04-104592 3
City of Federal Way Mechanical Permit #: 04 - 104592 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305C
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Project Name: THOMPSON Of,
Project Address: 30158 25TH SW Parcel Number: 893760 0080
Project Description: Replacement pf existing gas furnace
Owner Applicant Contractor
Richard E G Thompson GLENDALE HEATING GLENDALE HEATING
30158 25TH AVE SW 12462 DES MOINES MEMORIAL DR 12462 DES MOINES MEMORIAL DR
FEDERAL WAY WA SEATTLE WA 98168 SEATTLE WA 98168
98023-2354 (206)243-7700
Mechanical Valuation 3540 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description Quantity Description Quantity
Furnaces 1 1
PERMIT EXPIRES May 9,2005.
Permit issued on November 10,2004
I hereby certify that the . iA e/ormation is cone . d that - construction on the above described property and
the occupancy and the - ' be in .ccorda� e with s e la",rules and regulations of the State of Washington and
the City of Federal W. .
7.(
Owner or agent: / ,� Date:
V
II I
V
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104592-00-ME
Owner: RICHARD E G THOMPSON
Address: 30158 25TH AVE SW
FEDERAL WAY, WA 98023-2354
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 fi,f
Date ///4/04/
RECEIVED
cede Way �a - .4_ 0__ Y_:. SJ 2-
PERMITNOV 1 02004 SF MF CO ME EL PL DE EN FP
COMMUMIY D EVELOPMFJff SERVICE?
3353EDFIRST ALWAY,oA • 6397 97-1i APPLICATd-}
FEDERAL WAY,WA 91063-9711 TD /
253-661-1115•FAX 253661-1129 E D ERAL VV�Ay l
uwta,tituolfedentwau.com UILDING DEPT, I
The oilman. is -. ired in ormation-an inco •fete a••lication will not be acce•ted. Please •rint le.
PROPERTY INFORMATION or �.
SITE ADDRESS 3O1 5 6 i- ' Oue S-03 e CAS l l_Jal,_ 5 0 Z 3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL Y ( 1 LO - -0- Q LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) •
/Aaadt separate page for Ioipthp iepol description/
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING %MECHANICAL
❑ DEMOLITION 0 ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM '
PROT DESCRIPTION(Provide detailed description of work included on this permit r-,o( F I VP P fl
-5 3 V C)Le-,(
PROJECT NAME(Name of Business or Owner Last Name)
PEOPLE INFORMATION
PROPERTY NAr A-1(\
PRIMARY PHONE �j
OWNER C\ ` \1(\OIV -1 (L0-5?)c-55 - L(2 I
MAILING ADDRESS CITY,ST TE,ZIP
IZbto N a' SA- (� (A)c,_ gSbss
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
( ` )�1
MAID ADDRESS keiCAIF.---:\
CITY,STATE P CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - -B L / / ( ) -
CONTRACTORS REGISTRATION NUMBER(Ce7 of card required with sack application) EXPIRATION DATE
4 1 91405 to i6oar3L_ / /
APPLICANT COMPANY NAME --�AA APPLICANT NAME OFFICE PHONE
c i,, ''e) CITY,e6I Iris,.� ,.,, („1,7 ),,-,)_(,-, -�a,
MAILINGUADDRESS (�� l r / �{}( � CELL PHONE
\� l 2-- .,,A 1a V-k4'S 1 4.1,1 V(/011 Li �G"ar,C(C, ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect a Tenant a Agent ❑ Other(Describe) ()y ),_)--(42-, - 4L/
CONTACT NAM , 1 L PRIMARY PHONE E-MAIL ADDRESS
LENDER ,pEr RCW 19.27.095:,Lender information Is NAME
,;required Vproject vales exceeds$5,000"
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? Cl YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? O YES ❑ ha
WATER SERVICE PROVIDER 0 LAKEHAVEN o HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC) -
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 DOSTINO TOTAL PROPOSED TOTAL.EXISTING ASD PROPOSED
**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 $ >l t•5
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercus W OODSTOV ES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS I FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Showercombol SHOWERS WATER CLOSETS rrodeq 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 the city,including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this applicatio
NAME/TITL`F i� VV CIA S -CIYUU 3 DATE / f l 1 L�
ature)dTitle
(Sig (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
❑NEW o ADDITION o ALTERATION a REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? a YES a NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application