11-102670 Mechanical
City of Federal Way •
Community Development Services Permit #: 11 -102670-00-ME
P.O.Box 9718 lailli
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Federal Why,WA 98063-9718 Ins ection Re uest Line: 253 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 P q
Project Name: STEEL LAKE GRANGE
Project Address: 2902 S 298TH ST Parcel Number: 042104 9077
Project Description: Remove and replace two gas furnaces in existing Grange Hall.
,
Owner Applicant Contractor
STEEL LAKE GRANGE 805 SARAH TURNER GLENDALE HEATING&A/C
STEEL LAKE GRANGE 805 GLENDALE HEATING&A/C GLENDHA053Q2 (11/2/11)
PO BOX 4584 12462 DES MOINES WAY S 12462 DES MOINES WAY S
FEDERAL WAY WA 98063-4584 SEATTLE WA 98168-2266 SEATTLE WA 98168-2266
I ik ' ,r4:j 7'.':;11 4 Adattiiihit Permit Informs i 1
Mechanical Valuation 5384.20 Is this an Online or O.T.C.application? Yes
1 Mechanical Fixtures z
i r \ x, ' ii� 1 . A,A,?
Furnaces 2
PERMIT EXPIRES Monday, January 2, 2012
Permit Issued on Wednesday, July 6, 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 tr - City of Federal Way.
Owner or agent: / Date: —7/<P //
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THIS CARD IS T MAIN ON-SITE
CITY OF z • Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 11-102670-00-ME Address: 2902 S 298TH ST
Project: STEEL LAKE GRANGE 805 FEDERAL WAY, WA 98003-3365
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) 0 Gas Piping (4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date y Date 2 - 10- 1/
•❑ Rough Electrical ® Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
) 2 2--c)
CITY oFA' LVED — 1Federal Way 4,1_
COMMUNDYDEVELDPMENr SERVICES PERMIT. SF C*OELPL DE EN FP
3335383 AL5 8Th WA FAX 5E SOUTH•PO 27x978 ° 2 w APPLI CATI O N
FEDERAL WAY,WA 98063-9718 '`^ /
www,cttuolfedera4uau.coF FEDERAL WAIS
The following is requ •si •tion-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS ?(Ahz Q El l lean/ oi QQ
O SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 0 Ii 2 I D 1- 0 1 LOT SIZE(sj
LEGALNI I DESCRIPTION(e.g.Acme Estates,Lot 1) I J f (Ti 3j7(p 1)q q ipg M ji re�1y�l� W h ti; (l2 6`1 Pt' D'1
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING LebIE//
CHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
(4g7t-1 • ---i) ..i
vest)-n
PROJECT NAME(Name of Business or Owner Last Name) 51 Q 171 1.I//1 lX 0 Y Y31I
MI PEOPLE INFORMATION
PROPERTY NAME 1 , pp II A�'' '' \ PRIMARY PHONEI `7� /�
OWNER i Li L//�V brov v _( ) 1 SIU- 7I/�"I
MAILINGI� ADDRESS
(� TATE, II'j�./j 'i �y Q
-I 0 �`� . t T TATE,
V V al K a ° DO 3 E-MAIL ADDRESS
CONTRACTOR COMPANY NAME V\ t ji r APPLICANT NAME / OFFICE PHONEMA\ILING(.ADD (y �{ r) ST CE , P- O 4,3 - 7DD
C1 tAr7,„\, 7 Q✓ 1��.(Ul Gg.1IY g (ELL PHONE 6 I0 D - z s.I
CITY F FEDERAL WAY CENSE NUMBER EXPIRATION DATE FAX NUMBER
I°I - �I - 105b1 ' NL 1 ) -3 ) - 1 ( .) ; - LLIL)
RB REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
C71L�:111'D 1 �r1� � 11D ' ) I
APPLICANT COMPANY NAME APPLICANT NAME `OFFICE PHONE
MAILING ADDRESS ` ) -
CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER -
❑ Architect 0 Tenant 0 Agent 0 Other ( ) _
PROJECT NAME r_ PRIMARY PHO E-MAIL ADD�s
CONTACT 1D41 C8 0 7 ( 410 ) ,CIG`?D - I flCQon4�l(fot' � hi al pi
LENDER NAME Per RCW 19.27.095:
Lender information is required(f project value exceeds$5,000 0K
MAILING ADDRESS CITY,STATE,ZIP PHONE
)
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ 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 HIGIJLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
w R _
CITY OF OPERMIT
MF
Federal Way AllICO ME PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES APPLICATION
253-835-2607•FAX 253-835-2609
f(I of ideralwaii.coro
_ .. � ._.___....._.._._-
SITE ADDRESS SUITE/UNIT#
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT IDBUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY 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
PROJECT FINANCING NAME
El OWNER-FINANCED
Rey-tared value of$5,000 or more
(RCW 19-27.095) MAILING ADDRESS,CITY,STATE,ZIP 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 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 tis application.
SIGNATURE: .jetli ,r �f DATE W 7 1
PRINT NAME:
Bulletin#100--January 1,2011 Page 1 of 3 k:AHandouts\Permit Application
• •
VALUE OF MECHAMCAL 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(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
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
^. a
I.11 Z It i ,4:,- ., p.� - * fib
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 Yes .- No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
*
FIRST FLOOR(or Mobile Home)
mss,
COVERED ENTRY
GARAGE ❑ CARPORT Cl
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEWHOMES ONLY** '',
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL--NEN /ADDITION
Area Construction # of
AREA DESCRIPTION Occupancy Group(s) Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—RE.i4MODEL/TENANT IMPROVEMENT =-
AREA DESCRIPTION Area Occupancy Group(s( Construction # of Additional Information
in Square Feet Type Stories
TOTAL BU
TENANT Ar)A ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application