09-101757City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: NGUYEN
Project Address: 35403 12TH AVE SW
Project Description: Remove and replace gas furnace
• . . � Mechanical
Permit #: 09 -101757 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 502860 1940
Owner
AmAcant
Contractor
STEVEN NGUYEN
STEVEN NGUYEN
STEVEN NGUYEN
MYDUNG TRAN
826 31ST ST
826 31ST ST
826 31ST ST S
RENTON WA 98055
RENTON WA 98055
RENTON WA 98055
Mechanical Valuation............................................901.44 Is this an Online or O.T.C. application? ................. Yes
Furnaces ......................................... 1
PERMIT EXPIRES Monday, November 9, 2009
Permit Issued on Wednesday, May 13, 2009
1 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: AvA, Date: !F%��
F-w1NAUJ;vb s/z�/w
.. • THIS CARD IS TO EMAIN ON-SITE,
CITY OF Community Develop nt Inspection Record_
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09 -101757 -00 -ME
Owner: STEVEN NGUYEN
Address: 35403 12TH AVE SW
FEDERAL WAY, WA 98023-6959
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)
Approved
By Date
❑ Gas Piping (4125)
Approved to release test
By Date
❑ Final - Mechanical (4065)
Approved
By Date'_ Z 0 _ 047
For i_pector reference only
D Rough Electrical D FINAL - Electrical
Approved Approved
By Date By Date
CITY Or, 0 �w - /.0/- 1 52
Federal V ft PERMIT
CDMMUNIYDEVELOPAMWSBRV/CBS SF MF CO EEL PL DE EN FP
� 3332 • PO BOX 9 778
FEDERAL WAY, WA 9803&718
253-35-267•PAX253d3S260APPLICATION
urwn.�itnoAEderoluwweom
The following is rsgaired information -an n incomplete application will not be amwia& Please Print Legibly (in ink) or &APe•
S4- 03
ASSESSOR'S TAX/PARCEL / — — — — — — — —
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
/UNIT i
'4- U
l3,
v .I
TYPE OF PERMIT ❑ BUILDING ❑ PLUMMNG )kMECHANICAL q �
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION PVWdetailed description /off work kchtded on dzis Permit onlu)
N7 A n./71 %O /I mil /
ild Lr /1V .
PROJECT NAME (Name of Business or
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
i ♦ �% : i♦ Lit/ i ;�.
COMPANY NAME � Il � tXiV APPLI E
OFFICE PHONE -
MAILING ADDRESS CrIT. STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
COIRPRAC'rows surae T"'noN NQlltBEA IfJPt/ MNIt DATR
E-MAIL ADDRESS
.2`76
'LLPHON' OSI -27
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent KOther
NAME
Per RCW 19.27.095.-
9.27.095:Lender irVarmation is required #/Project value exceeds ,15,000
Zander
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EffiSTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK �
mucLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKESAVEN ❑ H'IGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAKERAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
AREA DESCRIPTION
BASEMENT
EXISTING
. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
FIRST
BBQ3
FANS
GAS WATER HEATERS MISC (Deacdbe)
SECOND
FIREPLACE INSERTS
HOODS
COMPRESSORS
THIRD
RANGES
DUCTS
GAS LOG SETS
ADDPPIONAL FLOORS (DESCRIBE)
a YES
a NO
K ATTED LOT?
DECK (❑ COVERED OR ❑ UNCOVERED?)
I DEMO PERMIT REQUIRED?
o YES
a NO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
MCNO®
"TOL
si
Tenet rsepc®ar
Tamar
"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 inrh de p"gtlnn Rvhp. #___4_
11flC2rAXrCAL
Value of Mechanical Work $
- - - -
(A COPY OF BID OR ESTID?ATE MUST BE INCLUDED WITHAPPLICATIONJ
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQ3
FANS
GAS WATER HEATERS MISC (Deacdbe)
BOILERS
FIREPLACE INSERTS
HOODS
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS I:n s/sec C-- l IAVS le.m..al.e l URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS fr.&#
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SAPS
I under PARD of Pw1ury that I ane the propenes owner or authorised agent of the
thi
,ftaknou►tedge, the int formutioa sabmitaed in support of this m
pt application is true and comck�P�l owner. I comply with
�that to the best of my
cabit
le
City of Federal Way regulations pertaining to the meek authorised by the issn roes of a pmt, I understand that issuance �Hc
does not remove the owners r'esponstMlitg for compliance with local, state, or federal lams regulating construction w snstronmental Janos.
s 0`711it
Ithw agree to hold harmless the City of Federal Way as to -W clatne (including host, &Vense36 and attorneys, fees incurred in the
in gestion and defense of such ciainnh which maybe made by amp person, including the xmdsv� and filed against the etty, but only
where such claim arises out iof sattom the reiimnee of the ctt�
the ettg as apart ofthts opplio'Re u ang its officers and employees, upon the accuracy of the information supplied to
Gv v
SIGNATURE. DATE S/ O
Property Owner and/or A o ' Aeant
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEIGM
B r' ILII IG SHELL ONLY?
o YES o NO
BASIC PLAN?
o YES
a NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
a NO
NEW ADDRESS REQUIRED?
o YES a NO
IIP/SEPA/SIM
a YES
a NO
K ATTED LOT?
o YES o NO
I DEMO PERMIT REQUIRED?
o YES
a NO
t
Bulletin #100 — January 1, 2009 Page 2 of 4 MandoutsTermit Application