05-100097 City of Federal Way Mechanical Permit #: 05 - 100097 - 00 - ME
Community Development Services
PO,Box 9718
Federal Way,WA 98063-9718
Ph•(253)835-7000 Fax (253)835-2609 Inspection request line: (253)835-3050
Project Name: UNDERWO D
Project Address: 29200 13TI1 S Parcel Number: 720560 0090
Project Description: Install new gar furnace
Owner Applicant Contractor
Dennis J Underwood &Denise E Underwood ALL SEASONS,INC. ALL SEASONS,INC.
29200 13TH PL S 5118 N HIGHLAND ST 5118 N HIGHLAND ST
FEDERAL WAY WA TACOMA WA 98407 TACOMA WA 98407
98003-3743 (253)278-9344
Mechanical Valuation 3144 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description Quantity Description Quantity
Furnaces 1
PERMIT EXPIRES July 9,2005.
Permit issued on January 10,2005
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 Ai' the laws,rules and regulations of the State of Washington and
the City of Federal Wa .
/
Owner or agent: 1 // Date: /7 /6)_5
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100097-00-ME
Owner: DENNIS J UNDERWOOD
Address: 29200 13TH PL S
FEDERAL WAY, WA 98003-3743
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 G. l_,3 Date I #4,6_5
are Of RECEIVED Q S� _ O Gj
I g Federal Way / � � 1
ht1 COMMUNITY DEVELOPMENT SERVICEMAN 1 p 2005 PERMIT SF MF CO EL PL DE EN FP
33325 8ru AVENUE SOUT7I•PO BOX 9718
IF FE°Eti-2607. WA 53-83- §, .�.,PPLI CATI 0 N D
253-835-2607•FAX 253-835 Y OF FEpERA /
miOm aLptrederah,,ay Com BUILDING DEpT. 1
The following is required information—an incomplete ap•lication will not be accepted. Please print legibly(in ink)or type.
MI PROPERTY INFMIMATION
SITE ADDRESS C 2-o a / 3 -- p/ s
ASSESSOR'S TAX/PARCEL# 7 2- C / LO6 O - 0 0 7Q LOT SI TSE( #
SIZE(s�
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desrnpeon)
i-; - I. PROJECT INFORMATION - -
TYPE OF PERMIT 0 BUILDING 0 PLUMBING SelS HANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included� onthispermit on/q)
11157-- // grO , _7 C/ L� 1 C �/�nciC� ��L��RCe Alps-ST-
� S
PROJECT NAME(Name of Business or Owner Last Name)
- - - - ' • - • PEOPLE INFORMATION -
PROPERTY NAME PRIMARY PHONE
OWNER 1,c G7 1 f. 4'yt c��` t $ )�3� ZZs Z
;_eitMAILING ADDRESS 1 „_i_ ?L 5 . CITY, AT ZIP
q�./�A
CONTRACTOR COMPANY NAME APPLICANT NAME �/ OFFICE PHONE
"1-0S'e4so/� J / n `-
MAILING
DkJ,Q �,u�(xtu �- (ZS3 ) z7$- ��y'I-
/
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
Som( h/ /. 9fi/4t"� S r �a � w� yc7 (�T
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER -
9- c S' Z6 Z-BSL /tel / 7 /O S• ( 'Li)) �1r!' - `i/y3
CONTRACTOR'S REGISTRATION NUMBER(copy of card require/9d with each applications EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
All 'L R5 5 / A c, (252) meg- - 7741
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
Soo ( W Z"$ ' -4c Lt./a_ ",Yc,7 ( ) -
RELATIONSHIP TO PROJECT � FAX NUMBER
0 Architect a Tenant i'Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
4 �.� Lra - ( 2 3) 2Z;?--- q 7 4'
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 PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HTGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
i . — . ' •
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. •
TO-AAL
BASEMENT - - -
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICALa
Valuuee`o Mechanical Work $ 3 `/LI ''(J-_
-.. J AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
/ BBQS FANS HOODS(comm<roml WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS I FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shoa<rCombo] SHOWERS WATER CLOSETS trod.) 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
J,_- '`a;y = --r?: _. _ . _ Z '-'DISCWISER/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 th�ty, includ' its„r�p cers a Aia—m.loyees, upon the accuracy of the information supplied to the city as a part of
this application. ` / _lir I / /
NAME/TITLE a Le t� .r/ ,-t fro et, �t.eJ� "e•-cs:2-," DATE G�����(Signature) (Title)
I RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent JORC:ontractor ❑ Architect ❑ Other
S
1
( FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? o YES o NO
{ ZONING DESIGNATION CHANGE OF USE? o YES a NO
t NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? a YES ❑NO
r
Bulletin#100-March 30,24)04 - Page 2 of 4 k\I-andouts-Rcvised\Permit Application