08-100067 • `
City of Federal way Mechanical Permit,: 08-100067-00-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
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Project Name: INTL CHURCH OF FOUR SQUARE GO RLI
Project Address: 1932 SW 350TH ST Parcel Number: 795620 0040
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Project Description: Replace gas piping for new furnace installation.
Owner Applicant Contractor
INTL CHURCH OF FOUR SQUARE GOSPEL INTL CHURCH OF FOUR SQUARE GOSPEL SUPERIOR HEATING
1932 SW 350TH ST 1932 SW 350TH ST SUPERH*077QK(11/11/00)
FEDERAL WAY WA FEDERAL WAY WA PO BOX 835
98023-6917 98023-6917 PUYALLUP WA 98371
Additional Permit Information
Mechanical Valuation 1060 Over the Counter Permit? Yes
Mechanical Fixtures
Gas Piping 1 Gas Pipe Outlets 4
PERMIT EXPIRES Thursday, January 7, 2010
Permit Issued on Monday,January 7, 2008
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 accords s e with he laws, rules and regulations of the State of Washington
(' nd .e city of Federal Way.
Owner or agent: IPA Date:! 7 O 7 '
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41k, • THIS CARD IS Tir EMAIN ON-SITE
CITY OF ~` - Community Development Inspection Record.
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-100067-00-ME
Owner: INTL CHURCH OF FOUR SQUARE GOSPEL
Address: 1932 SW 350TH ST
FEDERAL WAY, WA 98023-6917
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 I / /9
•
For inspector reference only _
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
a ECE%Vt. �- �� -�
- way p� PERMIT ® �
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.� FEDER4L WAY,WA 980G?-9718 ._:
253-835-2607�FAX253-835-260G1'jY O,:Li
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t �� • PROPERTYINFORMATIONjSITEE1fa` )L'- 3 oJ" r c ` Ef # f�R'ST /PEL# `I S (� U - OC7SIZE(sj) `� 16
DRION(eg.AcEsttes,Lot 1) 5HL'JA!7aserate IJbrthjdeS 1 I• PRO,JEGTINFORMATIONEOFQ BUILDING ❑ UINGED DEMOLITION ❑ ELQENGINEEGDFPNTIONSM
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PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
-cLi
MAILING ADDRESS CITY,STATE,ZE E-MAIL ADDRESS
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CONTRACTOR COMPANY NAME APPLICANT NAAM fE� OFFICE PHON9E
�c�(t�Er'r�fr �4� TDReL w�f (ZS3) p�i+ 2I 3
MAILIN�GG ADD STATE,ZIP �W CELL PHONE
CITY OF'F DERAL AY BUSIN NSE NUMBEREXPI 41YON D ' FAX UMBEL�� - y�0
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE EMAIL ADDRESS
APPLICANT' COMPANY APPLICANT NAME OFFICE PHONE
r,� u t vv'cL ��uifl n�' 3L(
MAILING ADDRESS } CIY,STATE,ZIP CELL PHONE
3�1f�O0 Zt`/Arr; uJ Fr�Q t�;n� t,ui� SIX®L3 (,
RELATIONSHIP TO PRO JEt;f FAX NUMBER
❑Architect ❑Tenant [)i Agent ❑ Other (253 ) 3 ' -7�o
PROJECT NAME PRIMARY PHONE E-MAIL ADD,�s S
CONTACToJ.00 u
LENDER NAME Per RLW IS.27.095:
Lender lnJbrmatlon is required(f project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
S DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE o TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC)
,
•
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
t, SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTALS=AING SF TOTAL PROPOSEDSF TOTAL SF
**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 0,o
Value of Mechanical Work$ /0 60 (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 Icommo dal)
COMPRESSORS FURNACES RANGES
DUELS GAS LOG SET'S REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo)o) IAVS(Bathroom Sin URINALS MISC(Describe)
DISHWASHERS RAINWATER SYS.T VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSEIS Imitet)
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 any person, including the undersigned, and filed against the city,but only
where such claim the reliance of the city,including its officers and employees, upon the accuracy of the information supplied to
the city as a part of is app/
SIGNATURE: `\
� A Cillk DATE /1-2‘I -U,
or Autherizesi Agent
so*torn 'e001
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
•
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-August 16,2007 Page 2 of 4 k\Handouts\Permit Application