06-102346r ,
City of Federal Way
Community Development Services echanical Permit #• 06 -102346 -00 -ME
P.O. Box 9718
Federal Way, WA 98063-9718 FILE
Ph: (253) 835-2607 Fax: (253) 835-2609,� rd � Inspection Request Line: (253) 835-3050
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Project Name: BANATA (S C4 / V X
Project Address: 28915 11TH L. S ti Parcel Number: 720570 0020
Project Description: ALT - re lace existi�i furnace with same.
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Additional Permit Information
Mechanical Valuation............................................3154 Over the Counter Permit? ...................................... Yes
Owner or agent: '-6i- �x
Owner
Applicant
Contractor
RICHARD BANATA
PERFORMANCE HEATING & A/C INC
PERFORMANCE HEATING & A/C INC
28915 10TH PL S
7649 S 180TH ST
PERFOHA15ORT 4/29/07
FEDERAL WAY WA 98003
KENT WA 98032
7649 S 180TH ST
KENT WA 98032
Additional Permit Information
Mechanical Valuation............................................3154 Over the Counter Permit? ...................................... Yes
Owner or agent: '-6i- �x
- THIS CARD IS TO REMAIN ON-SITE _
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -102346 -00 -ME
Owner: RICHARD BANATA
Address: 28915 11 TH AVE S
FEDERAL WAY, WA
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 C & Date 57/7- 0
`Z 150'7 1-- S
DECEIVED
Federal way PERMIT Q �- - -L a Z 3 -C .�
ooAGRW AVENUE SOU7 E- PO BOX 971 AY 10 2006 SF MF CO EL PL DE EN FP
93.T?s dTM AVENUE SO(fiN • PO BOX 9718
FEDERAL WAY, WA 98aa
253-835-2607• Pssaa-9718 OFFEQE A
R p LI C AT I O N
tww.afuo ederdwau.cm pVI,n)NG DEPT. °
The following is required information - an incomplete application will not be accepted. Please print Legibly (in ink) or 4W.
SITE ADDRESS 2 FS t AJ<' S SUITE/UNIT #
ASSESSOR'S TAX/PARCEL ik LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) R e'CQO ,-00 V l e �S� IJ e!. ��t9
(Attach arparate pogo jor L1Wft k9W de a0ftay
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING VMECRANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECTrCRIPTION (Provide detailed description of work included on this hermit onlu)
PROJECT NAME (Name of Business or Owner Last Name) w �� c1
PROPERTY NAME (�
OWNER P— LC (.,.L
CONTRACTOR
APPLICANT
r%^Wl •Am
lilt, fit- S
f7e00tr--,t t 0.,
(Z'--3) Ss�� - Y76-5-
w IFtz:)o-S
COMPANY NAME
�
APPLICANT NAME
OFFICE PHONE
Pr c---.o.re Kc^�
"r l4
W2-5-) ZS l - d356
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE -
FAX NUMBER
�i-B' L / 31 /Cita
(175-) -v( -0Z%.I()
CONTRACTORS REGISTRATION NUMBER (copy of card required with each applicotlonj
a E
EXPIRATION DATE
�Fot�A t
somal
COMPANY NAME
!'N t T`O f'w.�L
APPLICANT NAME
OFFICE PHONE
�c C� < < • 1-1 �
[� 1. arm q -
(`C 2--t Z 5 (
MAILING ADDRESS
CITY, STATE, ZIP —
CELL PHONE
RELATIONSHIP TO PROJECT
o Architect ❑ Tenant ❑ Agent (6 Other (Describe), Com
FAX NUMBER
q6yai
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS susrmc PROPOSED Tarty _...... qr 11 fAT ,.
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL 13
^ \
Value of Mechanical Work $
_ AIR HANDLING UNITS
_ BBQS
_ BOILERS
COMPRESSORS
DUCTS
BATHTUBS (or`rub/Shower Combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (a - s.**
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
I FURNACES
OAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS REFRIG. SYSTEMS
HOODS (commerdan WOODSTOVES
RANGES MISC (Describe)
OAS WATER HEATERS
WATER CLOSETS (roSeq MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
I certVy under penalty of perfury 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 i4ormation supplied to the city as a part of
this application.
NAME/TITLE
(Signature)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent t� ntractor
DATE
(Title)
❑ Architect ❑ Other
Bulletin # 100 — January 7, 2005 Page 2 of 4 k\Handouts\Permit Application
I �(,?;; 051 01)(1 t 7)
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST. # EXP. DATE
CCOl PERFOHA15ORT 04/29/2007
EFFECTIVE DATE 12/30/1985
PERFORMANCE HEATING & A/C INC
7649 S 180TH
KENT WA 98032
State of Washington
County of King
I certify that this is a true and correct copy of a document in the possession
of Performance Heating and Air Conditioning, Inc. as of this date.
Dated: J4 —I q —0(0.
(PriNa
My appointment expires: — Q
Residing in Bonney Lake Wa 98390