06-100064City of Federal Way
Community Development Services Mechanical Permit #• 06 -100064 -00 -ME
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: {253) 835-2607 Fax: (253) 835-2609 ` Inspection Request Line: (253) 835-3050
Project Name: KOLTENBAH
Project Address: 29815 8TH PL S Parcel Number: 515160 0105
Project Description: Replace gas furnace
Owner
Applicant
Contractor
BENJAMIN E C KOLTENBAH
GLENDALE HEATING & A/C
GLENDALE HEATING & A/C
REBECCA J KOLTENBAH
12462 DES MOINES WAY S
GLENDHA053Q2 11/2/05
29815 8TH PL S
SEATTLE WA 98168-2266
12462 DES MOINES WAY S
FEDERAL WAY WA
SEATTLE WA 98168-2266
98003-3745
Additional Permit Information
Mechanical Valuation............................................2080 Over the Counter Permit? ...................................... Yes
I hereby certify that the ove information is correct and at the construction on the above described property and
the occupancy and t e s ill b in acc ane -)with a laws, rules and regulations of the7Stto7Washington
/ il - nd th Ci Federal Way.Owner or agent: Date:C�c
THIS CARD IS TO REMAIN ON-SITE A
Cl" OF Community Development Inspection Record
#
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -100064 -00 -ME
Owner: BENJAMIN E C KOLTENBAH
Address: 29815 8TH PL S
FEDERAL WAY, WA 98003-3745
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 d
RECEIVED
er
• l&mlWay JAN 0 6 2006 PERMIT
CoMMWrJY L, EvEL0jKWSMvtCZS
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253-835-2607• FAX 253-835.2609 BUILDINGA
LI CATI O N
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The raffinubw to reattired Warnwtion - an tnoompiete application will to
SITE ADDRESS 'INq o
-0-6- -t -0 0- -0 -& 4
SF MF CO ME L PL DE EN FP
hitt. Pleam Orint leaibla /in roil or tmm.
SUITE/UNIT #
ASSESSOR'S TAX/ PARCEL # �— -L �- )k � 0 - O O D-- // LOT SIZE (sf) � t j
LEGAL DESCRIPTION (e.g. Acne Estates, Lot 1) b -� M i� r l !� I , I I i ID 1 W d D Ef a 1 V � Cl Df
IAS �P4wJbr� � �1
some
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING PACICHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM[
P QJECT DESCRIPTION (Pr , ide detailed de7V'001-1
' tion of work blckt d on this hermit onlul
if)fil"oi rte V W rkaal
PROJECT NAME (Name of Busihess or Owner Last Name)
PROPERTY
OWNER
C�Jl4.7Thl�•��
CONTACT
LENDER
EXISTING USE
NAME Ko1phb
a �h
APPLICANT NAME
l a RY O74
OFFICE PHONE
(06) -77�a
5- V /
MAII. ADDRESSCITY,
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I YCELi
STATE, ZT
�
(�LPHONE 0
MPANYN ME
a �h
APPLICANT NAME
T NAME
OFFICE PHONE
(06) -77�a
I=D E88
lrV l
I YCELi
q�I
�
(�LPHONE 0
C , STA E H'
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
REGISTRATION NUMBER (oeyr d eeet regdwl us& eeeh arruedJoy
CONTRACTOR'S L1Q
LLLrI�if-z
EXPIRATION DATE
<<'oZ106
CO NAME
s
APP
T NAME
OFFICE PHONE
ii
1r I [[[
ING RBS
C , STA E H'
CELL PHONE
RELATIONSHIP TO PROJECT -j-
tether .Lia l
FAX NUMBER
�q�
❑ Architect ❑ Tenant ❑ Agent (Describe) l� l Dr-
( 1o) a
,
- f
NAME PRIMARY PHO E . E-MAIL ADDRESS
_ \(
Moab"24.St l.0/tdr 1A11:1!'
f/l� sue 40066#!1►owl
NAME
MAILING ADDRESS
CITY, STATE, ZH'
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE S VALUE OF PROPOSED WORK
SPRINIMERED BUMDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM[ PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKERAVEN ❑ SIOBL INE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKERAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
�I
i
r-� PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING
. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
a NEW o ADDITION
o ALTERATION
a SWAIM a TXXM
FIRST
BUILDING SHELL ONLY?
a YES o NO
SECOND
Gym
o NO
ZONINO DE8I15NATION
THIRD
CHAS= OF Un?
o TE8
o NO
FOURTH
a YN8 o HO
IIP/SNDA/SII?
Oyu
ADDITIONAL FLOORS (DESCRIBE)
PLATTED LOT?
a TES o NO
DMO PUFaM REQUIRED?
DECK(COVEREDI)
ONO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
aaaaw
rwoeosm
Tara
+oear.msrsaw
�ora.owoioso•
ssru.w
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
type of fwture to be installed or relocated as part of this project, Do not
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUM LNG
BATHTUBS (orn,bjsbo combo
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS Meth. sii.)
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
I FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS lco®e, win
RANGES
GAS WATER HEATERS
WATER CLOSETS (Til" _
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ZL =RIC WATER HEATERS
to
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
! —Wy under penally of peduoy that the iq/ormation furnished by me is to and correct to the brat q f my knowledge, and farther, that I
am authorised by the owner of the above promises to perform the work Jbr which the permit application In mads. I further agree to hold
harmless the City cf iroderai Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and dgfsnse q/
such claim!, which may he made by any person, including the undersigned, and fUed against the City of lsderal Way, but only whore such claim
arises out of the reliance of the city, including its gVicers and employees, upon the accuracy of the iv&rmathm supplied to the city as a part of
this application. fl f
NAIM/TITLE 1 DATE V I I D 4 lob
b
la) (Title)
RELATIONSHIP TO PROJECT o Owner o Agent o Contractor o Architect O Other
Bulletin #100 — January 7, 2005
Page 2 of 4
k\Handouts\Permit Application
`; s,
a NEW o ADDITION
o ALTERATION
a SWAIM a TXXM
BUILDING SHELL ONLY?
a YES o NO
BASIC PLAN?
Gym
o NO
ZONINO DE8I15NATION
CHAS= OF Un?
o TE8
o NO
NEW ADDRESS REQUIRED?
a YN8 o HO
IIP/SNDA/SII?
Oyu
a NO
PLATTED LOT?
a TES o NO
DMO PUFaM REQUIRED?
a TES
ONO
Bulletin #100 — January 7, 2005
Page 2 of 4
k\Handouts\Permit Application