05-101731 City of Federal Way Mechanical Permit #: 05 - 101731 - 00 - ME
Community Development Services
P 0 Box 9718
„. Federal Way,WA 8063-9718
Ph'(253 835-0009 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: HOLY INNOCENTS CHAPEL
Project Address: 2530 S 298TH 5r Parcel Number: 768380 0032
Project Description: Installing a new outdoor furnace/HVAC unit with interior ductwork and fans,and gas piping.
Owner Applicant Contra* r
HOLY INNOCENTS SOCIETY HOLY INNOCENTS SCHOOL OF NW MR PLUMBER INV *WARREN WIl
2530 S 298TH ST 2530 S 298TH ST ATTN: SHARON HENSEL
FEDERAL WAY WA 98003-4219 FEDERAL WAY WA 98003 200 THIRD AVE SW
(253)931-3894
Mechanical Valuation 4000 Over the Counter Permit No
Mechanical Fixtures
Description Quantity Description Quantity Description Quantity
Air Handling Units 1 Furnaces 1 Gas Piping100
PERMIT EXPIRES December 18,2005.
Permit issued on June 21,2005
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 Wa .
Owner or agent j�/I� Date: C94 S
THIS CARD IS TO REMAIN ON-SITE
CITY OF 11411 Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-101731-00-ME
Owner: HOLY INNOCENTS SOCIETY
Address: 2530 S 298TH ST
FEDERAL WAY, WA 98003
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 arc 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) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By G �►. Date 5 (41/• O7 C„.By .(...s.)(...s.) Date-1 . 26.,,j- By c tj Date/0 .`0. crA
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Federal Wa ECEl\/ED PERMIT
eouxtulvnYDEVELOPMENT SERWCES SF M- CO ® L PL DE EN F'
33325dTMAVENUESO(iTN•POBW 78 1 4 I5APPLICATION To
FEDERAL WAY, er 9d06ca g:P ;4 CAli I
253-835-2607•FAX 253-835-2609 A
www.cityoll'edertilwau com
CITY OF FEDE iA WAY
The oIlowi • is .is; ;613.;,-Icon-an •Iete • ••iication will not be acce.ted. P P-. - •rant le.ibi in or • .
h►1 PROPERTY INFORMATIION
SITE ADDRESS P---5 30 S , •' F i .( IAS 1,1/A110)3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 7 b g 3 T O - 0 V ; LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 1 Sec/APIA SL,�✓ 7 t c.i Less- S/ i/ T
t 3 UI (n4'
Attach separate page for lengthy legal description)
Al A. C- -1I Slt.o'
1.1 PROJECT INFORMATIONyMECHANICAL
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide diled description of work included on this permit only) //��
1/45431f At rHotc .det
k N/I�Lr �cfa/e+-�c Ake/ 4 ts.
PROJECT NAME(Name of Business or Owner Last N.me) ?td?' 1 it$10C4901#5. SCA GG I 4d d/ri-1 dji (Ci(qp f,
im PEOPLE INFORMATION
1
PROPERTY NAMEl r! PRIMARY PHONE
OWNER Hai% /II l�(O CeilI7' SG C1rG", (053) 3 3/c�
07?7
MAILING DRESS CITY,STATE,ZIP
S3d A/I Si-, 1eQe l,"I Wa41 3
gra
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
firX5 ) 931 -31(9y
MAIL NG ADD.RE CITY,STATE,ZIP CELL PHONE
c200 3 t1Vt SO PPaiic,c. / 60 604 ( ) -
IF' t ...&— BUSINESSLICENSENUMBER B L 1 EXPIRATIONDATE3 FAX NUMBER -
CllfONTRACTOOR'S RRREEGISTRRATIIOGy/N NUMBER(copy of card required with each application)ca `t EXPIRATION DATE
/ /
APPLICANT COMPANY NAME � APPLICANT NAME OFFICE PHONE
MAILING/4df/I�JJ// bl NDDRESS OCe Wil So c i e,}`7 CITY,STATE,ZIP — CVSELL 3))NE
0/ -67 VI
i, 30 S, 2� ' s+. 0 ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant $Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
Venniti Al, GK i ( 53) $39 -675/
LENDER11-.: ; ,: a .w ,,_. -r+}[w,, NAME
fi.;,..Id�'P'' r.zz:_
MAILING ADDRESS CITY,STATE,ZIP
)_ V DETAILED BUILDING INFORMATION
EXISTING USE cCdt UGI PROPOSED USE SR Nt G
53L 1762 GNi-Y
EXISTING ASSESSED/APPRAISED VALUE $ I I/400 VALUE OF PROPOSED WORK $3f".010
SPRINKLERED BUILDING? ❑ YES yNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ,$.NO
WATER SERVICE PROVIDER lit LAKEIIAVEN a RIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER $.LAKEHAVEN ❑HIGIH.INE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION k EXISTING PROPOSED
SQ.FT. SQ.FT. FT.
1 ti
SECOND ,.
THIRD
FOURTH •
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT❑
NUMBER OF FLOORS zia ' PROPOSED TOTAL TOTAL!Mantra sr . ,TOTAL PROPOSED Sr TOTAL sr
**NEW HOMES ONLY** ' MBER OF BEDROOMS ESTIMATED SELLING PRICE $
"I
FIXTURES
Indicate number of each type of fixture to be installed/r`>,rocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS g2 FANS HOODS(commerciaq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS I FURNACES GAS WATER HEATERS
oQ. DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower combo) SHOWERS WATER CLOSETS(roue) MISC(Describe)
DISHWASHERS _ SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(B,hroom siDr.) ACUUM BREAKERS ELECTRIC WATER HEATERS
`
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the o' ation 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 officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE �Ire ri4let yL.ei l e*!t'DATE 3,)(6S(Signature) (httll: /JJJJJ
RELATIONSHIP TO PROJECT )•i(Owner Jl(Agent ❑ Contractor ❑ Architect 0 Other
ITION �' .* ALfIERATION n REPAIR • i'41ENANTCIMPROVEMENT
. 111, ELI: Y? _3ry tbt iO .h." . , BASIC PLAN?•."£ Q YES ,• �fNO a�
;::1‘1.0.1.4-,.. rI a.IGrNATION x_x> µ.ms:,I.., s
.F: s � � r? , CHANGE UFUjSE? �`ry a YES, . . a !i0 `i# ''a�
.020 e • •UD2ED? •r,: i xa NO/ UP SEPA 1Jf I ES 1. „t..' ❑ ES O
DEMOERMIT �2IQIIIRED "'�(]"3fES :r: p ,. v
Bulletin X1100—January 7,2005 Page 2 of 4 k\Handouts\Pennit Application