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05-105564 • , !' S ✓� City of Federal Way Mechanical Permit #: 05 - 105564 - 00 - ME Commnmty Development Services j P.O.Box 9718 Federal Way,WA 98063-9718 Ph (253)835-7000 Fax.(253)835-2609 Inspection request line: (253) 835-305C Project Name: LEBERT Project Address: 2841 SW 341ST Gt Parcel Number: 010921 0200 Project Description: Gas funace&hot water tank replacement Owner Applicant Contractor Gerald H Lebert BRENNAN HEATING&A/C LLC BRENNAN HEATING&A/C LLC 2841 SW 341ST CT 4601 S 134TH PL 4601 S 134TH PL FEDERAL WAY WA TUKWILA WA 98168 TUKWILA WA 98168 98023-7604 (206)248-7900 Mechanical Valuation 3130 Over the Counter Permit...............................Yes Mechanical Fixtures Description Quantity Description Quantity r Description Quantity Furnaces 1 ' PERMIT EXPIRES April 26,2006. Permit issued on October 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. n Q Owner or agent: See Application Date: lahiI17S THIS CARD IS TO REMAIN ON-SITE CITY OF Community Development Inspection Record Federal WayIVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-105564-00-ME Owner: GERALD H LEBERT Address: 2841 SW 341ST CT FEDERAL WAY, WA 98023-7604 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 By • tdi Date 3.Z( - 0 4 As. or of �/ C — FederalWay PERMIT 45'5. ` J / cOMMUMlYDEVELO,MEM SERVICES SF MF CO ME EL PL DE EN FP 33325CHAVENUE mum WA 2.63 BOX 9718 APPLICATION FEDERAL WAY,FAX 53435-260 ITD / / 253-835-2607•FAX 253135-2609 • )u w w.ci t uof(ede ra)w a u.co m The ollowi • is re,wired in ormation-an incom•Tete a••licatlon will not be acce•ted. Please •rint le,ibl in in or .. �j 1 1 /'M PROPERTY INFORMATION o� SITE ADDRESS a-i t SO 3"(-I S'T^ d7 ^ SUITE/UNIT# ASSESSOR'S TAX/PARCEL# 0 I O 174:-.1f 0� t - O a. CED LOT SIZE(sj) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) C) (Attach separate page far lengthy legal desoip6 n) ^ - ' 1111PROJECT INFORMATION TYPE'64F PERMIT 0 BUILDING 0 PLUMBING silt MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) EPL AC M.€ALS PROJECT NAME(Name of Business or Owner Last Name) ' NI PEOPLE INFORMATION . PROPERTY NAME -( LS ALe6E�2�' (AsPRI3)H OWNER C g ?4 - .`ueI MAILING ADDRESS CITY,STALE,ZIP av41 stb 34-t Cr F w. el g 0.-3 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE "3a1✓LaaQ. 14CA-ri4.4)k A/C. SNAtokle-AK( (Ado)4a48" -74100 MAILING ADDRESSCITY,STATE,ZIP CELL PHONE `4 00 t ( 34-a► i 1 L Tt»C(..�1 uq R$Ile$ (, ) • CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE - FAX NUMBER 010 - 04 - ( 0 t Cr a.a--B. L la-/ 31 /os' (A(*) 048 --7et.M' CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE SR ki-KI ('•► A al 7 l 10241 P.- / 3 1 / O APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE 15iteNo,tai l (-i-rev icA/C ( 014,1,a_4? ---/- O-13 MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE 401 S 13 .017 id Ic.)K[,.-1�� Clt ac(0? ( ) - RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect ❑Tenant ❑Agent 0 Other(Describe) (ado ) 014c2 -'"? E: ". CONTACT NAME u - - ' PRIMARY PHONE J (000)ALtg --/ E-MAIL ADDRESS • LENDER ..-47 ljcIt'/at-F s)'v,Rtlrt 'v 6t.;rr 1 r7„ NAME r-.,t.ft.r;:t JF,:(- 1,-4' i,'.:('t-3's{.Ci-X.47.'3-):.•C!i.; MAILUNO 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? ❑YES 0 NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) 1 - PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST - SECOND THIRD - FOURTH • ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE 0 CARPORT 0 =srDKa PROPOSED TOTAL r 6+� av Iirr4• 13i4r,,+,• SI U Wii NUM1R OF FLOORS - II "NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES • • Indicate number of each type of facture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL ,..., oo Value of Mechanical Work $ 51 3(.....)r AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(commecdati WOODSTOVES BOILERS • FIREPLACE INSERTS RANGES MISC(Describe) • COMPRESSORS G FURNACES I. GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING. BATHTUBS(or Tub/Shower Combo( SHOWERS WATER CLOSETS(r.n.q MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAYS(Bathroom sin.) 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 • -cers and employees,upon the accuracy of the information supplied to the city as a part of this application. 1, NAME/TITLE ( /I( L*4 A . %_IIIP `L .AAA b , DATE I OA j 7C;c- - (- .nature) (T itle) RELATIONSHIP TO PROJ T o Owner ❑AgentContractor a Architect ❑ Other _ ...l...v ...., - _.;•. ? _. �+ _ , , _ 3fir'1Qi+P ,, D)G fIfC i r}�!0,. ..,1,001., �t t;,1=—s0d1;x '"'t (FvCliPfi ; ;_XFT�.D)�r,..7...7.t--..-.4...1. --,.------ar" d _� a , i —...--:-.-1:: _ d_ib PSflL_ 0 %r 4 - '�'<*-) -0:i9 L' ` )(:3,p, A - y . iViS ` T7747; iEi 75✓ '(cS�61... '),'- o 11- tc • ) cc(el f • " Y:tI+A-0-k40> . 1,,7,4;;;A:.('.' rr,.`114) ,,- " Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts Permit Application