04-103254 •
City of Federal Way
Community Development Services Mechanical Permit #:04 - 103254 - 00 - ME
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661 4000 Fax.253 661 4129 Inspection request line: 253.835.3050
Project Name: AUGUSTINE tad
Project Address: 33133 30TH SW Parcel Number: 954280 1000
Project Description: Installing new 3-ton air-conditioner
Owner Applicant Contractor
Beth E Nichols ALL SEASONS INC(ELECTRICAL) ALL SEASONS INC(ELECTRICAL)
33133 30TH AVE SW 5118 N HIGHLAND ST 5118 N HIGHLAND ST
FEDERAL WAY WA TACOMA WA 98407 TACOMA WA 98407
98023-2721 (253)879-9144
Mechanical Valuation... 2800 Over the Counter Permit Yes
Mechanical Fixtures
Description 1Quantity Description Quantity Description Quantity
Air Handling Units I
PERMIT EXPIRES February 13,2005.
Permit issued on August 17,2004
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:_�A Z /05►
THIS CARD IS TO REMAIN ON-SITE •
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103254-00-ME
Owner: BETH E NICHOLS
Address: 33133 30TH AVE SW
FEDERAL WAY, WA 98023-2721
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) 0 Gas Piping(4125) Ela Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date Byp tip\ Date 4/1 Qc
, t
arr OF w" RECEIVErIA
Federal Way P E R M I T
COMMUNITY DEVELOPMENT SERVICES ,1(_ 1 7 nu-r SF MF C ME PL DE EN FP
33530 FIRST WAY SOUTH•PO6 -971 9718 AU U FED /A p T L I C AT I O N �
FEDERAL WAY,WA 98063-9718 rG1,/�`-\�1 fir/ To
253-661-4115•FAX 253-661-4129 �,.W{�'
www atuoffederalwau corn GO OF F rs DEPT
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The ollowin• is re•uired4n ormation-an incom•lete a••lication will not be acce.ted. Please •rint le•ibl in in or •e.
PROPERTY INFORMATION
SITE ADDRESS 33133 30TH AV SW SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# _9_ _5_ _4_ _2_ _8_ _O_ - 1 O_ _O_ _O_ LOT SIZE(sj)
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1)
(Attach separate page for lengthy legal descnphon)
IN PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING XMECHANICAL
0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
INSTALL 3 TON AIR CONDITIONER
PROJECT NAME(Name of Business or Owner Last Name) _AUGUSTINE
PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER BETH AUGUSTINE ( 253 ) 331-9944
MAILING ADDRESS CITY,STATE,ZIP
33133 30TH AV SW FEDERAL WAY, WA 98023
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
ALL SEASONS INC ROBYN BRADSHAW ( 253 ) 879-9144
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
5118 N HIGHLAND ST TACOMA, WA 98407 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
19 98 105262 00 BL 12/31 /2004 ( 253 ) 879-9144
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
A L L S E I * 0 3 0 5 5 12/17 /2005
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
ALL SEASONS INC ROBYN BRADSHAW ( 253 ) 879-9144
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
5118 N HIGHLAND ST TACOMA, WA 98407 ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
n Architect ❑ Tenant ❑Agent 0 Other(Descnbe) ( 253 ) 879-9144
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
DAVE BRADSHAW ( 253 ) 879-9144
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE RESIDENTIAL PROPOSED USE RESIDENTIAL
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 2800.00
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
—SEWER SERVICE PROVIDER -a LAKEHAVEN ❑ HICULINE o PRIVATE(SEPTIC)
I
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ.FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $ 2800.00
1 AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial( WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toikq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
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 city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. / p ,/
NAME/TITLE 1111, / i� f p V i /cS6G DATE (C� �(O— Z 60 4
Signat (Title)
RELATIONSHIP TO PROJECT 6. Owner 0 Agent [Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
o NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application