14-104707i ` I Mechanical
City of Federal Way ' 14 104707 00 ME
Community &Econ. Dev. Services Permit #.
33325 8th Ave S:
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609 i Inspection Request Line: (253) 835,3050
y
Project Name: LANGIS
Project Address: 32613 16TH CT SW
Project Description: Install ductless heat pump.
Parcel Number. 010453 0570
Owner
ARRIican
Contractor
PAUL LANGIS
BLACK HILLS INC (GENERAL)
BLACK HILLS INC (GENERAL)
32613 16TH CT SW
1003 85TH AVE SE UNrr A
BLACKlU066JL (7/19/15)
FEDERAL WAY WA 98023
OLYMPIA WA 98501-5706
1003 85TH AVE SE UNIT A
OLYMPIA WA 98501-5706
Additional Permit Information
Is this an Online or O.T.C. application? ................. es
Mechanical Fixtures
Air Handling Units ......................... 1
PERMIT EXPIRES Tuesday, March 10, 2015
Permit Issued on Thursday, September 11, 2014
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.
A
Owner or agent 44--�
Date: a -i N -1 14
f <
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
14 -104707 -00 -ME Address: 32613 16TH CT SW
PAUL LANGIS FEDERAL WAY, WA 98023-5438
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)
0 Final - Mechanical (4065)
Approved
Approved to release test
Approved
By f A -Z, Date t 2—, r
By //Date
By P�{. (� Date t 7
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
` i Ilrj
SEP 11 20i
aff(w
Federal W2MTY OF FEDERAL WAY
CDS
40
PERMIT APPLICATIO1N
PERN[IT NUM33ER -/Y -Z-6 &-E,
TARGET DATE
SITE ADDRESS
SUITE/UNIT
3 I(", -S va 6
PROJECT VALUATION
ZONING
ASSESSOR'S T/PARCEL #
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING EPALMCHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
S
PROJECT DESCRIPTION
Detailed description of Mork to
be included on this permit only
PROPERTY OWNER"
NAME
PRIMARY PHONE
-
MAILING C
E-MAIL
CITY
STATE ZIPn ,
Llc...�(/
NAME (1 1 L
- v 1/
PHONE O
CONTRACTOR
MAILING ADD
E-MAIL
CITY i
BTATE
ZIP
FAR -3 -
WA STA LICEN#
TION DATE
r/` /APa
FEDERAL WAY BUSINESS LICENSE #
NAME y V0
P PHONE_ L ✓✓
MAILING ADD F\ Vt /jam
\ _ ��J
E-MAIL
APPLICANT
sTA
F
NAME
PROORY PHONE
PROJECT CONTACT
-
(The individual to receive and
MANN° ADD
f� I /��
v�
E-MAEL,
respond to all correspondence
V v
CITY
FAX
concerning this application)
PROJECT FINANCING
NAME
10
OWNER -FINANCED
Required value of $5,000 or more
PRCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
NJ/ P
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
of such claim), whit may be made by any person, including the undersigned, and filed against the city,
the investigation defen:arises
but only wher suc claim out of the re ace fthe city, including its officers and employees, upon the accuracy of the
information p1i the as of this p 1 0
I (
SIGNATURE:' DATE
PRINT NAME: l l/Li
Bulletin #100 - January 1, 2013 Page 1 of 3 k:\Handouts\Pelmit Application
0
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
FOR OFFICE USE
BASEMENT
NEm BuILDINa
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
$�-
to be installed or relocated as
Indicate how many of each type offixture
to be installed or relocated as
part of this prgiect. Do not include existing
fixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS L
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
VACUUM BREAKERS
BOILERS
FURNACES
HOT WATER TANKS (cas)
WATER HEATERS (Electric)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
WASHING MACHINES
DUCTING
GAS PIPING
WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OFPLUMBING WORK
PLUMBING PERMIT
FOR OFFICE USE
BASEMENT
NEm BuILDINa
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include eidstingftxtures to remain.
BATHTUBS (or Tub/shower combo)
LAVS (Hand sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DECK
DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
FOR OFFICE USE
BASEMENT
NEm BuILDINa
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
ADDITION
❑ Yes ❑ No
❑ Yes ❑ No
E5IDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
NEm BuILDINa
FIRST FLOOR (or Mobile Home)
ADDITION
SECOND FLOOR
COMMERCIAL — REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
COVERED ENTRY
Occupancy Group(s)
Construction
# of
Stories
Additional Information
DECK
GARAGE ❑ CARPORT ❑
TENANT AREA ONLY
OTHER (describe)
PROJECT AREA ONLY
Area Totals
spa
PRO
TOTAL
**NEW ROAM ORLY**
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Tye
# of
Stories
Additional Information
NEm BuILDINa
ADDITION
COMMERCIAL — REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — January 1, 2013 Page 2 of 3 k:\Handouts\Petmit Application