06-103984r City of Federal Way M •
echanical Permit #• 06-103984-00-E -
t Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Li 53) 835-3050
Project Name: RODRIGUEZ
Project Address: 36102 14TH AVE SWOIgcel Nu er: 21800 770
Project Description: Installation of A/C (Air Handling Unit)
Owner Applican 1K Contra
MICHAEL RODRIGUEZ GAS APPLIANCE SERVICES INC GA PLIANC RVICES INC
36102 14TH AVE SE 1103 N 36TH ST G S* R (7/19/07)
FEDERAL WAY WA 98023 36 ST
SEATTLE WA
s8103 ATA1103
Ad al Permit In ation �;l Mechanical Valuation ..........................................459 Over r Pe t ..................................Yes
Mec cal Fixtur -.0
THIS CARD IS TO REMAIN ON-SITE
off,► of Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -103984 -00 -ME
Owner: MICHAEL RODRIGUEZ
Address: 36102 14TH AVE SW
FEDERAL WAY, WA 98023-7283
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
r �
*BIS RECEIVED
AUG 10 Zoos PERMIT
CO21OWNm 0EVV-OMfWff SERVICES
333258MAVENUE SOITIH•PO BOX 9718 PPLI CATION
� F� OF FEDERAL
4iJILDING DEP
SPIE ADDRESS
ASSESSOR'S TAX/PARCEL #
- an
2 1k41
LEGAL. DESCRIPTION (e.g. Acme Estates, Lot 1)
0(_e-1C.3ct2�
SF MF CO ��L PL DE EN FP
be accented. Please nrint leaiblu lige ink) or tune.
SUITE/UNIT #
LOT SIZE (SJ)
(Attach s pwcae pMejbr re� k4.Xd desc WdorV
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0'�[ECILANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of ubrk included on this permit orilu)
PROJECT NAME (Name of Business or Owner Last Name) ��� U z-
PEOPLF INFORNIATION
PROPERTY
NAME PRIMARY PHONE
OWNER e0 2t z X253) 9 --0<-2 -1,
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXMSTING USE
MAILING ADDRESS CITY. STATE. ZIP
COMPANY NAME APPLICAINT NAME OFFICE PHONE
6,1.5 H fad )l03Z -soon
MAILING ADDRESSCITY. STATE. ZIP CELL PHONE
5�
N� 4< r w/t
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
B L �G) 7f2- - /3d3
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each appleatioo) EXPIRATION DATE
rz Sf�pS d�� ,� 4 /
COMPANY NAME APPLICANT NAME OFFICE PHONE
C'6- t -
MAILING ADDRESS"
CRY. STATE. Z 'r� ' ! rCELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe) ) -
NAil3E (PRIMARY PHONE E -NL IL ADDRESS
i
Per RCW 19.27.098: Lender irtformation is
required {fprgieci value exceeds $5.000
NAME
&'zA
C17 . ATE ..IP
PHONE
NAil3E (PRIMARY PHONE E -NL IL ADDRESS
i
Per RCW 19.27.098: Lender irtformation is
required {fprgieci value exceeds $5.000
NAME
&'zA
MAILING ADDRESS
C17 . ATE ..IP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALDE $ VALUE OF PROPOSED WORK $ JS po
SPRINIELERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKERAVEN ❑ HIGELINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LATETTAVEN Cl HiGELINE ❑ PRIVATE (SEPTIC)
AW
AREA DESCRIPTION
EXISTING
FT.
PROPOSED
89. FT.
TOTAL
SQ.FT.
BASEMENT
EVAPORATIVE COOLERS
BBQS
FANS
FIRST
FIREPLACE INSERTS
COMPRESSORS
FURNACES
SECOND
GAS PIPE OUTLETS
ZONING DESIGNATION
THIRD
o YES
❑ NO
NEW ADDRESS REQUIRED?
FOURTH
UP/SEPA/SU?
r YES
c NO
ADDITIONAL FLOORS (DESCRIBE)
�D YES o NO
DEMO PERMIT REQUIRED?
o YES
DECK (COVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
ffi'n`c raneos>m
TOTAL
TOTAL iueruc 3<
ia`"` ra°s°°® a'
'v`"` ar
**NEW HOMES ONLY*" NUbIBER 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 fdadures to renttari
MECJL1&MCAL
Value of Mechanical Work $
a�
AIR HANDLING UNITS
EVAPORATIVE COOLERS
BBQS
FANS
BOILERS
FIREPLACE INSERTS
COMPRESSORS
FURNACES
DUCTS
GAS PIPE OUTLETS
PL 7AUUNG
BATHTUBS (0r"rub/Shaws Combo)
SHOWERS
DISHWASHERS
SINKS
GAS PIPE OUTI.ETS
SUMPS
WASHING MACHINES
URINALS
LAVS (Bathroom Smlo)
VACUUM BREAKERS
GAS LOGS
HOODS (comm .W)
RANGES
GAS WATER HEATERS
WATER CLOSETS rron-I _
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
RE. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
I cert/ under penalty Rf 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 of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense 4f
such claim), which may be made by any person, including the undersigned, and jUed against the City of Federal Way, but only where such claire
arises out of the reliance of the city, including its ojoicers and employees, upon the accuracy of the igformation supplied to the city as a part of
this application.
� 4
NAME/'TITLE ` DATE
(Slgnature) Mtle)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent " Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
❑ YES o NO
BASIC .PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
❑ NO
NEW ADDRESS REQUIRED?
o YES c NO
UP/SEPA/SU?
r YES
c NO
PLATTED I,074
�D YES o NO
DEMO PERMIT REQUIRED?
o YES
^ NO
Bulletin #100 - Januar; 1, 2CCti Page 2 of 4 k\Handouts,Pennit Application