11-100202 • Mechanical
City of Federal Way Permit #: 11 -100202-00-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: BAKER 25'27 (
Project Address: 30915 28TH AVE S Parcel Number: 798440 0040
Project Description: Changeout furnace
Owner Applicant Contractor
NICOLE L STEELE A HAYES HEATING&COOLING LLC A HAYES HEATING&COOLING LLC
ROBERT T BAKER 276 SW 43RD ST HAYESHC939JR(4/19/11)
30915 28TH AVE S RENTON WA 98057 276 SW 43RD ST
FEDERAL WAY WA 98003 RENTON WA 98057
�y '� Additional Permit Information P,
Mechanical Valuation 2739.73 Is this an Online or O.T.C.application? Yes
Mechanical Fixtures
Furnaces 1
PERMIT EXPIRES Sunday, July 17, 2011
Permit Issued on Tuesday, January 18, 2011
• 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.
Owner or agent: -- Date:r
r(NLwD
1 Zo II
THIS CARD IS TO REMAIN ON-SITE -
•44%.S......'
•
CITY OF Construction InsOttion Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 11-100202-00-ME Address: 30915 28TH AVE S
Project: NICOLE L STEELE FEDERAL WAY, WA 98003-5004
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 0e2/7
0 Rough Electrical Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF ilk
_ 6 J / y /
FederalWay 0....% PERMIT ,
COMMUM7YDEVELOPMENT SERVICES ��411111/ SF MF CO VIEIEL PL DE EN FP
3332ER SWATH. BOX 9718 APPLICATION
FEDERAL
L WA WAY,WA TO
98063-9718 / /
253-835-2607.FAX 253.835.2609
UMW atWoffederalway.cnm IAN 1 8 G G.
The following is required information– ; Iicomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
IP 7"7
SITE ADDRESS_ _-}C- f/..5 & ct I✓'t" 5
/ SUITE/UNIT# � 1(-k' '�
ASSESSOR'S TAX/PARCEL �y 'I ''
# 7 o' E i - o- ° LOT SIZE(V)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING Lid MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onitt)
PROJECT NAME(Name of Business or Owner Last Name) /3C:',f4 -`--
U PEOPLE INFORMATION
PROPERTY NAME
-� y r s PRIMARY PHONE
OWNER 71 C2,1- e-v.-Y'-- c:,,C7 t f" (.9(1) 3L-L/ - c. ya.c-.
MAILING ADDRESS -Y=ti CITY,STATE,ZIPE-MAIL ADDRESS
6
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICEPHONE
4 ,r / :3 9-y ter- ,r 4,-1). /IAA/ /74)/e-a> (-Ve:Ce)24®y -'R.-it':
'
MAILING ADDRESS1 CITY,STATE,ZIP I
�v CELL PHONE
«: 7 6- I� ` 3 _5- ' le,.,i L,d, ,:e- Ca3 `7 ( ) _
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
b-v 6-a Its2&- -- „.W-14 ( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
CiyC..,Cy<_5"' 3‘,/':" 9-7Z 'WI'ed?0,//
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS "'' CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect o Tenant 0 Agent 0 Other ( )
PROJECT NAME PRIMARY PHONE E_
CONTACT MAIL ADDRESS
( -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
at DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS"
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 ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING sr TOTAL PROPOSED SI TOTAL ST
**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.
MECHANICAL 7 3
Value of Mechanical Work$ % 7.3 (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(Commercial)
COMPRESSORS r FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(tulle[)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
• SIGNATURE
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 arty 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 /�
Property Owner and/or Authorized Agent
❑NEW ❑ADDITION o ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
•
NEW ADDRESS REQUIRED? a YES ❑NO UP/SEPA/SU? o YES ❑NO
•
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? a YES ❑NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application