05-106257 r
• r_ CitMechanical Permit #• 05-106257-00-ME
cornrn =p= ervices
P.O.Box 9718
Federal Way,WA 98063-9718
Ph (253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
4.
Project Name: DAVIS .
Project Address: 28313 15TH AVE S Parcel Number: 025130 0160
Project Description: Changeout existing gas furnace with new gas furnace.
Owner Applicant Contractor
LEE M DAVIS PERFORMANCE HEATING&A/C INC PERFORMANCE HEATING&A/C INC
28313 15TH AVE S 7649 S 180TH ST PERFOHA15ORT 4/29/07
FEDERAL WAY WA KENT WA 98032 7649 S 180TH ST
98003-6100 KENT WA 98032
,
Additional Permit Information
Mechanical Valuation 3100 Over the Counter Permit? Yes
Mechanical Fixtures
Furnaces 1
CONDITIONS:
PERMIT EXPIRES Monday, June 5, 2006
Permit Issued on Wednesday, December 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 will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent 1 1 1 CO , 1 +11, Date: 11-1 c c
ti\
THIS CARD IS TO REMAIN ON-SITE
Air
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106257-00-ME
Owner: LEE M DAVIS
Address: 28313 15TH AVE S
FEDERAL WAY, WA 98003-6100
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) ❑ Gas Piping(4125) 12Y Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By0_16.,`;v Date ti
�. 212`�a O RECEIVE VS - l 0 S
Federal Way �� `�"
PERMIT DEC 0 7 20ff MF CO ( `��PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33530 FIRST WAY SOUTH•PO BOX 9718 ��
FEDERAL WAY,WA 98063-9718 APP L I C AT IO
253-661-1115•FAX 253-661-4129
uwru.dttalfedemlwavoorn B 0
UILDING AY
The ollowi • is re•uired in ormation-an inco •fete a.•lication will not be acce•ted. Please •rint le.ibl (in ink)or .
i PROPERTY INFORMATION
1•� ZS ADDRESS `S '1 1 3 is"' /'1t S. SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 0Z. S 13 60 I (e)03 - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descnpt,on)
PROJECT INFORMATION rr
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING 1�MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
C'IA cr 64-- 00fi �Kc�4'ir-7 &SS Fvrvtg1(4- \,'t k'" lok W-e j
PROJECT NAME(Name of Business or Owner Last Name) I)f\,..%
PEOPLE INFORMATION
PROPERTY NAME
sr. 0 PRIMARY PHONE { /
OWNER �vk,S (213 ) SZ.' - 7/V(,
MAILING ADDRESS CITY,STATE,ZIP
2.-ceII3 F -Ar'\ vi A-7 Iti 0- 9$053
CONTRACTOR COMPANY NAME APPLICANT NAME
OFFICE PHONE
pc-kr�otr^A, t I4-rt 7--Call .F�.K) ( yes) zr( a34:.
MAILING ADDRESS A CITY,STATE,ZIP CELL PHONE
?C,Y 9 5- / '-b 1— lc<k a- tri,r'- R to 31-- ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
JCL— SS - OWN c1CL2 dV - B L /Z / 31 / Tic ( till) 2 1 02-p 0
CONTRACTOR'S REGISTRATION NUMBER(coPy of card required with each application) EXPIRATION DATE
1eas014-PI)SOAl" - - - f ' 71 / 07
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
SAIL. ►4-S Ce/N'r('Ck t( ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE
/ �f t� E-MAIL ADDRESS
74/9) r./6,1)G.i) ( l/Zc) (i/ ( -c).3 I"6.
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE +'C F_ PROPOSED USE C
EXISTING ASSESSED/APPRAISED VALUE $ ? VALUE OF PROPOSED WORK $ 3)00 -00
SPRINKLERED BUILDING? 0 YES jNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 'NO
WATER SERVICE PROVIDERLAKEHAVEN 0 HIGHLINE o TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
R
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
A' MENT /
FIRST A
•
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FECORS? TOTAL EXISTING TOTAL.PROPOSED TOTAL ERI AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of future to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL o
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shoaerCombo) SHOWERS WATER CLOSETS MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) 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 officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE /Z/7/6 c
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
o NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES ❑NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES a NO
PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100—March 30,2004 Page 2 of 4 k\I-landouts—Revised\Permit Application