06-105976r } it
f
Cky of Federal Way
Cotnmunity Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: NICHOLS
Project Address: 420 SW 368TH ST
of Y
Mechanical Permit #: 06 -105976 -00 -ME,.
Project Description: Installation of (1) new heat pump and ducting.
Inspection Request Line: (253) 835-3050
Parcel Number: 302104 9106
Owner
Applicant
Contractor
MICHAEL A NICHOLS
DICK'S HEATING AND A/C INC.
DICK'S HEATING AND A/C INC.
SHARON R NICHOLS
1516 45TH ST E SUITE 200
dicksi*214dh (7/5/07) CO
420 SW 368TH ST
SUMNER WA 98390
1516 45TH ST E SUITE 200
FEDERAL WAY WA
SUMNER WA 98390
98023-7357
Additional Permit Information
Mechanical Valuation............................................9530 Over the Counter Permit? ...................................... Yes
Mechanical Fixtures
Air Handling Units ......................... 1 Ducts ........................................... 5
PERMIT EXPIRES Thursday, November 20, 2008
Permit Issued on Monday, November 20, 2006
I 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
and the City of F eral Way.
Owner or agent:y Date:
THIS CARD IS TO REMAIN ON-SffE •
CITY OF Community Development Inspection record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -105976 -00 -ME
Owner: MICHAEL A NICHOLS
Address: 420 SW 368TH ST
FEDERAL WAY, WA 98023-7357
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 ,Z cz
C=ff A
Federal Way
COAJ&=nYDEVELAPMEAT SERVICES
33325 VI AVENUE SOUIN • PO BOX 9718
FEDERAL WAY, WA 98063.9718
253-835.2607• FAX 253.835-2609
I ww-dtw?nAomkm Cpm
RF-cNED
RMIT
, w0*61CATI O N
N
- an incomplete application mill not
SITE ADDRESS 0 VV . ,If -Aix -
ASSESSOR'S TAB/PARCEL # �L t - -
LEGAL DESCRIPTION (e.g. Acne Estates, Lot 1)
0 (b - t () S7 -q -7 cam,
SF MF CO(� EL PL DE EN FP
ited. Please print leoffilu rm ink) or tune.
SUITE/UNIT #
LOT SIZE (si
Unach sepvare pgelw hgM9le8d desd�tloN
PROJECT•• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING A MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on t11is nemiff onlu)
PEOPLE INFORMATION
•
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
COMPANY
/
d
APPTNAM'1!V �
OFFCE [��lPHO� - _�
OM ,
ADDRESS
/CELL PHONE
l
CRY. STATE. ZIP
o
-..
(CEELjL PHOh.
`CITY � /SOF FEDERAL, WAY BBUS
21L-0 9—L Q
LICENSE�N]U11 BER
� Z O— D —B
EXPIRATION DATE
/ /
FAX[�� -
U
L
3/
CONTRACTOR'S ISIRA�N�R
(copy of crrd
with each applicatlo�
DTION DATE
COMP E��
ul'tksI
APPUCAPIT NAME
OFFICE PHONE -
( 1
MAHING ADDRESS
CITY. STATE. ZIP
/CELL PHONE
l
REIATIONSHIP To PROJECT /
❑ Architect ❑ Tenant Agent
FAX NUMBER
❑ 0" ter (Descl9be)
( _
I NAME N.('�� �1 / / 1 _ _ () 7 ) � r / /` 21
_ EPH -MAQ, ADDRESS
�� �D9isi �a.l' Iil�r d)1'lAidt107:38
d'�^ME
d pz a 't�afiue, ds;SS�i QO
MAILING ADDRESS
C17Y. STATE. ZIP
EXISTING ASSESSED/APPRAISED VALUE $—
SPRnUUZRED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN
SEWER SERVICE PROVIDER ❑ LAKEHAVEN
PROPOSED USE
VALUE OF PROPOSED WORK
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
❑ ffi[a� ❑ TACOMA ❑ PRIVATE (WELL)
❑ HIGHLINE 0 PRIVATE (SEPTIC)
AREA DESCRIPTION
BASEMENT
ESISTING
89. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK (COVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
r:apoe®
mrec
TotALZZu mer,
rarwr lxaeaeroa.
mreyw
••NEW HOMES ONLY** NUMBER OF BEDROOMS
of each type of jlietwe io be installed or relocated as part of this project Do not include existinqfvdureS to remain
DSECMIUCAL
Value of Medurnical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (o Tub/sho co.bo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS 13.th,vam sulk.)
EVAPORAIIVE COOLERS GAS LOGS
FANS HOODS Icommeb.0
FIREPLACE INSERTS RANGES
FURNACES GAS WATER HEATERS
GAS PIPE OUTLETS
SHOWERS WATER CLOSETS rroa�o
SINKS DRINMNG FOUNTAINS
SUMPS RAINWATER SYST
URINALS HOSE BIBBS
VACUUM BREAKERS ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
I Ce! ft under penalty of pegw y that the iqf wmatdon. furnished by me is true and correct to the best of mg 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 ciaW. which may be made by any person, including the undersigned, and f fled against the City of Federal Wag, but only where such claim
arises this out of the city, including its o0icers and employees, upon the accuracy of the Wormation supplied to the city as a part of
application. l
NAME/TITLE _ DATE ®- 06—
Mde)
RELATIONSHIP TO PROJECT ❑ Owner O Agent A Contractor ❑ Architect o Other
Bulletin #100 - January 7, 2005 Page 2 of 4 k\Handouts\Permit Application