04-102727City of Federal Way
Commupity Development Services
33530 IstWay S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:04 - 102727 - 00 - ME
Project Name: LEDOUX VJV
Project Address: 33022 49TH�SW
Project Description: Install gas furnace and air-conditioning unit.
Inspection request line: 253.835.3050
Parcel Number: 802952 0160
Owner
Applicant
Contractor
Edward J Ledoux & Elizabeth M Ledoux
ADVANCED FILTER & MECH INC
ADVANCED FILTER & MECH INC
34509 9TH AVE S #304
418 VALLEY AVE NW UNIT Bi 15
418 VALLEY AVE NW UNIT B115
FEDERAL WAY WA
PUYALLUP WA 98371
PUYALLUP WA 98371
98003-8709
(253) 770-2440
Mechanical Valuation..........................................3500 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description_ _____],QuantityF Description�LQuan Description Quantity
Air Handling Units �� 1 Furnaces —
�_ 1
PERMIT EXPIRES January 5, 2005.
Permit issued on July 9, 2004
I hereby certify that the above information is 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 y.
Owner or agent: Date: ' 19 Loy
Js -
0
THIS CARD IS TO REMAIN ON-SITE;
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102727 -00 -ME
Owner: EDWARD J LEDOUX
Address: 33022 49TH AVE SW
FEDERAL WAY, WA 98023-3324
This card is part of your required inspection documents. 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 - Mechanical (4065)
Approved Approved to release test �,!� Approved
By Date By Date By /12-F Dated `"6
affy of
Federal Way
6MMUN17Y DEVELOPMENT SERVICES
33530 FIRST WAY SOUTH • PO BOX 9718
FEDERAL WAY, WA 98063-9718
253-6614115• FAX 253-6614129
'm df volfederal wa y. com
The folloulina is reauin
SITE ADDRESS
PERMIT SF MF E L PL DE EN FP
APPLICATION" '('''''� °
a.
on -an incomplete application 4,ted. Please print legibly (in inkJ or tune.
— L1 4 'hn
ASSESSOR'S TAX/PARCEL # —1JL --!� -S a - -o- L (�— V
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
SUITE/UNIT #
LOT SIZE (sj)
lAnach separate pagefor le gthy legald—ipaonl
PROJECTINFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 'MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLEt •- •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
r— ad ( 2,5-1- ® L
MAILING ADDRESS CITY, STATE, ZIP
COMPANY NAME
APPLICANT NAME
APPLICANT NAME
OFFICE PHONE
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( -
( 7, 3) '7 7v-
2=` 1/o
MAILING ADDRESS
PRIMARY PHONE
CITY, STATE, ZIP
CELLPHONE
NAME
MAILING ADDRESS
CITY, STATE, ZIP
(z55)
CITY F FEDERAL.AVAY
BUSINESS LICENSE NUMBER FXPIRATION DAT
FAX NUMBER
A- b -f1 61-NT�MCU
q4 -6-40L / /
(7z63 770
Zq4
CONTRACTORS REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION
DATE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( -
NAM QQ
PRIMARY PHONE
E-MAILADDRESS
Per RCW 19.27.095: Lender information is,
required if project value exceeds $5,000
NAME
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
VALUE OF PROPOSED WORK
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED S!2. FT.
TOTAL
BASEMENT
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
FIRST
WASHING MACHINES
URINALS
HOSE BIBBS
SECOND
VACUUM BREAKERS
ELECTRIC WATER HEATERS
NEW ADDRESS REQUIRED? o
THIRD
UP/SEPA/SU? o YES
o NO
PLATTED LOT? ❑ YES o NO
FOURTH
o NO
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EXISTING
TOTAL PROPOSED
TOTAL EXISTING AXD PROPOSED
"NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECELANICAL GO F7 c� Ci fi U w r a C 6 �G
Value of Mechanical Work $ 1-7)5
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG. SYSTEMS
BBQS FANS HOODS (commeNdai) W OO D STOV ES
BOILERS FIREPLACE INSERTS RANGES MISC (Describe)
COMPRESSORS Z FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
BATHTUBS (-Tub/Shower Combo(
SHOWERS
WATER CLOSETS (reieq MISC (Describe)
DISHWASHERS
SINKS
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
RAINWATER SYST
WASHING MACHINES
URINALS
HOSE BIBBS
LAVS (Bathroom Sinks)
VACUUM BREAKERS
ELECTRIC WATER HEATERS
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way, but only where such claim
arises out of the reliance of the city, including it � officers and employees, upon the accuracy of the information supplied to the city as a part of
„�
this application.
n
NAME/TITLE
RELATIONSHIP TO PRO.(/ECT ❑ Owner ❑ Agent o Contractor
DATE
(Title) p
o Architect Other L py' VV'A
FOR OFFICE USE ONLY
o NEW ❑ ADDITION
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑ NO
BASIC PLAN? ❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE? o YES
❑ NO
NEW ADDRESS REQUIRED? o
YES o NO
UP/SEPA/SU? o YES
o NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED? ❑ YES
o NO
Bulletin #100 — March 30, 2004 Page 2 of 4 k Handouts — RevisedU'ermit Application
Ii, F62S-052-000 (8/07)
NOT TRANSFERABLE
BUS. NUMBER
930260
DATE PAID
3/12/2004
LICENSE YEAR
2004
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST.>+<# EXP. DATE
CC01 ADVANFM044RD 12/19/2004
EFFECTIVE DATE 12/04/1996
ADVANCED FILTER & MECH INC
418 VALLEY AVE NW
BLDG B STE 115
PUYALLUP WA 98372-2503
CITY OF PUYALLUP POST IN CONSPICUOUS PLACE
BUSINESS REGISTRATION CERTIFICATE
The person, firm or corporation named below is granted this business certificate pursuant to the provisions of the Cly Business
License Ordinances to engage In, carry on or conduct the business, trade, calling, profession, exhibition or occupation described
below. Issuance of the certificate Is not an endorsement, nor certification of compliance with other ordinances or laws. This license
is Issued without verification that the licensee is subject to or exempt from licensing by the State of Washington.
BUSINESS TYPE: Sub -Contractor
NOTES:
BUSINESS LOCATION 418 VALLEY AVE NW STE B-115
IN PUYALLUP
BUSINESS NAME ADVANCED FILTER & MECHANICAL
ATTENTION DAVID ROSS
MAILING ADDRESS 418 VALLEY AVE NW STE B-115
CITY AND STATE PUYALLUP, WA, 98371-3312
11111111111111,1111111111111111 11,111111111111111111
EXPIRATION DATE
8/31/2004
OF PUVA
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OF WASE
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