05-105713 Y r
City of Federal Way Mechanical Permit #: 05 - 105713 - 00 - ME
Community Development Services
PO.Box 9718
FederalWay,WA 98063-9718
Ph.(253)835-7000 Fax:(253)835-2609 Inspection request line: (253)835-30513
Project Name: HENRY Q\
Project Address: 34812 28TH'SW Parcel Number: 502946 0210
Project Description: Installation of gas furnace.
Owner Applicant Contractor
JIM HENRY GENESEE FUEL&HTNG CO INC GENESEE FUEL&HTNG CO INC
34812 28TH PL SW PO BOX 18206 PO BOX 18206
FEDERAL WAY WA 98023 SEATTLE WA 98118 SEATTLE WA 98118
(206)722-1545
Mechanical Valuation 3000.0 Over the Counter Permit..... . Yes
Mechanical Fixtures
Description Quantity Description Quantity r _ Description iQuantity
Furnaces 1
PERMIT EXPIRES May 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 be '- :cc• dance with the laws,rules and regulations of the State of Washington and
the City of Federal Wa, . ,
Owner or agent: Date:
i//743---
goir
•
w _ , THIS CARD IS TO REMAIN ON-SITE . .
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105713-00-ME
Owner: JIM HENRY
Address: 34812 28TH PL SW
FEDERAL WAY, WA 98023-3072
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 Date By Date By GJ Date/2
• �a RECEIVED CONSTRUCTION PERMIT APPLICATION
®EMAL' APPLICATION NUMBER: 05- 1Q, 713 -60.'
NOV 0 7 ?1,J, APPLICATION NUMBER: - _ — , �-
CITY
R OF FEDERALW�` APPLICATION NUMBER: - -
**The fdS Information-Please print(hi ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
�, __ '1PROPERTY INFORMATION
SITE ADDRESS: 3`i g l Z `?L caw ASSESSOR'S TAX/PARCEL#: 6-0 (O- Q all b
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
II PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING ❑ PLUMBING MECHANICAL ❑DEMOLITION
o ELECTRICAL ❑ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): L deo 1"?L ,1g1a
PROJECT NAME:
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME
/44 bf ,Vq ( as3) 1- 77‘.2
MAILING MAILING ADDRESS(STREET ADDRESS; STATE,ZIP):
34872_ ag- t ISL Si) c- 3 14 %'1)
CONTRACTOR: NAME: GENESEE DAYTIME PHONE:
(206 )722 - 1545
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
3616 S GENESEE ST,SEATTLE WA 98188 ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
( )
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(may of card required) G ENESFH 3 7 0 0 6 e i / p.cT 0-7
APPLICANT: NAME DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
)
RELATIONSHIP TO PROJECT: FAX NUMBER:
o ARCHITECT ❑TENANT ,t 9THER(DESCRIBE): ( )
?' E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER o APPLICANT . •R
II DETAILED BUILDING INFORMATION
EXISTING USE: S EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ ' 1)1)1
SPRINIU.ERED BUILDING? ❑YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES o NO
WATER SERVICE PROVIDER: o LAICEHAVEN Q HIGHLINE o TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑HIGHLINE ❑PRIVATE(SEPTIC)
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SOC Page 1 of 1
0 0 King County
Department of Development
and Environmental Services
900 Oakesdale Ave SW
Renton,Washington 98055-1219
November 1,2005
Summar of Char. es and Pa ments
Applicant: : L RED HEATING AND A/C Activity Number: :05M2265
12:45 NE 126TH PL Project Number: B05M2265
KP• AND,WA 98034 Development Number:
Permit Type: B-MECH
425 814-0'.6 Status: ISSUED
Charge x
Description Amount
Bldg Inspection $132.83
Counter Service Fees $102.64
SUB TOTAL CHARGES: IMIIIEr $235.47
PaN,limas
Description Check# Checklo 'd Payee D.to Entered Amount
SUB TOTAL PAYMENTS: $0.00
BALANCE: $235.47
The fees shown above re. esent current charges as of this date and are an estimate based on the i ormation
provided to DDES at the ime of application.
For services that are endered on an hourly basis,the cost of those services will be based on the actua ours
worked. Hourly fe: - are charged at the rate in effect at the time of service,and will be billed monthly,alon, with
any other outsta .ing fees.
Fees that have •een posted prior to permit issuance will be collected at that time. Fees subsequently posted ‘'ll be
billed to the applicant.All fees must be paid in full before DDES issues Final Approval,T.C.O.or C.O.