05-106183 f' i" i r
City of Federal Way Mechanical Permit #: 05-106183-00-ME
Community Development Services
P 0 Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: FULLER
Project Address: 37107 12TH AVE S Parcel Number: 322104 9007
Project Description: Installation of new Heat Pump and Air Handler.
Owner Applicant Contractor
GREGORY C FULLER GEO DYNAMICS COMPANY GEO DYNAMICS COMPANY
PATRICIA ANN FULLER 505 F ST SE GEODY**003C8 (2/28/06)
37107 12TH AVE S AUBURN WA 98002 505 F ST SE
FEDERAL WAY WA AUBURN WA 98002
98003-7457
Additional Permit Information
Mechanical Valuation 9040 Over the Counter Permit? Yes
Mechanical Fixtures
Air Handling Units 1 Furnaces 1
CONDITIONS:
PERMIT EXPIRES Saturday, June 3, 2006
Permit Issued on Monday, December 5, 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 t e City of Federal Way.
Owner or agent: ��--- _l Date: /2—S= e2c'tiv:g.aS�
4J& — 1 - a $'^ t- 0 �t.1
-die .:1-ATTHIS CARD IS TO REMAIN ON-SITE „ -., •
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106183-00-ME y
Owner: GREGORY C FULLER
Address: 37107 12TH AVE S
FEDERAL WAY, WA 98003-7457
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) 0 Gas Piping(4125) [r Final-Mechanical (4065)
Approved Approved to release test Approved
By Date By Date Bar %LI Date i 2`t%_aS
333z - 'e'
�,�. = RECEIVED CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: ,0 . - L. £ (12 1 e..a -
DEC 0 5 2005 APPLICATION NUMBER: -
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
**The fos olvlippg 14,1giedinformation–Please print(in Ink)or type**
Please note: Electrical,Fim Prevention Systems and Engineering permits may require a separate application.
? ■ PROPERTY INFORMATION
SITE ADDRESS: 37/L) I -- ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING X MECHANICAL o DEMOLITION
o ELECTRICAL ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): -i74/..S 4// i9 4:-#t Ai Li S` /4 • / e e
4,7
OtOJpc'NAME:
f�'r
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: r DAYTIME PHONE:
7 / //f2 (253 )44/ -!/SJ
MAILING ADDRESS(STREET SIDDRESS;CITY,STATE,ZIP):
37 0•/ -/x- ' y ' �' fr!}� Ihi' , 41i9 91/e/i 3
CONTRACTOR: NAME: DAYTIME PHONE:
4i °'v 01-re)• S (7,J) ) '735 -n 7e)e)
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
5'05 F St SC ,,' 1t4,.f )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
12 - 1 2 ! 0 7 -Y&l'l'/;‘,4-15 '7n/
CONTRACTORS REGISTRATION NUMBER: y\/ y r / / �] EXPIRATIONTDATE: `/
(copy of card required) L� Co iG / `/ L� 6 .3 — / J4 "0
APPLICANT: NAME: DAYTIME PHONE:
67-‘i(-!S (25`3 )-73S
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP)::/ ' / / ^� EVENING PHONE:
t' S- /- i/ �r ./�-6( n.F LZA/� )c0/2.- ( )
RELATIONSHIP TO PROJECT: / I(co-rt
r J FAX NUMBER:
o ARCHITECT o TENANT '''OTHER(DESCRIBE): ( " ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: O PROPERTY OWNER 0 APPLICANT 'CONTRACTOR
J
• DETAILED BUILDING INFORMATION
EXISTING USE: /Lf�,.,�Lf.,l7 / / _ EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ /
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ %//��Ps CI d' 00
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES o NO
WATER SERVICE PROVIDER: • o LAKEHAVEN 0 HIGHLINE o TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN o HIGHLINE o PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICES $_
■ 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
Indkatr number of each type of fixture
MECHANICAL
I AIR HANDLING UNITS) I EVAPORATIVE COOLERS) GAS LOG(S) REFRIpG..�+SYSTEM(S)(
BOILER(S)BOWS)
HOOD(S)
INSERTS) RANGE(S) / MISC.( Eft C= )
/ COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: kliELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKERS) o ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I artily under penalty of perjury that the Information furnished by me Is true and correct to the beet of my knowledge,and
further,that I am authorised 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 mud:claim),which may be made by any person,including the undersigned,and flied against the City of
Federal Way,but only where such claim arises out of reliance of the dty,induding its officers and employees,upon the accuracy
of the information supplied to as of !cation.
NAME/TITLE: :f DATE: / C/0 S�
o PROPERTY OWNER O APPLICANT 0 CONTRACTOR
FOR OFFICE USE ONLY:
0 NEW 0 ADDITION O ALTERATION 0 REPAIR O TENANT IMPROVEMENT
CENSUS CODES LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑YES o NO
COMP PLAN DESIGNATION BASIC PLAN? 0 YES o NO
SECTION TOWNSHIP RANGE NOW ADDRESS REQUIRED? of YES ❑NO
PLATTED LOT? o YES 0 NO CHANGE OF USE? 0 YES o NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY.WA 98063-9718.253-661-4000•FAX:253-661-4129