12-101528City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: CALVARY LUTHERAN CHURCH
Project Address: 2415 S 320TH ST
Project Description: Remove/replace gas furnace
Wchah,icai
Permit #: 12 -101528 -00 -ME
Inspection Request Line: (253) 8353050
Parcel Number: 797820 0525
Owner
li an
Contractor
CALVARY LUTHERAN CHURCH
NARROWS HEATING & AIR CONDITIONING
NARROWS HEATING & AIR
2415 S 320TH ST
(GENERAL)
CONDITIONING (GENERAL)
FEDERAL WAY WA
5121 S BURLINGTON WAY
NARROI*216J3 (4/5/14)
98003
TACOMA WA 98409
5121 S BURLINGTON WAY
TACOMA WA 98409
.Additional Permit 'Infarmation
Mechanical Valuation............................................6120
Is this an Online or O.T.C. application?.................Yes
Mechanical Fixtures
Furnaces ......................................... 1
PERMIT EXPIRES Tuesday, October 2, 2012
Permit Issued on Thursday, April 5, 2012
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
a the City of Federal Way.
Owner or agent: Date:
-� "-"� 5/x/12
THIS CARD IS TO MAIN ON-SITE r
CITY OF Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 12 -101528 -00 -ME Address: 2415 S 320TH ST
Project: CALVARY LUTHERAN CHURCH FEDERAL WAY, WA 98003-5442
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)El
Gas Piping (4125)
Final Electrical
Approved
Final - Mechanical (4065)
Approved
By
Approved to release test
Approved
By
Date
By
Date
By
Date
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
Federal Way
OTY CIF
FePERMIT SF MF CO E PL DE EN FP
F
COMMUNITY DEVELOPMENT SERVICES
APPLICATION253-835-2607• FAX 253-835-2609 RECEIVED
wwu�.c tuoffederalwauxom
APR'Q 5 2012
SITE ADDRESS SUITE/UNIT N
`i 1 S 5 • 3 �-o - 5�-- CITY OF F DERAL WAY
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL MCDS
LotC. v o
9 S
TYPE OF PERhHT
❑ BUILDING ❑ PLUMBING J8j MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeoumer Last Name)
/ „1`' Cr C
(�`
Lr
PROJECT DESCRIPTION
�EJ��\V�
' i L � bl t cr L � �(, C.-' � � o• 5 ��nC r`e�� �
v T
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
(,--1 wr E'✓ C: L q1 N h Q
PRIMARY PHONE
a5 3 8-39
MAUANG ADD
a Lkl 5 3 ao-k!i '5
E-MAIL
I i c al" t1 a, a
CITY STA ZIP
REA erg A Ci g oc>
PHONE
MAMING ADDRESS,
1 5. 3 �.z : ,, %^ IN �-
E-MAILi
CONTRACTOR
c—ITYT—�cL
STATE
ZIPg
c�
FAX
WA EI
ATE CONTRACTOR'S LICENSE M UMUTION DATE
`K2�oz J/13
FEDERAL WAY BUSINESS LICENSE M
NAM'
j
J `" ` `� Ci.W�
PHONE
:2 -T5 q
APPLICANT
MA=G ADDRESS
c ; vc;I r- cam.
E-MAU.
CITY S-TAtT
ZIPC
FAX
PROJECT CONTACT
NAME
PHONE
(77-te individual to receive and
MAH1NG ADDRESS
E-MAU.
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAU,
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.0951
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 this application.
cja
SIGNATURE: DATE
PRINT NAME: :.
Bulletin #100 -January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application
t�r
0 0
VALVE 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 (Commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include
existingfixtures to remain.
BATHTUBS (orTLb/shower Combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Hitchen/vtuity)
WATER HEATERS (e -unci
HOSE BIBBS
SUMPS
WASHING MACHINES
OT
CRITICAL AREAS ON PROPERTY? I WATER PURVEYOR I SEWER PURVEYOR I VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
Bulletin #100 — January 1, 2011 Page 2 of 3 Ul-landoutsTermit Application