11-103979 •City of Federal Way • Mechanical
Community Development Services Permit #: 11 -103979-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 P q
Project Name: SIMMONS
Project Address: 2833 S 308TH LN Parcel Number: 092104 9314
Project Description: Install ducting and heat pump; relocation of hot water tank..
Owner Applicant Contractor
BOB SIMMONS RENAUD ELECTRIC CO INC(GENERAL) RENAUD ELECTRIC CO INC(GENERAL)
2833 S 308TH LN 2300 TALLEY WAY RENAUEC951CQ(2/18/13)
FEDERAL WAY WA 98003 KELSO WA 98626 2300 TALLEY WAY
KELSO WA 98626
1131 Additional'Permit Information
Mechanical Valuation 7000 Is this an Online or O.T.C.application9 Yes
r.,
Mechanical fixtures ,
Compressors/Heat Pumps 1 Ducting 1 Hot Water Tanks 1
PERMIT EXPIRES Saturday, March 31, 2012
Permit Issued on Monday, October 3, 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
an the Cit of Federal Way.
Owner or agen.: J, (i,),,d �%fJ`� ' Date: /0 r3 -f(
it/till
44.10%...„v..
THIS CARD IST EMAIN ON-SITE
CITY OF •
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 11-103979-00-ME Address: 2833 S 308TH LN
Project: BOB SIMMONS FEDERAL WAY, WA 98003-4800
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 Date9�_ 2__((
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
3604238281 403,411:28 Q9 ji-20�i� q 3?
E E - // , 5
{ r o� .. PERMIT srI c PI EP
Federal Wad t
COMMUNITY DEVELOPMENT SERI-ICES 0 APPLICATION
253-835-2607•FAX 253-835-2609 OCTI ��b
m1 .AIR tiLMIEI0.9.com 111
,.____CITY OF FEDERAL WAY
SITE ADDRES ----------- 81ST&/UNIT*
{ 2233 S. SOP Ir ria 1 ff,
PROJECT VALUATION ( ZONING ASSESSOR'S TAX/PARCEL#
$ 1,0 00 . i 0q ...4 1 0 4 _ - __-L 3 1 t,
❑ BUILDING 0 PLUMBING , MECI{ANICAL
TYPE OF PERMIT
❑ DEMOLITION 0 ENGINEERING 7 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) s(,
y- rv"1 Qr,sr-vvs '`
PROJECT DESCRIPTION ` 4 S #Lr-r-i laACt i eZ `Pi t, a- ..
Detailed description of work to -,a U.) ("L,12)C
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 16010 SLIYI r-o n - 34+0 14--I_,,, 3 13 .,
MAILING ADDRESS Lane_ E-MAIL 2
233 • 3C Lane_
CITY STATE ZIP
GL Pk -_W
_.....,..- -_ NAME PHONE
&n cx.0.CA eta.-Y,. CO 3( (423-1,
MAILING ADDRESS E-MAIL
CONTRACTOR 2300 T0-1Ael WC 4 t-t°04.4x .el
Y STATE { ZIP FAX
SCJ C Pi" `3( (4'2_3 - i
WA STATE CONTRACTOR'S LICENSE k EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE d
' EN)P,k.i .Wal —m ___ 06x` 30/20t
NAME PHONE
MCL- `L rA — c .f-8 .u.Gj Al K 3to o (4-23-i '
APPLICANT MAILING DRESS E-MAIL
•
2-300-16-11• Pi
146041.0. TVA aucteler;h7;
CITY f. STATE ZIP FAX I.
teASO WA cato Lk) . `` ! !
PROJECT CONTACT NAME PHONE
(The individual to receive and G �jt Suck) PAN`" •& - 41, --it-t---1-0
respond to all correspondence MAILING Al)DI�� E-MAIL
concerning this application) 2300 k 61--tA btA.( (aJ reiNatAddieeN,
CITY STATE ZIP FAX
KR .ts ) t o CA2..6 S(so 413 - it-1-2-4) S
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING Ni
b �v OWNER-FINANCED
Required value of$5,000 or more � i�nS
(ROW 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 Taws regulating
construction or environmental Iaws.
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 relia ce of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a pa of t • • Iication.
¢ 2y' , j
SIGNATURE: r--"` . %L CI DATE -- �./ % €•
PRINT NAME: 6v. Le;e Al.k_ - �
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Bulletin 4100---January 1,2011 Page 1 of 3 k\Handouts\Pennit Application
3604238281 .3:45:09
09-30-2011 4/7
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VALUE OF MECHANICAL WORK $_:111000' (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(c.e..erciati
BOILERS _l_ FURNACES Ah6tivtop, ( HOT WATER TANKS(ca:j
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
t DUCTING GAS PIPING WOODSTOVES 1
'ili\: i ^ * �,,, wr y* ,s,;,4,R ,4 v '� f r s , w -c- �� t,` • ie I x I T c \ r4SIr.. V �, r k»
i:.,..;. ...,.,�.VI/I . ..,..., ,.,,,...,.-s. -..<,.,,1'.�:,=.5'410.k,,,,.;it_IRS-4'k.:. ;.,.+,.,,ItI . ,,L,,_ .Z,. _ '" y..,, .,,�,, MA �.,.,... `I, :,',44,Vg , tF;
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.
I BATHTUBS(or mbisi.ower Comity( LAVS(Hand Sink.) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS i VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitrhuz/uliiiir) /t WATER HEATERS(e)c-trici
HOSE BIBBS SUMPS WASHING MACHINES
TlYir`4FYICeT $:
y
�C: i ntom• TIO
CRITICAL AREAS ON PROPERTY? -IrWATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
7
$ 610ed5ry
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLE• .: =TEM? PROPOSED FIRE SUPPRESSION SYSTEM?
L Yes-E 0 o i Yes c No
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
HILIENI <
FIRST FLOOR(or Mobile Home)
`EcONI) ] I Gnk
COVERED ENTRY
CX : K a xs
GARAGP. ❑ C'Ah}'ci12T
O` ..L:R.(descnt)e) :
=arum PROPOSED VITAL
Area Totals
ESTIMATED SELLING PRICE$ j #OF BEDROOMS
\L \ em4g ^ \ I t nif na.0ZNwADr- T.
t ,` E r.
;-\ L } " A + —. Eri \ i -- ,,-. iut. f, . ,, nn \ . tV &,.4- t +„,,, ,• \ vR �S , /\ i� Area Construction # ofAREA DESCRIPTION n Square Feet i
Occupancy Group(s) , a Stories Additional Information
a .
NEW BUILDING , g a
ADDITION I
AREA DESCRI• ION Area Occupancy Group(s) Construction #ri I Additional Information
in Sq_, re Feet Type S
r i I ! BUILDINCI 0 4 v t )
\
j i
TEN AREA ONLY
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