHANICAL INC
29854 1ST AVE S (GENERAL) (GENERAL)
FEDERAL WAY WA 98003 418 VALLEY AVE NW UNIT B115 ADVANFM044RD(12/29/10)
PUYALLUP WA 98372-2503 418 VALLEY AVE NW UNIT BI 15
PUYALLUP WA 98372-2503
Mechanical Valuation 9870 Is this an Online or O.T.C.application? Yes
Ala
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Compressors/Heat Pumps I Furnaces' 1
PERMIT EXPIRES Tuesday, September 7, 2010
P it Is ed on Tht day,,,archll 2010
I hereby certify that the abo informati' is correct andt th the construction on the above'described property and
the occupancy and the :e i -ccordancezwith th laws, les and regulations of the State of Washington
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-)Owner or agent: ��- L, '�,A �� Date: � (/ //6�
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' - THIS CARD IS TO AIN ON-SITE ..
Crr,roF • Construction In ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-100963-00-ME Address: 29854 1ST AVE S
Owner: CARL & FRANCES GORETSKI FEDERAL WAY, WA 98003-3642
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.
Ei Mechanical Rough-in(4165) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Datef� `,
415 q
j Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
-- PERMIT \-1'9 S F C ME EL PL DE EI FP
Fede
COfMTBITYDEVELOPMENT SERVICES Jr'�
253-835-2607•FAX 253-835-264911Z 1 A P PL I CAT I O N
www.cUvo federalwa4.com VA1
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NAME OF PROTECT ,
(Tenant or Homeowner Name) e.
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❑BUILDING 0 PLUMBING �$.,&F,C.HANICAL.
TYPE OF PERMIT
❑ DEMOLITION 44.ELECTRICAL 0 ENGINEERING 0 PREVENTION
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1J—,DESCRIPTION (�/ -C___Detailed description of work to t� ` `" C-°' ,(-->_-.).,‘ ---.
be included on this permit only
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NAME
.- PRIMARY PHONE
PROPERTY OWNER @ -L ,(i,- . "'S .—t Z59535>-- e. g
MAILING ADDRESS,CITY,STATE,MilP E-MAIL
OWNER IS ALSO: 0 CONTRACTOR c,.APPLICANT 0 PROJECT CONTACT
NAME PRIMARY PHONE
v- cl.1`:) -�1 `4 1f•.,P1pj..� (253) 7-7-7 - .4(11°
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CONTRACTOR MAILING ADDRESS,CITY,STTArE,-'ZZII�P'-"�"c��
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CONTRACTOR
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4+(A 5(CONTRACTOR'S L\ -0NSE I jo,EXPIRATION DATE i ERAL�A� - r ,-7 `f 3
WjY BUSINESS LICENSE#
t.JtIAIL 4-t-if(Z-L) /2z,3o/ 1(
N PRIMARY PHONE
APPLICANT / ( c, C •
, )4.744 '966
MAILING ADDRESS,CITY,STATE,ZIP FAX
P t ViA ':% teiNAR '5
PROJECT CONTACT NAME nil)
PRIMARY PHONE
a
(The individual to receive and � r C. - ,.7,-t:,
✓ 0
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) ig1 72)-`9WS
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
PROJECT FINANCING NAME
Required for projects with a 1/1-0c.-77 0 OWNER-FINANCED
value of$5,000 or more MAILING ADD CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095) ( ) -
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit I understand that the
issuance of this permit does not remove the owner's resp bility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harm the/City of Federal Way to any claim(including costs, expenses, and attorneys'fees incurred
in the investigation and def of suc claim)�/Which may m by any person, including the undersigned, and filed against the
city, but only where such aim a out of 1i►e reliayrce f t city, including its officers and employees, upon the accuracy of the
information supplied •• he ty as •part of this
app
SIGNATURE: /'. - ./'' •-z.� DATE I f✓CJ
PRINT NAME: (... 4.--z:
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Bulletin#100—January 1,2010 Page 1 of 4 k:\Handouts\Permit Application
I
111•111101 11110111 HiliffilinthgeigglitEOMMICALIFINTU)
Value of Mechanical Work$ 47!S V'". (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each tyre o fixtu e to be installed or relocated as part of this project. Do not include existing fixtures to remain.
TS. FANS - C GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commezci4
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or nib/shower combo) LAVS(gendsinis) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utrty) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF E]aSTI1NG IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(III Square Feet) EXISTING FIRE SPRDIKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes '❑ No -
SDE I »:><«> `>< <= <» < .... <> » > «><= < 0::MR.3z`=
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
BASEME....
FIRST FLOOR(or Mobile Home)
• COVERED ENTRY
DELI€
GARAGE 0 CARPORT 0
SIiISTAO PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
AREA DESCRIPTION Area Construction #of
Occupancy Group(s) Additional Information
in Square Feet Type Stories
ADDITION
AREA DESCRIPTION Area Construction #of
Occupancy Group(s) Additional Information
in Square Feet Type Stories
rAL..BUILDINQ
TENANT AREA ONLY
Bulletin#100—January 1,2010 Page 2 of 4 k:\Handouts\Permit Application