04-103937 ` 1
City ufl~ederal Way Mechanical Permit #: 04 - 103937 - 00 - ME
Community Development Services
P O.Bet<.9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request like: (253) 835-3050
Project Name: DOCKSTADER
Project Address: 32648 39THSWei Parcel Number: 873195 1630
Project Description: Remove and replace gas water heater and gas furnace
Owner Applicant Contractor
Robert Dockstader &Beverly Dockstader VALLEY FURNACE INC VALLEY FURNACE INC
PO BOX 507 PO BOX 507
PUYALLUP WA 98371 PUYALLUP WA 98371
(253)848-3517
Mechanical Valuation 3560 Over the Counter Permit Yes
Mechanical Fixtures
Description __Quantity Description Quantity Description 'Quantic)
Furnaces 1
PERMIT EXPIRES March 26,2005.
Permit issued on September 27,2004
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 Federal Way.
Owner or agent: - — Date: 7—G
O6
`• O
THIS CARD IS TO REMAIN ON-SITE•
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103937-00-ME
Owner: ROBERT DOCKSTADER
Address: 32648 39TH PL SW
FEDERAL WAY, WA 98023-2648
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.
0 Mechanical Rough-in(4165) ❑ Gas Piping(4125) Ii Final-Mechanical(4065)
Approved Approved to release test Approved
A
By Date By Date B �� J Date S
,
,
vr UT1Of RECEIVED CONSTRUC I ION PERMIT APPLICATION
SEP 2 7 2004 La NUMBER:Oki - G0
APPLICATION NUMBER: - - _
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEPT.
**The following is required information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.-
•
- ■ PROPERTY INFORMATION '
SITE ADDRESS: .F2-‘1/0. 3f Pm,/ S/ir ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
:- • PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING PLUMBING MECHANICAL ❑ DEMOLITION
El ELECTRICAL LJ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PSP/�.--ea• j a_ s 74Gt/Niict.
.. 1. le,G174e3'r Aef. 1( _de,
PROJECT NAME:
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME DAYTIME PHONE
MAILING ADDRESS(SIRES 1 ADDRESS,CITY,SIAMI,ZIP)
U ; '44 P/ !'r F d ' I �A y s".
CONTRACTOR: NAME' !/ Y //'/y�� DAYTIMEPHONE �1
MAIADDRESSJE''(SIAM ADDRESS, ITY,STATE,ZIP) (2-53 EVENING P)1 9 v 3 -/
P p, 13.X ✓x'07 P1,4 y //if". r�'g / �e
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
CONTRACTOR'S REGISTRATION NUMBER F R// EXPIRATION DATE
(copy of card required) v19 L i�" //c/� /" 'e / l
APPLICANT: NAME ��'''''^^'JJ DAYTIME P110111
MAILING/2P(�IO ADDRESS,CITY,STA �� EVENING PHONE
GP-17 74i^41 c fc,- ( )
RELATIONSHIP TO PROJECT. FAX NUMBER
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
- - • - ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION$
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 3/,��O O��-
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES LI NO .
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA El PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
*
•
# —
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• - . . :---*.• . ' - . • PROTECT FLOOR AREAS r -
FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
--- ---- ---------------- - ----
THIRD
FOURTH — - -- -- — -- —-- - ----- ---
OTHER FLOORS(DESCRIBE)
DECK
^GARAGE
HOW MANY FLOORS?
TOTAL:
-- . - • - ■-'FIXTURES - • - -
Indicate number of each type of fixture
MECHANICAL
1 AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: (_] ELECTRIC (i GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) / WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC J, GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUMP(S)
- -• '' - . ■ DISCLAIMER/SIGNATURE BLOCK
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 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 information supplied to the city as a part of this application.
NAME/TITLE: DATE: 9.--- -7----0=0*n,,,
❑ PROPERTY OWNER APPLICANT CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO +
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
—
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ElYES ❑ NO
COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH•P.O BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX 253 661-4129