04-102043City of Federal Way
Community Development Services
33530 191 Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: JOHNSON
Mechanical Permit #:04 - 102043 - 00 - ME
Inspection request line: 253.835.3050
Project Address: 31416 8TH & A Ve 5 Parcel Number: 858800 0165
Project Description: Install natural gas piping from meter to pool heater. Heater installed by others.
Owner
Applicant
Contractor
Travis Johnson & Rose Johnson
KLIEMANN BROTHERS HTG & A/C IN
KLIEMANN BROTHERS HTG & A/C IN
31416 8TH AVE S
4703 116TH ST E
4703 116TH ST E
FEDERAL WAY WA
TACOMA WA 98446
TACOMA WA 98446
98003-5302
\
(253)537-0655
Mechanical Valuation..........................................1700 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Description Quantity DescriptionQuantity
Gas Piping �� I
PERMIT EXPIRES November 20, 2004.
Permit issued on May 24, 2004
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 agent: /l/�-� Date:
THIS CARD IS TO REMAIN ON-SITE ,
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102043 -00 -ME
Owner: KLIEMANN BROTHERS HTG & A/C IN
Address: 31416 8TH AVE S
FEDERAL WAY, WA 98003-5302
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 ByG tj Date& - 3 By G C' Date �jj • . exl
CITY OF
^`
Federal Way
XOMMUMN DEVELOPMENT SERVICES
33530 FIRST WAY SOUTH • PO BOX 9718
FEDERAL WAY, WA 98063-9718
253-6614115• FAX 253-661-4129
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PERMIgECEivED
APPLICATWI14 Znoa
- an
SF MF COME EL PL DE EN FP
r--/ - / I
Please
SITE ADDRESS �/r s SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # _L�'_ -Fp p -C—) - LOT SIZE (s�
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach sgarute page for I—Ohy 1e9d d--ipnen)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
or
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul
70
PROJECT NAME (Name of Business or Owner Last Name) ���,�t� S•J
PEOPLEI • ' •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
I- LI J••, PRIMARY PHONE
1 nrerr r
CITY, STATE, ZIP
3/-- give ,S'' �.� ,�
COMPANY NAME
APPLICANT NAME
�
OFFICE PHONE
(753 ).s:r7 - -06,s y
MAILING ADDRESS
STATE, ZIP
CELL PHONE
//ICITY,
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
— — — — — — — B
L
CONTRACTOR'S REGISTRATION NUMBER (eopy o[eard required with each application)
EXPIRATION DATE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
NUMBER
( -
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
WOODSTOVES
FIREPLACE INSERTS
RANGES
FIRST
FURNACES
GAS WATER HEATERS���
o YES
SECOND
ZONING DESIGNATION
SHOWERS
THIRD
MISC (Describe)
SINKS
DRINKING FOUNTAINS
FOURTH
SUMPS
RAINWATER SYST
DEMO PERMIT REQUIRED?
ADDITIONAL FLOORS (DESCRIBE)
HOSE BIBBS
VACUUM BREAKERS
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL EXISTING
TOTAL PROPOSED
TOTAL EXISTING AND 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.
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (—Tub/Sha—combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bath- Sinks)
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
FANS
HOODS (C-rciat)
WOODSTOVES
FIREPLACE INSERTS
RANGES
MISC (Describe)
FURNACES
GAS WATER HEATERS���
o YES
GAS PIPE OUTLETS
ZONING DESIGNATION
SHOWERS
WATER CLOSETS (roast)
MISC (Describe)
SINKS
DRINKING FOUNTAINS
o YES
SUMPS
RAINWATER SYST
DEMO PERMIT REQUIRED?
URINALS
HOSE BIBBS
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 its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application. I I � 1 1
NAME/TITLE 11��' llA
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
o NEW o ADDITION
o ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
❑ NO
NEW ADDRESS REQUIRED? o YES o NO
UP/SEPA/SU?
o YES
❑ NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED?
❑ YES
❑ NO
Bulletin 4100—March 30, 2004 Page 2 of 4 kU-Iandouts — ReviseMermit Application