09-103307 ,
• Utoi/ Meehafiical
City of FederaWay Permit #: 09-103307-00-ME
Community Development Services
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: HANSEN
Project Address: 5412 SW 326TH CT Parcel Number: 189831 0160
Project Description: Remove/replace gas furnace
Owner Applicant Contractor
SCOTT W HANSEN GRIFFIS HEATING INC GRIFFIS HEATING INC
LISA ANN HANSEN 402 E MAIN ST SUITE 130 GRIFFHI088DZ(12/27/10)
5412 SW 326TH CT AUBURN WA 98002 402 E MAIN ST SUITE 130
FEDERAL WAY WA AUBURN WA 98002
98023-3601
8, Additional Permit Intformation
Mechanical Valuation 4563.00 Is this an Online or O.T.C.application? Yes
Mechanical ixtures h 3
Furnaces.,... I
PERMIT EXPIRES Sunday, February 21, 2010
Permit Issued on Tuesday, August 25, 2009
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 accor•a ce with the laws, rules and regulations of the State of Washington
I e City of Federal Way.
Owner or agent: ��1111 Date: b (P-S=6
S ��
1/11/09
THIS CARD IS TO MAIN ON-SITE
CITY OF • Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 09-103307-00-ME Address: 5412 SW 326TH CT
Owner: SCOTT W HANSEN FEDERAL WAY, WA 98023-3601
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) 0 Gas Piping(4125) 0 Final-Mechanical (4065)
Approved Approved to release test Approved
By
Date By Dateoc:1_0B Date ,_c t`zg
•
•
Rough Electrical Final Electrical
CI
of Way
❑ Approved ElApproved Approved
By Date By Date By Date
ilp Of
- 4.9 .. (0 9 C);1_
eiay0 * 410 vElyRMIT _ ^
COMMl/MfYDEVELOPMENT SER SF MF CO_ EL PL DE EN FP
33325 8*s AVENUE SOUTH•PO BOX 9718 APPLICATION
FEDERAL WAY,WA 98063.9718 TD
253.835-2607•FAX 253.835.2609
www.cituolfederalwau.com AUG 2099 /
The following II,
re. �rai on-i an info •fete application will not be accepted. Please print legibly(in ink)or
type.
le PROPERTY INFORMATION
ii
SITE ADDRESS_ <54//� 326 ti., Cf ,o4-LW-9y&14 ft"43 SUITE/UNIT N
ASSESSOR'S TAX/PARCEL# I g 9 $ ,L- EL / 60 LOT SIZE(si)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) Dash t n-t 14i (CO1C(S 'NO 4 oz I)D6 Lo-1- I
(Attach sepamta pager length!,legal d bipyan) to
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING /MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlq)
'Tnsmu.. ( Yct,.ne. Gas FLA'SCG.
PROJECT NAME(Name of Business or Owner Last Name)
NI PEOPLE INFORMATION
PROPERTY NAME I PPRIMARY PHONE
p
XErt'
OWNER - t (.4. 4 -CtiLS� 5.3)CQ,30 -3l
c/
MAIDING ADDRESS CI STATE,ZIP E-MAIL ADDRESS
'i(2 Sw 324..4. cT Ieder�l waj, wp gird
CONTRACTOR COMPANY N��rrA/1 APP CANT NAME OFFICE PHONE
(""1 VtAA\.�,+ , C
MAILING ADDRESS � � ��°` -'� O-,J) 7-3S-'�
��� / N �j, C j q CITY STATE,ZIP
t y!� La)C� t ,. 1'v - `J t 1 3V A..IZr�J i4.-4-
(' N` CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER0-0 EXPIRATION DATE FAX NUMBER
— - 1 b 3"") J g.— 31 b ( i �l ";��2
CO CTOR'S REGISTRATION NUMBER EXPIRATION DATE EMAIL ADDRESS
, 1A0�b 12.— ��-off
APPLICANT COMPANY NAME APPLIORNI NAME OFFICE PHONE
d► ( )
MAILING ADDRESS (43..../0,_e V CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT ( )
FAX NUMBER
❑ Architect ❑ Tenant ❑Agent 0 Other ( ) _
PROJECTNAME Ra.::,
CONTACT I ,� PRIMARY PHONE
� I E-MAIL ADDRESS I
LENDER NAME Per RCW 19.27.095:
Lender information is required If project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
. ( )
• DETAILED BUILDING INFORMATION 1 e
EXISTING USE PROPOSED USE
+
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
VID ❑ TACOMA 0 PRIVATE(WELL)
SEWERWATER SERVICESERVICE PROPROVIDERER O❑LAKEHAVENLAKEHAVEN ❑❑ HIGHLINEHIGHLINE ❑ PRIVATE(SEPTIC)
ARCAS
AREA DESCRIPTION EXISTING
immum
PROPOSED TOTAL
mon
BASEMENT S•• FT, S•.FT,
8•. FT.
FIRST
SECOND11111111111
�-�_-■.
THIRD
ADDITIONAL FLOORS(DESCRIBE) •-.
DECK(0 COVERED OR 0 UNCOVERED?) _-
GARAGE 0 CARPORT 0
MUM=NUMBER OF FLOORS
MUM= TA
•
TOL EXRITIN°sr TOTAL PROPOS
ED SP TOTAL SP
""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.
C
MECHANICAL S . 00
Value of Mechanical Work$ / b (A COPY OP BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS
BHQS FANS GAS PIPE OUTLETS WOODSTOVES
BOILERS GAS WATER HEATERS MISC(Describe)
FIREPLACE INSERTS HOODS(CommerdaU
COMPRESSORS V FURNACES
DUCTS. RANGES
GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS Or Tub/Shower Combo( LAVS(BathroomSinke( URINALS
DISHWASHERS RAINWATER SYST MISC(Describe)
DRINKING FOUNTAINS VACUUM BREAKERS
SHOWERS WATER CLOSETS
ELECTRIC WATER HEATERS SINKS (roues
HOSE BIBBS WASHING MACHINES
SUMPS
SIGNATURE
I ce under penaltyof
knowledge,I cdy�he information perjury that athe property
prtyy owner
ner or authorized agent of the property owner.I certify that to the best of my
submitted in supportapplication is true and correct.I certify that I will comply with all
City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of tlicable
his 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 of the ci , including its officers and employees, upon the accuracy of the information supplied to
the city as a part o this application.
SIGNATURE -� DATE /zi g
Property s t d/or Authorized Agent
nit
a NEW o ADDITION o ALTERATION a REPAIR
°TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN?
ZONING DESIGNATION °YES °NO
CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU?
YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED?
a YES a NO
Bulletin#100—January 1,2008 Page 2 of 4
lalandouts\Pertnit Application