05-100390 City of Federal Way Mechanical Permit #: 05 - 100390 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA -9718
Ph:(253 835-0009806Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: DAVIS l/
Project Address: 30045 5TH/SW Parcel Number: 039590 0130
Project Description: Install gas boiler w/tankless water heater. Boiler to service hydronic radiant heat system.
Owner Applicant Contractor
Duke Davis Duke Davis Duke Davis
30045 5TH AVE SW 30045 5TH AVE SW 30045 5TH AVE SW
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-3518 98023-3518
Mechanical Valuation 2000 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description Quantity Description Quantity
Boilers 1 Gas Piping 1
PERMIT EXPIRES July 27,2005.
Permit issued on January 28,2005
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: t Date: J fa F!. ,c
tf
THIS CARD IS TO REMAIN ON-SITE
CITY OFA Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100390-00-ME
Owner: DUKE DAVIS
Address: 30045 5TH AVE SW
FEDERAL WAY, WA 98023-3518
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 17,f Date Z -Zy--a,T By Pj,i Date2-24--Or By ,/ fDate 2-25 - Ar
N �
*;.1
t y
0
z
y
z
� d
g
k
A n
.. y
1
Of
A. RECEIVED
0 �' .... ( o a 3 9` 0
Federal Way s 2095 PERMIT
COMMUNITY DEVELOPMENT SERVICES SF MF CO 19 EL PL DE EN FP
33325 8370 AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 983063-9 TD
253 8335-2607•FAX 25983406335-
53 8335-26 1MN OF FEDE PLICATION
www.dtuofrederalwaycorn BUILDING D • � /
The ollowi • is re• ired in orrnation-an inco .lete • •.lication will not be acce•ted. Please •rint le•ibl (in i or
■ PROPERTY V INFORMATION
�,,�y u C
SITE ADDRESS . -AJ-1 S nn S z J SUITE/UNIT# ---
ASSESSOR'S TAX/PARCEL# 3 l Sc/ C- 0 ( 3 0 LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 9 c 1,-.....1 t.- . 0.,1_.al,,E It-
(Math separate page for lengthy legal descnptton)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
/`JCS✓ 64-'3 t-iva (-4&A-r * 00,c.&--2.
PROJECT NAME(Name of Business or Owner Last Name) ) ?i,i'L S
• PEOPLE INFORMATION
PROPERTY NAM PRIMARY PHONE
OWNER �Jw-r % or 4A S (ZS1 ) F33ct - 'Z,S-d4.—
MAILING ADDRESS CITY,STATE,ZIP CC&u S,$'t Q os-f
30-04-S- sTK Ave Sa. ' Feb 4..r Ali 1,./A- 7E013
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
—B L / / ( )
CONTRACTORS REGISTRATION NUMBER(coPy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
OW 1✓�l•---_ ( )
-
MAILING ADDRESS CITY,STATE,ZIP — CELL PHONE
( ) _
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
:h,.;.
LENDER itt ���, ws.: �� n ormatto NAME
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN 0 HIGHLINE a PRIVATE(SEPTIC) ,
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
4
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 $ 2 0 0
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) W OODSTO V ES
tek BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES HNC. ►` GAS WATER HEATERS
_ DUCTS treDC GAS PIPE OUTLETS
(got t-cyT2 P„ )c Hof ^ I
't-6 tJNl i
PLUMBING
BATHTUBS or Tub/Shoaercombo) SHOWERS WATER CLOSETS(Toilet) 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 application.
(zg/NAME/TITLE DATE / 5
re) (Title)
RELATIONSHIP TO PROJECT l6t,Owner 0 Agent 0 Contractor 0 Architect 0 Other
-x G) .4 "tom
+::s DIYTION '- ';p AI.TERATION o REPAIR a; i TEN NT IMPROVEMENT. " M
.+tat ssrrw.:''.fie DMON tt�. .. x .. - - : =".:'.,: ^tW
cj�tt � G .� rr,ONLY? ti YES io'NO BASIC"PLAN?.:: 5p5py o YES 6,0 NO;`= - ,44;
aJ!�G DESIGN ION ' x"'� :x.DMON A •l),ISRATI , ❑YES o'NO.
' !DRESS UAmED.? 0YES; NO` UP/SEPA/SU?1'3N • .,42,.;i .t ❑YES,'.
DEMU:PERMIT REQUIRED? xo YES kfi"TO�'��
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Pcrmit Application