05-105714 City of Federal Way Mechanical Permit #: 05 - 105714 - 00 - ME
Community Development Services
P.O.Box9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
I .
Project Name: BLANCHARD
Project Address: 1122 SW 322ND s' Parcel Number: 926493 0800
Project Description: Installtion of new heat pump,replace gas furnace and gas water heater.
Owner Applicant Contractor
Charles R Blanchard &Linda L Blanchard NORTHWEST CLIMATE CONTROLS INC NORTHWEST CLIMATE CONTROLS INC
1122 SW 322ND ST 101 23RD ST SE BLDG B-2 101 23RD ST SE BLDG B-2
FEDERAL WAY WA PUYALLUP WA 98372 PUYALLUP WA 98372
98023-5557 (253)435-8834
Mechanical Valuation 6000 Over the Counter Permit Yes
Mechanical Fixtures
Description 7Quantity Description Quantity Description lQuantity
I Air Handling Units 1 Furnaces 1
CONDITIONS:
,5
This parcel is l��'within a Wellhead Protection Area(Capture Zone 1)and must comply with FWCC,Chapter 22,
Article IV"Critical ►,reas" and fin out a Hazardous erialtI to ate ent,If applicable.
PERMIT EXPI�
Ma 6,2006.
Permit issued on November 7,2005
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 i cordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: //77(05
b„,,,,„,(:). cJ 11 - '.. t - QS e.. v
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105714-00-ME
Owner: CHARLES R BLANCHARD
Address: 1122 SW 322ND ST
FEDERAL WAY, WA 98023-5557
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) Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date B30 Date \\.....-2_11— %
RECEIVED
oc G CONSTRUCTION PERMIT APPLICATION
NOV 0 7...2005 APPLICATION NUMBER D5-_ e 5 ,
CITY OF FEDERAL WAY APPLICATION NUMBER: ".1-
BUILDING DEPT. APPLICATION NUMBER: _.._ - -
**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: I 2" Z S 32-2--°4 S - ASSESSOR'S TAX/PARCEL#: 0 °, 1c 3- OF-06
LEGAL DESCRIPTION OF SUB.IECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING i/PLUMBING igJMEC HANICAL o DEMOLITION
o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM / 4
PROJECT DESCRIPTION(Provide detained description): ��2�'e-�Gt,��}{(/,1. � c��P�,f LA-Q2-1-0
PROJECT NAME: I Lf-A/c- (W
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
Ce u C/ L-,c-,uC.t4141z-A ( ) -
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,
/r/A 2 Sr,3 322 d W4
CONTRACTOR: -1,1
DAYTIME PHONE:
as3) Z/3S - 31/
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,EP): EVENING PHONE:
)6, 1 3'-' 5+ see- -Z PiA5aatikr ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
13dos ad. - Low S f ) - QQ ( ) -
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy d card required) A U i7'71 C C q9 D / q f 2 l / l ✓S
APPLICANT: ,yi `L, q - C����Yl o�. C 14,x4,4Q
✓�I�IiT vWrr�a'l DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,IIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT o TENANT `OTHER(DESCRIBE): ttnitejin ( ) -
J E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT >fiaNTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ ( °
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN 0 HIGHLINE o TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE ❑PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
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
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOOD ( )
BOILER(S) FIREPLACE INSERT(S) RANGE(S) ( MISC.(,_ 44--*COMPRESSOR(S) I FURNACE(S) faititi
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: a ELECTRIC *TAS
PLUMBING
BATHTUBS) LAVATORY(S) URINAL(S) I WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o C \,AS
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 * of Facial ' as to any claim(including costs,expenses,and attorneys'fees incurred in the
Investigation and defense of such chin), ich - be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim a , , • the reliance of the city,including its officers and employees,upon the accuracy
of the information supplied to the city as a • rt . this application.
NAME/TME: DATE: (76/(iir
o PROPY OW__NER._„ _p / RACTOR llfr
FOR OFFICE USE ONLY::
0 NEW 0ADOITION ❑ALT RATION 0 REPAIR £JTENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILD/NG SHELL ONLY? ❑VES a NO
COMP PLAN DESIGNATION BASIC PLAN? a YES c NO
SECTION TOWNSHIP,_..__RANGE NEW ADDRESS REQUIRED? o YES o:NO
PLATTED LOT? a YES ci:NO CHANGE OF USE? a YES 0 N
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253-661-4129
www.dtyoffederalway.con!