09-102177City of Federal Way 10
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: RUSSELL
Project Address: 31428 13TH AVE SW
Project Description: Remove/replace existing gas furnace
Mechanical
Permit #: 09 -102177 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 416810 0070
Owner
Applicant
Contractor
BENJAMIN RUSSELL
SUPERIOR HEATING
SUPERIOR HEATING
31428 13TH AVE, SW
PO BOX 835
SUPERH*077QK (11/11/09)
FEDERAL WAY WA 98023-4507
PUYALLUP WA 98371
PO BOX 835
PUYALLUP WA 98371
Mechanical Valuation............................................750.00 Is this an Online or O.T.C. application? ................. Yes
i
` THIS CARD IS TO FVAIN ON-SITE '
CITY of rommunity Development Inspection. Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09-102177-00-ME
Owner: BENJAMIN RUSSELL
Address: 31428 13TH AVE SW
FEDERAL WAY, WA 98023-4507
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)
. 1 Approved
By G W Date - i Q�r -
For fiins ctor reference on
—e _ _------- --
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CUT OF
Federa!K E IV E D PERMIT
C0A1A XIffDEVELOPMENTSERVICES
33345 8IN AVEMIE SOErM • PO BOR 9718
FEDERAL WAY, WA
453-835-4607•PAX 2= 1 1 20,39PLICATION
WW"CM
97.-/0aI Z!z-
SF
MF CO (gE�i L PL DE EN FP
off*1V9 @ 9R**-tW A* incomplete alppilcation will not be accepted. Phase print legibbj (tn ink% or tgpe.
SITE ADDRESS
ASSESSOR'S TAS/PARCEL #� �Q
1• PROPERTY INFORMATION
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMMG XMECHANICAL
SUITE/UNIT #
LOT SIZE (s,)
❑ DEMOLITION ❑ ELECTRICAL ❑ BNGEMMMING ❑ FIRE PREVEIITION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work mduded on this permit on&)
< -
PROJECT NAME (Name of Bt mess or Owner Last
PEOPLEINFOMIATIOV
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
ESISTIIFG USE
NAME -7
/ v G
PROdARY PHONE
MAILING ADDRESS
31(-/.z s(3�-" C''t
Sw
.STATE. ZIP
ever" t wt�'oZ
E -MALL ADDRESS
COMPS- J / ) /�
"V v 710 I
/ v G
APPLICANT NAME OFFICE PHONE
( _
MAILINO ADDRESS 0
CITY. STATE, ZIP
OZ,'
7— i V ELL PHONE _
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRA71ON DATE FAX NUMBER
C0FntACT01V8 R80I8TRATION HQYSYR
CV-Hk 07.761.c
ZZPMATION DATE E-MAIL. ADDRESS
-11
COMPANY NAME
APPLICANT NAME
I Z- l
OFFICE PHONE
( ) -
MAILING ADD
w
CITY. STATE, ZIP
OZ,'
CELL PHONE
1W6 - ClJZ
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect fflTenant ❑ Agent ❑ Other
NAME' -,>PRDIARY PHONE E-MAIL ADDRESS
IsJe n 1 Gti,5" I 50 h - o s
NAME
PerRCW 19 27.09&
L—isr irfjormadan is required ijprvjsct value exceeds ,"000
MAILING ADDRESS
CITY. STATE, ZIP
PHONE
PROPOSED USE
EXMMING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRIIPELERED BUILDING? ❑ YES g NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES E NO
WATER SERVICE PROVIDER 1KLAREHAVEN ❑ HIGHL= ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER MCLAKEHAVEN ❑ HIGHLIIYE ❑ PRIVATE ISEPTICI
AREA DESCRIPTION
EffiSTIBG
. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
o YES o NO
BASIC PLAN?
a YES
FIRST
ZONING DESIGNATION
CHANGE OF U=?
SECOND
a NO
NEW ADDRESS REQunm?
o YES o NO
THIRD
o TES
0 80
PLATTED LOT?
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED?
o YES
o NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
eaa Toro
a�oro®
rorty
Torecamamosr
70M rsoraem ar
TOM it
"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 fi dures to remain.
Value of Medmical Work $ 0 7S (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPMCATIOM
AIR HANDLING UMTS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (.rT b/sue..rcew*
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVE SW*
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
QAS WATER HEATERS
HOODS (cmm.ay
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS (ros.q
WASHING MACHINES
WOODSTOVES
MISC (Describe)
MISC (Describe)
r cerA9 under penaft of perry that I am the properly owner or authorised agent of the properly owner. t cat(& that to the best of my
knowledge, the ir4 formation submitted in support of Ws permit application is true and correct r cat(& that r will comply with all applicable
City q f Federal mag regulations pang to the work authorized by the issuance of a permit r understand that the issuance of this permit
does not remove the owner's respons1btUey for compliance with local, state, or fedaui laws regulating construction or environmental lawa
r f urther agree to hold harmless the City of Federal Way as to any claim (including costs, w W ses, and attorneys' fees incurred in the
investigation and tai — of such claim). which maV be +Wade bg arty person, including the undersigned, and filed against the city, but only
where such claim arises out of the reliance of the ctty, including its qfflcers and employees, upon the accuracy of the b?Jbrmation supplied to
the city as apart of this application.
SIGNATURE:
Prooertv Owner and/or Authorized Agent
a NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IDnkROVEMENT
10 rl WING SHELL ONLY?
o YES o NO
BASIC PLAN?
a YES
a NO
ZONING DESIGNATION
CHANGE OF U=?
C3 YES
a NO
NEW ADDRESS REQunm?
o YES o NO
IIPISEPA/SU?
o TES
0 80
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 — January. 1, 2009 Page 2 of 4 Mflandouts\Permit Application