11-101506■
'LE
I of * MechanicalCityFederalWay } Permit tt. 11 -101506 -00 -ME
Community Development Services
P.O.O. Box 9718 y�
Federal Way, WA 98063-9718 (253uest Inspection Re Line:
Ph: (253) 835-2607 Fax: (253) 835-2609 p q ) 835-3050
Project Name: ZILLMER
Project Address: 31233 22ND AVE SW Parcel Number: 178980 0030
Project Description: Remove/replace furnace
Owner
Applicant
Contractor
ROBERT O ZILLMER
GRIFFIS HEATING INC (GENERAL)
GRIFFIS HEATING INC (GENERAL)
31233 22ND AVE SW
402 E MAIN ST SUITE 130
GRIFFH1088DZ (1/5/13)
FEDERAL WAY WA 98023-7807
AUBURN WA 98002
402 E MAIN ST SUITE 130
AUBURN WA 98002
Mechanical Valuation............................................3577
................................... 1
PERMIT E.
Owner or agent:
Is this an Online or O.T.C. application?.................Yes
bove described property and
of the State of Washington
J f J CS i
4/z9/0
crr,r of VA�p
Federal Way
PERMIT #:
Project:
THIS CARD IST MAIN ON-SITE
Construction I ection Record
INSPECTION REQUE TS: (253) 835-3050
11 -101506 -00 -ME Address: 31233 22ND AVE SW
ROBERT O ZILLMER FEDERAL WAY, WA 98023-7807
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.
Mechanical Rough -in (4165)
Gas Piping (4125)
Final Electrical
Approved
Final - Mechanical (4065)
Approved
By
Approved to release test
Approved
By
Date
By
Date
By
tA�Date ., a S
Rough Electrical
Approved
❑
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
DATE
INSPECTOR
AREA AND TYPE OF SPEcTION
CITY of
Federal Way
COMMUNITY DEVELOPMENT SERVICES
253-835-2607• FAX 253-835-2609
(!!J!1<". fit�0�[QP.1YFIfF.'(FU, f.OFi
OPERMIT
APPLICATION
N - (C I
F C ME PL
(S- 0ro
DE EN FP
SITE ADDRESS M JSUITE/UNIT
S12 3 3 2 14ve I �pt'�� , Gt/yf ?ioZ3
#
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
IO0
-7- V
_t T _q I_ __'i l.) - 0 Q
❑ BUILDING ❑ PLUMBING MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Name/Homeowner Last Name)
(Tenant
Gr
` Q iT1L S C'
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
Vb6e,rk Z` `t ln,ew-
PRIMARY PHONE
S _ S7 ^ L �Olo
MAILING ADDRESS
22 -not JG
E-MAIL
_91Z3-5
STATE
ZIP
NAME ' R rt S t+-/ `,..
PHONE
''` 7�J../ '
�"'.i - r -3
MAILING ADDRESS� *130
/3Q
E-MAIL
CONTRACTOR
CITY ' ` n �
STATE
�71,•
ZI� k00 n -+'
FAX a-
69
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
G HX 0 0 93,6 7 -
NAME
PHONE
Shwv_ 04:51
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
xAME� 2 1 A A `-� /^
Z I r -F7
1' ONE . -.3 rs Q 0
O
(The individual to receive and
MAILING ADDRESS y�
4 0 S� O
E-MAIL
SATN.
respond to all correspondence
concerning this application)
n i'
Are. 'Q,.
CITY
STATE
,a-
ZIP
q Foo 2-
FAX
-943-73.5-32-90
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
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 reliant of the city, including its officers and employees, upon the accuracy of the
information su city as apart of thi p li tion.
lQ
! ---
SIGNATURE: DATE `
PRINT NAME: S
Bulletin #100 - January 1, 2011 Pagel of 3 k:AHandouts\Pemiit Application
g fixtures to remain.
OTHER (Describe)
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/sho—Combo)
LAVS (H --Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS lK;mnen/utaity)
WATER HEATERS (Electric)
i
HOSE BIBBS
SUMPS
WASHING MACHINES ,
_,<
Bulletin #l00 —January 1, 2011 Page 2 of 3 k:,Handouts\Permit Application