06-101966t ,
c T
C of Federal Way
Mechanical Permit #: 06 -101966 -00 -ME
P.O. Box 9718
Fec!Qral Way, WA 98063-9718
Ph: (25ay835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: VERSHAHL
Project Address: 3309 SW 329TH CT
Project Description: Furnace replacement
Parcel Number: 109975 0450
Owner
Applicant
Contractor
TIMOTHY JON VERSDAHL
GRIFFIS HEATING INC
GRIFFIS HEATING INC
3309 SW 329TH CT
402 E MAIN ST SUITE 130
GRIFFHI088DZ (12/27/06)
FEDERAL WAY WA
AUBURN WA 98002
402 E MAIN ST SUITE 130
98023-2754
AUBURN WA 98002
Additional Permit Information
Mechanical Valuation............................................3000 Over the Counter Permit? ...................................... Yes
PERMIT EXPIRES Tuesday, October 17, 2006
Permit Issued on Thursday, April 20, 2006
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
.,,,,rd the City of Federal Way.
Owner or agent: Date: 0/o
Fymt,uEo
y
THIS CARD IS TO REMAIN ON-SITE f
CITY OF A Com-uftity Development Inspection Record
Federal Wray IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -101966 -00 -ME
Owner: TIMOTHY JON VERSDAHL
Address: 3309 SW 329TH CT
FEDERAL WAY, WA 98023-2754
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 Date 64, O
.. RECEtVE�
My OF - lO
Federal Way APR 1 9 "PERMIT COMMUNITY DEVEWPMENfSERVICES SF MF CO EL PL DE EN FP
33325 81w
FEDERAL
, WA 9 • PO-BOX3 9716 CATI O N
FEDERAL WAY. WA 980639718 CITY OFF
253-835-2607• FAX 253-835-2609 BUILD
www.cituoffederalwau.com
The of uired i ormation - an incom fete a lication will not be ted. Please rant goiblymink) or
? G� - PROPERTY•• •
SITE ADDRESS 3 J O 1 SLw l ;L-9"-'-'
L-9� 3yC-t-
l- SUITE/UNIT M
ASSESSOR'S TAR/PARCEL # LOT SIZE (s,)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Am -h -p-W pegs for k Wit h.
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING !p( MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
F�.�.rZr�A-ce.- IzeA�Rc-��ea�
PROJECT NAME (Name of Business or Owner Last Name) 1 m J- CAV I i
PEOPLE•• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
N A-PMMAW PHONE
nti
MAILING ADDRESS CITY, STATE, ZIP
3 3oq SL") UTIl ��2 . LOA _ C1'a-
CO/ANY N��^
l'lC
OFFICE PHONE
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
�a- Oki S 20
CVY. S ATE. Zip
_ P . g Wo
CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
a,Q-Q 9.r 9 -2 k0
EXPIRATION DATE
12 / 3( /U(.
FAX NUMBER
(91S3)>aT ---`;440-
-1
.3 --B
CONTRACTOR'S REGISTRATION NUMBER (copy of cud required with each application)
k i D
EXPIRATION DATE
/0(.o
_Oki
COMPANY NAME APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY. STATE, ZIP
MAILING ADDRESS
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant &<gent ❑ Other (Describe)
( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
i 'N41 % S (344 n 3r - 3 rr ro
LENDER
EXISTING USE
P+er RCW 19.27.098: Lender igformation is
required (f project value exceeds $5.000
NAME
MAILING ADDRESS
CITY. STATE, ZIP
PHONE
( ) - -
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ 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 0 LAKEHAVEN ❑ HIGHI INE 0 PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
FT.
PROPOSED
SQ.FT.
TOTAL
SQ. FT.
BASEMENT
a ALTERATION
o REPAIR a TENANT IMPROVEMENT
AIR HANDLING UNITS
FIRST
GAS LOGS
REFRIG. SYSTEMS
BBQS
SECOND
HOODS (Commemlat)
WOODSTOVES
BOILERS
THIRD
RANGES
MISC (Describe)
COMPRESSORS
FOURTH
GAS WATER HEATERS
DEMO PERMIT REQUIRED? o YES
DUCTS
ADDITIONAL FLOORS (DESCRIBE)
PLUMBING
DECK(COVERED?)
BATHTUBS (or Tub/5howerCombo)
GARAGE O CARPORT ❑
WATER CLOSETS tibuet)
MISC (Describe)
DISHWASHERS
NUMBER OF FLOORS
DRINKING FOUNTAINS
�
TorN.'lw
TorAcmoroesow
�
••NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SEU ING PRICE $
Indicate number of each type offixture xture to be installed or relocated as part of this project Do not Include existing futures to remain.
MECHANICAL
3000
Value of Mechanical Work $
o NEW ❑ ADDITION
a ALTERATION
o REPAIR a TENANT IMPROVEMENT
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
REFRIG. SYSTEMS
BBQS
FANS
HOODS (Commemlat)
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Describe)
COMPRESSORS
L_ FURNACES
GAS WATER HEATERS
DEMO PERMIT REQUIRED? o YES
DUCTS
�_ GAS PIPE OUTLETS
PLUMBING
BATHTUBS (or Tub/5howerCombo)
SHOWERS
WATER CLOSETS tibuet)
MISC (Describe)
DISHWASHERS
SINKS
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
RAINWATER SYST
WASHING MACHINES
URINAIS
HOSE BIBBS
LAVS (Bathroom Sinks)
VACUUM BREAKERS
ELECTRIC WATER HEATERS
I certify under penalty 4f perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorised 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 4f 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,Jiled against the City 4f Federal Way, but only where such claim
arises out of the reliance 4f the city, i luding its o,Uicers and employees, upon the accuracy of the information supplied to the city as a part of
this application. f f ^
NAME/TITLE
(Signature) m le)
RELATIONSHIP TO PROJECT ❑ owl ❑ Agent M-0ontractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
o NEW ❑ ADDITION
a ALTERATION
o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN? o YES
o NO
ZONING DESIGNATION
CHANGE OF USE? o YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP/SEPA/SU? ❑ YES
❑ NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED? o YES
o NO
Bulletin #100 - January 1, 2006 Page 2 of 4 k\Handouts\Permit Application