15-102111 -O(�0522-
• a
CITY OF PERMIT APPLI( L ON `
Federal Way
3�010
S- 1 0 ( I - M �� MAY 042015
PERMIT NUMBER v
TARGET DATE CITY OF FEDERAL WAY
CDS
SITE ADDRESS SUITE/UNIT 8
3957 SW 329TH PL
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N _
$ 6,428 '3 2- V -\ - 0 ('
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBIN MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT \-)Cj �� 1� Q (l Cr
PROJECT DESCRIPTION INSTALL NEW HEAT PUMP SYSTEM
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER MATTHEW RUPPERT 770-851-7787
MAILING ADDRESS EMAIL
3957 SW 329TH PL
CITY STATE ZIP
FEDERAL WAY WA 98203
NAME PHONE
MM COMFORT SYSTEMS 425-881-7920
MAILING ADDRESS EMAIL
CONTRACTOR 18103 NE 68TH ST, C-200
CIkYEDMOND STATE ZIP FAX
WA 98052
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE It
MMCOMMC934B4 01 25 15 20-07-100701-00-BL
NAME _-- PRIMARY PHONE
AMANDA EISTER 425-881-7920
APPLICANT MAILING ADDRESS EMAIL
18103 NE 68TH SLC-200
CITY REDMOND STATE ZIP FAX
WA 98052
NAME PRIMARY PHONE
PROJECT CONTACT JANET CHELGREN
(The individual to receive and MAILING ADDRESS EMAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING ❑ OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the •ty of Feder. "ay as to aaiiy.claim(including costs,expenses, and attorneys'fees incurred in
the investigation and defense of such im),whi• may be made by any person,including the undersigned, and filed against the city,
but only where such claim arises o of the eliance of the city, inch •ing its officers and employees, upon the accuracy of the
information supplied to the city as • •art of t is application.
SIGNATU — _�` DATE 4/30/15
PRINT N SMA IA EISTER
Bulletin#100—January 1,2013 Page 1 of 3 k:AHandouts\Permit Application
• .
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS { OTHER1n __
(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commerctap ti—[C CL\
BOILERS FURNACES HOT WATER TANKS(Gas p lJ I, ` p
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Haan Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility WATER HEATERS(EI ctnc)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet( EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
__ ..._.N _ _......._._.._..........._.......................
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2013 Page 2 of 3 k:AHandouts\Permit Application