11-101766 • . -
Mechanical
y
CommuCitynityof DevelopmentFederalWaServices Permit #: 11 -101766-00-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: RUTH
Project Address: 29641 21ST AVE S Parcel Number: 931510 0090
Project Description: Replace gas furnace.
Owner Applicant Contractor
MICHAEL R RUTH MOUNTAIN VALLEY HEATING&A/C INC MOUNTAIN VALLEY HEATING&A/C INC
29641 21ST AVE S (GENERAL) (GENERAL)
FEDERAL WAY WA 98003 13407 SE 339TH ST MOUNTVH970N2(3/5/12)
AUBURN WA 98092 13407 SE 339TH ST
AUBURN WA 98092
Additional,Permittnformation
Mechanical Valuation 3400 Is this an Online or O.T.C.application? Yes
Mechanical Fixtures
Furnaces 1
PERMIT EXPIRES Saturday, November 5, 2011
Permit Issued on Monday, May 9, 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 1 II be in accordance with the laws, rules and regulations of the State of Washington
--• - " ' o Federal Way.
Owner or agent: Date: l _
+ •
lrf( /11
THIS CARD IS TO EMAIN ON-SITE r
CITY OF Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 11-101766-00-ME Address: 29641 21ST AVE S
Project: MICHAEL R RUTH FEDERAL WAY, WA 98003-4245
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.
El Mechanical Rough-in (4165) 0 Gas Piping(4125) D Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date y I( Date S � � �/—ll
•
El Rough Electrical El Final ElectricalCI Right of Way
Approved Approved Approved
By Date By Date By Date
•
1116.
n± Q l`7 (a rof n ECCthii -
r
E R M I T {{�Lrw LLooPL DE EN FP
Federal Way9
COMMUMTY DEVELOPMENT SERVICES APPLICATION MAY 0 92011i)'
Ed
253-835-2607•FAX 253-835-2609 �Ly
ww rtyffeelewlwa own �DD
CITY OF FEDERAL WAY
SITE ADDRESS
DS C 1 o SUITE/UNIT#
2 l ' y/ 2/ St Ave S �c)eru (f itJQU3
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ , `-/ZS0 `73 / S" / 0 - 0
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING JkMECHANICAL
❑ DEMOLITION ❑ ENGINEERING El FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) /4 1'c k -e I 2,,4-4
PROJECT DESCRIPTION �-! 1 ` f..c, / p/�ce
a /-
Detailed description of work to
be included on this permit only
NAME��J / PRIMARY PHONE ?�r
PROPERTY OWNER a 'tet/ G a �.-/ �v �I^. 2%41.1 ` 24 1,5" J p 93
MAILING ADDRESS E-MAIL
2ZG6Y/ 2(5,4
iVinc c
CITY
! ^ STATE ZIP)4 2)003
NAME, , F PHONE
/ ✓l 0 /o,4-GIS VO,/e7 MC-!,'el y r AC r . ,`/.2f ---226 _0050
MAILING ADDRESS E-MAIL
CONTRACTOR /35�0 J �k _
CITY STATE ZIP FAX
416y44 l t/A 98o92-.
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
OvrvrL/ 9-7Cyl/2 S S /2o/L 06 -!b52, 5 /
2.4PHONE
`pf l rp
(�• Z ✓UP 4 'A /'W. j, ;/�Py s -?fit/ —PLICANT MAILING ADDRESS E-MAIL
SSL i..�.-e ZA Goa O<rz .t.04)
CITY I STATE ZIP FAX
PROJECT CONTACT NAME PHONE
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECTNAME -_
f OWNER-FINANCED
RequIred III . ;'
IRCW 19.27.095) MAILING ADD SS CITY,STAT -------- PHONE
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. e City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense /suc claim), which may be made by any person, including the undersigned,and filed against the city,
but only where such claim ses • t of the reliance of the city, including its officers and employees, upon the accuracy of the
information sup••• .• • ... a part of this application.
SIGNATURE: , DATE 5 - ` //
PRINT NAME: `4, S�--t,t..j-e..4".
—
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
• i
� TECH iIicAL FixTui?,
VALUE OF MECHANICAL WORK $ ) (a copy of bid or estimate must be provided)
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(Comm<rciat)
BOILERS L. / FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
a z a X,
Indicate how many of each type offixture 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/UtSity) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES e+ritl. °, ;
'�? raj. .AL_'
GENERAL
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?
Ei Yes n No ❑Yes 5 No
RESIDENTIAL;,' -"N NV 011 AIDDI ` CSN
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
COVERED ENTRY
at
GARAGE ❑ CARPORT El
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ORLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
C Oii MERG L—NEW/I)I) "l:IO1
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
MME.i2Cl it REMODEL/TENANTIMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet T�Te Stones
TOTAL BUILDING-
TENANT AREA ONLY
PROJECT AREA ONLY I'
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application