09-100754 Mec ianical
City of Federal Way • • Q
Community Development Services Permit #: 09-100754-00-ME
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: FAIRBURN
Project Address: 31015 51ST AVE SW Parcel Number: 321020 0235
Project Description: Running gas line for PSE installed gas furnace.
Owner Applicant Contractor
KORT FAIRBURN KORT FAIRBURN KORT FAIRBURN
31015 51ST AVE SW 31015 51ST AVE SW 31015 51ST AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
4 4 11, Additional Permit Information ,
Mechanical Valuation 600 Is this an Online or O.T.C.application? Yes
iY S c . s., v ➢ - ir � ,, ,
Furnaces 1 Gas Piping 1
PERMIT EXPIRES Wednesday, August 26, 2009
Permit Issued on Friday, February 27, 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 accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
4 Owner or agent: 7 �_� Date:
1
• THIS CARD IST EMAIN ON-SITE -
CITY OF xi• Community DevelopiTent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09-100754-00-ME
Owner: KORT FAIRBURN
Address: 31015 51ST AVE SW
FEDERAL WAY, WA 98023-2021
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) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date 3/0g
•
•
•
For inspector reference only
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
�- 02_ - 1.6o 7
anoF A x,
PERMIT
COMMUNITY DEVELOPMENT SERVICES CFB 9, r7 ?fi^. 5.-
Federal Way ? SF MF CO OEL PL DE EN FP
33325 8*H AVENUE SOUTH.PD BOX 9718 — APPLICATION
FEDERAL WAY,WA 98063-9718 TD / /
253-835-2607•FAX 253-835-2609 r-
www.dtrtofederalwa9.com ``•w r-
4
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
11 PROPERTY INFORMATION
SITE ADDRESS 35 5!ST S Vv J,DLL SUITE/UNIT#
Ale
ASSESSOR'S TAX/PARCEL# -
—— LOT SIZE(si)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach sepnruteFoot,for lengthy legal description)
I PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING )MECHANICAL
0 DEMOLITION 0 ELECTRICAL I. ENGINEERING 0 FIRE PREVENTION SYSTEM
•
PROJECT DESCRIPTION(Provide detailed description of work included on i.,�.ermit onl
,loA' 2.1(.'"r
4 �2.1(.'" l' /q � GLv
G ` 1Gt�
,,, hc. CA.,e- /1ti4 iii•t
•
PROJECT NAME(Name of Business or Owner Last Name)
El PEOPLE INFORMATION
PROPERTY NAME �j t, PRIMARY PHONE
OWNER ``(/�
MAILING ADDRESS O,v� ' l ) _e„ (..
STATE,ZIP E-MAIL ADDRESS &
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
C. !M,s
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant o Agent 0 Other ( )
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT le....---0...—
(
--,t,�
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE o PRIVATE(SEPTIC)
PROJECP FLQQR Ai2EAS
•
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 O
=MSG PROPOSED TOTAL TOTAL PROPOSED Sr TOTAL Sr
NUMBER OF FLOORS
"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.
MECBAMCAL
Value of Mechanical Work$ , ; (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(commeteial)
COMPRESSORS FURNACES RANGESc-e0
DUCTS GAS LOG SETS REFRIG.SYSTEMS feu
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Tou
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
_ __ ___ SIGNATURE' . , _ _
I certify under penalty of perjury that I ant 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 claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to
the city as a part of this application.
SIGNATURE: -.. DATE -1-124:14717<'
Property Owner and/or Authorized Agent
y
sy «^� 'MT
a NEW a ADDITION o ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? o YES o.NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application