04-103065 FIF
;of
ederal Way
To nrmunFy Development Services Mechanical Permit #:04 - 103065 - 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: WILLISON0
Project Address: 33315 5TH/SW Parcel Number: 729801 0220
Project Description: New A/C add-on
Owner Applicant Contractor
Ross C Willison &Judith C Willison PUYALLUP HVAC INC PUYALLUP HVAC INC
33315 5TH PL SW 130 15TH ST SE 130 15TH ST SE
FEDERAL WAY WA
98023-6181 \PUYALLUP WA 98372 (253)845-0581
Mechanical Valuation. 5033 Over the Counter Permit Yes
Mechanical Fixtures
j_ Description Quantity Description Quantity L Description 'Quantity
LAir Handling Units 1 Compressors 1
PERMIT EXPIRES January 30,2005.
Permit issued on August 3,2004
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: See_ i p p t C1([c"✓' Date: 7(3
THIS CARD IS TO REMAIN ON-SITE _ .
CITY OF Community Development Inspection Recbord.
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835,3050
PERMIT #: 04-103065-00-ME
Owner: ROSS C WILLISON
Address: 33315 5TH PL SW
FEDERAL WAY, WA 98023-6181
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) 0 Final-Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By v Date 9 ir
RECEIVED BY t _C1 (
• i , - COMMUMTY DEVELOPMENT DEPARTMENT 1
COMMUNITY DEVELOPMENT'SERVICES
4` Al O 004 33530 FIRST WAY SOUTH•PO BOX 9718
cnv of FEDERAL WAY,WA 98063-9718
FederalWay PERMIT APPLICATION 253-661-4115*FAX
www ayaffederal 253-6614129
6corn
M
0 ({ — -( - - L � — ery TO
For Office lime Only File Number: / /
The ollowi • is -• iced i orrnation-an •. •lete . • •lication will not be • .. • d. Please • nt Iib in i or T• .
� j • PROPERTY INFORMATION
SITE ADDRESS: SS bl S' •li c3 SUITE/APT#ASSESSOR'S TAX/PARCEL#: 1 2.e4 b L 07-2-Q SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1) •
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT(This application): ?BUILDING ?PLUMBING MEC: ?DEMOLITION
?ELECTRICAL ?ENG I : A- I ' I' ' PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlllt• I✓\6-fa Lit v,y hie, �S ah
add}- c5Y1, �l
PROJECT NAME(Name of Business/Owner Last Name): l i iv
i,i- / t I /frL
• PEOPLE INFORMATION
PROPERTY NAME: l' PRIMARY PHONE:/ 7
OWNER: f Mos LJU11t1SDr\ (2(3,3 D -C '232,
MAILING ADDRESS( ET ADDRESS;(. ;;TTY,STATE,ZIP
S-�3 is �� pt� cw LecC Q LL/ ( Y/ 4�, t�
CONTRACTOR: NP *-
E COMPANY \� OFFICE PHONE:
G DDR/ .'ifd 4-f >J111 (2MAILING D REST ADD S (. /Y CITY, ATE,ZIP I CELL PHONE
I t- 61-- ��J! wti, 3-12 ! ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIR,4TION DATE: 1 FAX NUMBER.
GZ-Q 1r-_ID S q 0.-DO aig I /lam (�-53 )LII -CGWS
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION
DATE.
(copy of card required with each application} P L i 1! G$14-142 - - - 0(/C„4, /c
J
LENDER: NAME'
DAYTIME PHONE:
iu hopo..d V•I•r>*5,000) ( ) -
MAILING ADDRESS(STREET ADDRESS;(: CITY,STATE,ZIP
APPLICANT: NAME: COMPANY I OFFICE PHONE:
( ) -
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
?Architect ? Tenant ? Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJ- : ?Property Owner )?Contractor ?Applicant EMAIL ADDRESS:
• DETAILED BUILDINGUIINFORMATION
EXISTING USE: PROPOSED USE: a
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF'PROPOSED WORK: $
L
SPRINKLERED BUILDING? ?YES ?NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ?YES ?NO
WATER SERVICE PROVIDER: ?LAKEHAVEN ?HIGHLINE ?TACOMA ?PRIVATE(WELL)
SEWER SERVICE PROVIDER: ?LAKEHAVEN ?HIGHLINE ?PRIVATE(SEPTIC)
• t
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PEED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
N FIXTURES . -
Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $S tC2S3.
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commtraaq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES lt, MISC(Describe)
I COMPRESSORS FURNACES GAS WATER HEATERS A,'L PrO0 V a
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tb/Shower combo
SHOWERS WATER CLOSETS(roam) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom amk VACUUM BREAKERS ELECTRIC WATER HEATERS
I. :Sc 1.\ \1' I- `--1(;",,\I I KI Hl H( I.
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 authorised 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 - City of Federal •, ,but only where such claim arises out of the reliance of the city,including its officers
and employees,i , ,n .. , i- , the igf supplied to the city as a part of this application.
�w " //2 4 4
NAME/TITLE: � / 1 r DATE:
.,gnaturel
RELATIONSHIP TO ' -OJECT: ? Property Owner ? Appli ? Contractor_) Architect ?
FOR OFFICE USE ONLY:
?NEW ?ADDITION ?ALTERATION ?REPAIR ?TENANT IMPROVEMESIT
BUILDING SHELL ONLY? ?YES ?NO BASIC PLAN? ?YES ?NO
ZONING DESIGNATION: CHANGE OF USE? ?YES ?NO a
NEW ADDRESS REQUIRED? ?YES ?NO UP/SEPA/SU? ?YES ?NO
PLATTED LOT? ?YES ?NO DEMO PERMIT REQUIRED? ?YES ?NO
Bulletin#100-January 13,2004 Page 2 of 4 k:\Handouts-Revised\Permit Application