05-106452 City of Federal Way Mechanical Permit #: 05-106452-00-ME
Community Development Services
P.O Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: TROTSYUK
Project Address: 37623 18TH PL S Parcel Number: 721265 0800
Project Description: New gas furnace
Owner Applicant Contractor
VERA TROTSYUK VERA TROTSYUK VERA TROTSYUK
37623 18TH PLS 37623 18TH PLS 37623 18TH PL S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Mechanical Valuation 1400 Over the Counter Permit? Yes
Mechanical Fixtures
Furnaces 1
CONDITIONS:
PERMIT EXPIRES.Surtday, June 1:8,2006
Permit Issued on Tuesday, December 20, 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
�,,Cand the Ci of Federal Way. /� /
Owner or agent: � �� r i , te: S�/) _�
\
�rS
THIS L'.ARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record -
Ferderal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106452-00-ME
Owner: VERA TROTSYUK
Address: 37623 18TH PL S
FEDERAL WAY, WA
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) Final-Mechanical(4065)
Approved Approved to release test ( Approved
By Date By Date B' 4,14 Date J 2a(tYZT
Dec 19 05 03:30p p.
E�B1gistrs 2
VEE�INI
ei
OTT OF - SEC 2 0 2005 �_- i5D& c�2-
Federal way PERMIT
wENT �T5F MF COEL PL DE EN FP
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333255^•AVENUE soling•P060XFt'Y OF FE a "k•' CATION TD
FEDERAL WAY,WA 9ROfi39718
z5 ess2607.FAX 253-835-2609 BU ILD I 10� / / S
1w(1'+1••rnlu.(it un
The •llow' • is ired •rination-an «• 'lete •,' ' • • will not be '««-•ted. Please • t le•' '.-_ (in ink)or ..i,'.
• PROPERTY INFORMATION
SITE ADDRESS 3 7 P gr• 1 £ ' S - ! L/ SUITE/UNIT*
ASSESSOR'S TAX/PARCEL ti 7 I let, 5' - 'v 1_ V/ a LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Aane Estates,Lot 1)
1Auk.-A seixrair PaOe)T lengthy lewd desvMNr'n1
• PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ❑PLUMBING ❑MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
e la ikAtctti .u,✓v_C"J
PROJECT NAME(Name of Business or Owner Last Name) \,V 0+5 IA_
K.-
mu PEOPLE INFORM-ATION
PROPERTY NQ PRIIMA�RYPHONE / p
OWNER €/ Tro ¢ 5/ Li " (-S'4)8/ -6gVI
7 ggEi 18 PL 5 7 STATE.
ZIP
q/ ?SO0 3
CONTRACTOR ke�- APPLICANT NAME OFFICE PHONE -
NG ADDRESS 11/r CITY.STATE,ZIP CELL PHONE
( ) -
CIT Y OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - -B L / I ( )
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT lY75 APPLICANT NAME OFFICE PHONECA) -
C�IW
LING ADDRESS CITY.STATE.ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
C Architect ❑Tenant
❑Agent 0 Other(Describe)
(
-
CONTACT E-MAIL:NAtlADDRESS
V9g1JSpmayi I ) it 1-Q 11b
LENDER Per ItCn 9.27.09 . Lender
information is NAME
required(f project value exceeds 55.000
MAIUNC ADDRESS CITY.STATE,ZIP PHONE
/
l ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPIUNKLERED BUILDING? o YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES o NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑HIGHLINE ❑TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER o LABEHAVEN o IIIGHLINE 0 PRIVATE(SEPTIC)
Dec 19 05 03: 30p Blair Mus p, 3
s
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
S9,M'. S9.F1'. Sq.IrT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
-
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)_
GARAGE B CARPORT
NUMBER OF FLOORS fIS !ROTO® TOTAL!ROTOTOTALTOPALEillinM}SF TOTALrsorosND TOTAL.,
""NEW HOMES ONLY NUMBER OF BEDROOMS ESTIMATED SELLING PRICE S _
FIXTURES
Indicate number of each type offixtture to be installed or relocated as part of this project. Do not Include existing fixtures to remain.
MEC—HA/MAL �� R V
(Value of Mechanical Work $ I)
I AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
_ BHAS FANS HOODSWOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS V FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS pm-Mb/Shower CashM SHOWERS WATER CLOSETS(roIIW MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE B113135
LAYS It1..mnx.m Sink sl 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 lnwwledge,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 inwestigation and defense of
such chin*,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./' p �f' p+ I�/(J ,,//►
NAME/TITLE ✓ V'vY K �/ �7 DATE V` r W g — S
(Slerutarol Inucl
RELATIONSHIP TO PROJECT 0 Owner ❑Agent 0 Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
o NEW ❑ADDITION o ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILD/NG SHELL ONLY? o YES o NO BASIC PLAN? o TES o NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? n YES o NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? a YES o NO
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts'Permit Application