15-1052794L 01- * Wchat ical
City of Federal Way Permit #: 15-105279-00-M E
Community &Econ. 11ev. Services
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 p q
Project Name: WALTER
Project Address: 32917 4TH AVE SW Parcel Number: 9264910540
Project Description: Installation of a ductless heat pump.
Owner
A121211can
Contractor
DON WALTER
SUNDANCE ENERGY SERVICES INC
SUNDANCE ENERGY SERVICES INC
32917 4TH AVE SW
(MECHANICAL)
(MECHANICAL)
FEDERAL WAY WA 98023
10228 MAIN ST
SUNDAES063J9 (9/12/17)
BOTHELL WA 98011
10228 MAIN ST
BOTHELL WA 98011
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Mechanical Fixtures'
Compressors / Heat Pumps............ 1
PERMIT EXPIRES Tuesday, April 12, 2016
Permit Issued on Thursday, October 15, 2015
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 the City of Federal Way.
Owner or
7?)agent: Date: '
r\J��%U)Cz
CITY OF VAFP
Federal Way
PERMIT #:
15 -105279 -00 -ME
THIS CARD IS TOIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
Address: 32917 4TH AVE SW
Project: DON WALTER FEDERAL WAY, WA 98023-6102
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.
E]
Mechanical Rough -in (4165)
Gas Piping (4125)
Final - Mechanical (4065)
Approved
Right of Way
Approved
Approved to release test
Approved
By
Date
By
Date
�.S Date
—_T
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
RECEIVE
tTY�F OCT zap PERMIAAPPLICATION
Federal Way
cry of FEDERAL WAY 3
CDS b
PERMIT NUMBER _ Di '7 ?
(- L TARGET DATE
SITE ADDRESS rSUITE/UNIT
#
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL#
P50
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING IECHAN[CAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
wA L,° E ,
A AAF— pe ifff t4464-1,"- lj
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME AQAJ WA ��,,
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PRIMARY PHONE
ZS3-3(57--t51)9
MAILING ADDRESS
3 { siA-J
E-MAIL
CITY �flGj/�L' ��✓
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ZIP ��OL+
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MAILING ADDRESS
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E-MAIL
NAAA1
CONTRACTOR
CITY
0 .
STATE
V-/^V..
ZIP
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A
FAR
L121 -u94--511
WA STTE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
PAX
PROJECT CONTACT
NAME N9,�.'✓r
PRIMARY PHONE
(The individual to receive and
MAILING ADDRESS
E-MAIL
respond to all correspondence
CI'T'Y
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
0 OWNER -FINANCED
Required value of $5, 000 or more
(RC_W 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that 1 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 theas part of this application.
q
SIGNATURE: DATE
//��
141 -AP -11
PRINT NAME: 141—A n% t/V�C_
Bulletin #100 -January 1, 2013 Pale 1 of 3 k:�HandoutslPermit Application
AJ
oW
dC
f MECHANICAL PERMIT
Indicate how many of each type
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
to be installed or relocated as
FANS _
FIREPLACE INSERTS —
FURNACES —
GAS LOG SETS _
GAS PIPING
—
VALUE OF MECHANICAL WORK
WATER PURVEYOR
$
/(/ 54z—,�, a
F this project. Do not includ
tin ft -tures to remain.
GAS PIPE OUTLETSOTHER
(Descr b
HOODS tcommerciall
?
HOT WATER TANKS iG—i
Indicate how many of each type offixture
REFRIGERATION SYST
part of this project. Do not include existingfwtures to remain.
WOODSTOVES
LAVS i,HandS-k.)
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUILIBING WORK
PLUMBING PERMIT
# of
AREA DESCRIPTION
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feetj
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existingfwtures to remain.
BATHTUBS (or Tub/Shower combo)
LAVS i,HandS-k.)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS Qiimhen/utiliry)
WATER HEATERS (Electric
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
AREA DESCRIPTION
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feetj
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
in Square Feet
Yes ❑ No
❑ Yes _ No
CONINIERCIAL — NEWADDITION
Area
Construction
# of
AREA DESCRIPTION
Occupancy Group(s)
Additional Information
in Square Feet
TXpe
Stories
NEW RUiLDMG
ADDITION
COMMERCIAL — REINIODEUTENANT IMPROVEMENTS
Area
Construction
# of
AREA DESCRIPTION
Occupancy Group(s)
Additional Information
in Square Feet
Type
Stories
TENANT AREA ONLY
Bulletin #100 - January 1, 2013 Page 2 of 3 k:\Iandouts\Permit Application