06-105707a
I City of Federal Way
Community Development Services
P.Q. Box 9718
Federal Way., WA 98063-9718
Ph: (253) 835.260) Fax: (253) 835-2E
Mechanical Permit #: 06 -105707 -00 -ME
Inspection Request Line: (253) 835-3050
Project Name: JEZEK
Project Address: 2620 S 359TH ST Parcel Number: 412980 0175
Project Description: REP - Replacement of furnace & hot water tank. Adding two outlets of gas pipe.
Owner
Applicant
Contractor
LOUIS JEZEK
DICK'S HEATING AND A/C INC.
DICK'S HEATING AND A/C INC.
2620 S 359TH ST
1516 45TH ST E SUITE 200
dicksi*214dh (7/5/07) CO
FEDERAL WAY WA
SUMNER WA 98390
1516 45TH ST E SUITE 200
98003-7157
SUMNER WA 98390
Additional Permit Information
Mechanical Valuation............................................3850 Over the Counter Permit? ...................................... Yes
Mechanical Fixtures
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
d the City of Federal Way.
Owner or agent: (7- Date:- / 2A zz) 6
"A V y - I
A
` THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record -
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -105707 -00 -ME
Owner: LOUIS JEZEK
Address: 2620 S 359TH ST
FEDERAL WAY, WA 98003-7157
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 B Date o By C Date /—�
®• ` RECEIVED
�« Nov 0 62006
Federal Way w�Fr'ERMIT
• COMMUN Dio'VELOPMENTSER Y OF FEDERAL
9932 w -B970 BUILDINGPPLI CATI O N
253.635.2607• FAX 253.835-2609
www.dtw/Tederal m,wm
The following is
- an
will not
SF MF CO W7EL PL DE EN FP
ited. Please print legibly (in ink) or type.
SITE ADDRESS �� ? l,C� c7 �' SUITE/UNIT #
ASSESSOR'S TAX/PARCEL It — — — — — — — LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
Mdadh srymafe PWfa 1.9W dnw0bsN
PROJECT•• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING fiJ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (,Provide detailed description of work included on difs permit onlu) I /�
p rv�-e-y� t 17 �[.. J ✓� F. f Q . Q) i� f / C �C. lY ✓ v+ /C /7r �i�i via. �� J� w /P �C
O GCS
PROJECT NAME (Name of Business or Owner Last Name) t7" L C b�
PEOPLE•• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
) -
G ADDRESS CITY, STATE, ZIP
D 7 O
COMPANY NAME
APPLICANT NAME
APPLICANT NAME
OFFICE PHONE
-eT57�
CELLPHONE
l ) -
RELATIONSHIP TO PROJECT
o Architect o Tenant e�Agent ❑ Other (Describe)
FAX NUMBER
( ) -
MAHMG ADDRESS
CITY, STATE, ZIP
(CELL PHONE
t
/7
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER I2ATI A -
FAX NUMBER
L
-B L
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each appHcadon)
�TUIAIION
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAIdNG ADDRESS
CITY, STATE, ZIP
CELLPHONE
l ) -
RELATIONSHIP TO PROJECT
o Architect o Tenant e�Agent ❑ Other (Describe)
FAX NUMBER
( ) -
NAME PRIMARY PHONE E-MAILADDRESS
37 - 6ec5
>srIY.z?tilim 3i0for* cton�ts '-
+3YR value:Squ
�MALLING
NAME
ADDRESS
CITY. STATE, ZIP
EXISTING ASSESSED/APPRAISED VALUE
PROPOSED USE
VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? o YES o NO
WATER SERVICE PROVIDER o LAKEHAVEN o HIGHLINE ❑ TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN 0 HIGHLINE o PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
69. FT.
BASEMENT
PROJECT
FLOOR
AREAS
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
69. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
memru
reoroe®
"rec
mxwwamtru(asr
sorer sr
soru as
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
each type of f fixture to be installed or relocated as part of this project Do not include existing f fixtures to remain.
MECHANICAL y
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (or T,b/Sho—Combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bath,00m Smkw)
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (Commerdap
RANGES
GAS WATER HEATERS
WATER CLOSETS fronetl
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Descrlbe)
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 Flederal Way as to any claim (including costs, atpenses, 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 offlows and employees, upon the accuracy of the information supplied to the city as a part of
this application. --) /
RELATIONSHIP TO PROJECT o lOwner o Agent ❑ Contractor ❑ Architect ❑ Other
Bulletin #100 —January 7, 2005 Page 2 of 4 MandoutsTermit Application