06-104793r
City of Federal Way
Cpwmtnunit y Development Services Mechanical Permit #• 06 -104973 -00 -ME
P.O. Box 9718
Federal WBy, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: NORTON
Project Address: 33949 28TH PL SW Parcel Number: 010920 0740
Project Description: REP - Remove and replace gas furnace
Owner
Applicant
Contractor
ROBERT NORTON
AAA HEATING AND A/C
AAA HEATING AND A/C
33949 28TH PL SW
22653 83RD AVE NW
AAAHTR1971LW 6/16/07
FEDERAL WAY WA
KENT WA 98032
22653 83RD AVE NW
98023-7716
KENT WA 98032
Additional Permit Information
Mechanical Valuation............................................2417.46 Over the Counter Permit? ...................................... Yes
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -104973 -00 -ME
Owner: ROBERT NORTON
Address: 33949 28TH PL SW
FEDERAL WAY, WA 98023-7716
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 !,/
:L
SITE ADDRESS
ASSESSOR'S TAX/PARCEL #
-OL - -L a �-(- -9,
SF MF CO 6 EL PL DE EN FP
ted. Please print legibly (in ink) or type.
SUITE/UNIT #
LOT SIZE (sl)
LEGAL DESCRIPTION (e.g. Acrne Estates. Lot 1)
Lllluch seNurev�j�,r Ierujlhy le9ul ls..yiior)
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING1VIECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIP�TIJO�his ri
DESCRIPTION e7 vide detailed description of u,ork inchlded on tpermit o)
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE• •
PROPERTY NAME l21ID1A121' 3'HONE
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
---
RECEIVE—
MAILING ADDRESS
3 R Li 1,
SEP 2 9 nod
• Federal Way
CITY OF FEREELRMIT
COWILNITY DEVELOPMENT SERVICES
BOX 9518
33321 'RALIVA
� (�
NTCATI-EDE1tAL
ISOLITII•63
R'A1. N'A 98063'9718
ON
Y
2:i3 835 2ti07• F.4C 233 835 2609
(ELL I'I I()NE�
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
-B L
FAX NUMBER
The_followinq is required iTtformation - an incomplete application will not be
SITE ADDRESS
ASSESSOR'S TAX/PARCEL #
-OL - -L a �-(- -9,
SF MF CO 6 EL PL DE EN FP
ted. Please print legibly (in ink) or type.
SUITE/UNIT #
LOT SIZE (sl)
LEGAL DESCRIPTION (e.g. Acrne Estates. Lot 1)
Lllluch seNurev�j�,r Ierujlhy le9ul ls..yiior)
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING1VIECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIP�TIJO�his ri
DESCRIPTION e7 vide detailed description of u,ork inchlded on tpermit o)
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE• •
PROPERTY NAME l21ID1A121' 3'HONE
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
---
I'
MAILING ADDRESS
3 R Li 1,
CI "G 'rr. ZIP —
a is 9F0 2-3 —II
COMPANY NAME 1
AP'LICANT NAME ,r
OFFICE PI KINE
MAILING� SS � � � •
CITY. STATE. ZIP /
!/
(ELL I'I I()NE�
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
-B L
FAX NUMBER
CONTRACTOR'S REGISTRATION NIJMBFR (copy of card required with each application) EXPIRATION DAA F
COMPAN NAME
APPLICANT NAME
OFFU E 610
MAIhiNG nDDRESS
7� S'3
CrrY. S'rA ZIP
CP;LI. PHONE
tZ44 I 71)--2
--_—_-
RELATIONSHIP TO PRWECT
❑ Architect ❑ Tenant gent ❑ Other (Describe)
FAX NUMBER
( ) 3-1 r
NAMF,
PRIMARY PI ZONE
F MAIL ADDRESS
Per RCW 19.27.093: Lender igformation is
required V project value exceeds $3.000
NAME
MAILING ADDRESS
CITY. STATE. ZIP
PITONE
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES C NO FIRE SUPPRESSION SYSTEM PROPOSED/RE9UIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
Sw._FT.-
BASEMENT
u ALTERATION
c REPAIR TENANT IMPROVEMENT
FIRST
o YES r NO
BASIC PLAN? YES
--- --- -
SECOND
CHANGE OF USE? YES
NO
THIRD
r YES n NO
,
UP/SEPA/SU? r, YES
NO
FOUR"I'H
a YES o NO
DEMO PERMIT REQUIRED? YES
NO
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE O CARPORT ❑
NUMBER OF FLOORS
EXISTING
PROPO8ED
TOTAL
TOTAL EXISTING SP
TOTAL PROPOSED 811
TOTAL OF
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
{mber of each type of fixture to be installed or
J 1 n
ilk
Value of Mechanical Work $^_
AIR HANDLING UNITS
BBQS
BOILERS _
COMPRESSORS
DUCTS
PLUMBING
B/VnrrUBS I.,T,Ois1--Cu ,W)
DISI IWASI IERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bath rucirn Sinkvl
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SI IOW ERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
as part of this project. Do not include existing futures to remain.
GAS LOGS
I IOODS (c,. m W)
RANGES
GAS WATER I IEACERS
WATER CLOSETS rank (1 _
DRINKING FOUN'T'AINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER I IEAI'ERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (IN,scribe)
MISC (Describe)
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 irlformation supplied to the city as a part of
this application.
NAME/TITLE.2"'6,4 DATE _
ignaturel (Title)
RELATIONSHIP TO PROJECT ❑ Owner V Agent i Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
NEW a ADDITION
u ALTERATION
c REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES r NO
BASIC PLAN? YES
11NO
ZONING DESIGNATION'
CHANGE OF USE? YES
NO
NEW ADDRESS REQUIRED?
r YES n NO
,
UP/SEPA/SU? r, YES
NO
PLATTED LOT?
a YES o NO
DEMO PERMIT REQUIRED? YES
NO
Bulletin #100 -January 1, 2006
Paee 2 of 4
k\Handouts\Permit Application
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