13-105303 Mechanical
City of Federal Way Permit #: 13-105303-00-M E
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: PHANIVONG
Project Address: 30118 11TH PL S Parcel Number: 515390 0010
Project Description: Replace oil furnace with same.
Owner Applicant Contractor
SAMANTHA T PHANIVONG OLSON ENERGY SERVICE(GENERAL) OLSON ENERGY SERVICE(GENERAL)
30118 11TH PL S 4415 LEARY ST NW OLSONES95IL3 (10/24/15)
FEDERAL WAY,WA 98003 SEATTLE WA 98107 4415 LEARY ST NW
SEATTLE WA 98107
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Mechanical Fixtures
Furnaces 1
PERMIT EXPIRES Sunday, May 25, 2014
Permit Issued on Tuesday, November 26, 2013
I hereby certify that -- above information is correct and that the construction on the above described property and
the occupancy a/id the use will be in accordance with the laws, rules and regulations of the State of Washington
an. - 9f Federal Way. t f
Owner or agent: ,
VINIO 411111.‘ Date: ` � '
�O
P�.
N
THIS CARD IS TO 'MAIN ON-SITE
c,n OF ' 0 Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-105303-00-ME Address: 30118 11TH PL S
Project: SAMANTHA T PHANIVONG FEDERAL WAY, WA 98003-4147
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) El Gas Piping(4125) -
-El Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By r Date 1 F/; /
0 Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF • PERMITS pp TION
Federal WayE
NOV 2-6 2013
PERMIT NUMBER
If 3
- L0 - - TARGETJA EOF FEDERAL WAY
LDS
SITE ADDRESS SUITE/UNIT#
30 L L 1 01" Po.c., S,
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT ❑ BUILDING D PLUMBING 1 MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
VY
L J 4�
PROJECT DESCRIPTION P( 01 k. tNV� `' r v
n['' X �V
lita
Detailed description of work to K
be included on this permit only
NpEPRIMARY PHONE
PROPERTY OWNER In VVONA S: °S.4- lac ' 23 ' S'S'S':)-
�
, .� L c,J J A
MAILING)U ADDRESS 1 ll Pi, S E-MAIL
CIT 1l ��^^ Qry ST TE ZIP �'1�y-'1�
V'C.GL'lav ja.1 ' VU J
NAME PHONE
CO Jere; lou sgLSS-2-2-
MAILING
Z2
MAILING ADDRESS
�" E-MAIL `_
CONTRACTOR `Lkt5 1.t�Rk/vLlilf�Gt.� NL'� 1�vitQ C�U1�uvlC�i1Q , i7
CITY .l STATE ZIP
.
-N,AOr10,E ;,9 0 V__1 Sv3
WA STATCCONTRACTOR'S LICENSE# EXPIRATION DATE FEDERALWAAY BUSINESS LICENSE#
( L` Oti V5 L� 3 /0 / 2i,' /I j-- 2 C j-_c I -1 O i?I 'O�--Dp
L
NAME PRIMARY PHONE
(_.JV41.0 ATIr-
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
`
PROJECT CONTACT " l LDVI` GGIC.:
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME t,
PROJECT FINANCING !4i/ OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP 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 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 supplie• . the city as a part of this application.
SIGNATURE: i. 4/944444---"L4---" DATE i/J15 Al
PRINT NAME: . J// d( rji (h
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
• • VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS 1— FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Yes - No i Yes ': No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT ❑
OTHER(describe)
................................................................................................................................................................................................
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-January 1,2013 Page 2 of 3 k:\I-Iandouts\Permit Application