11-104595 Mechanaical
City of Federal Way • •
Community&Econ. ev.Services
33325 8th Ave S FILE Permit #: 11-104595-00-ME
Federal Way,WA 98003
Ph:(253)835-2607 Fax(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: EDWARDS a
Project Address: 1134 SW 296TH ST Parcel Number: 119600 4830
Project Description: Remove and replace oil furnace
Owner Applicant Contractor
, PETER N EDWARDS SARAH TURNER GLENDALE HEATING&A/C
1134 S 296TH PL GLENDALE HEATING&A/C GLENDHA053Q2 (11/2/13)
FEDERAL WAY WA 98023-3456 12462 DES MOINES WAY S 12462 DES MOINES WAY S
SEATTLE WA 98168-2266 SEATTLE WA 98168-2266
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Mechanical Valuation 5001.08 Is this an Online or O.T.C.application? Yes
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Furnaces 1
PERMIT EXPIRES Monday, May 14, 2012
Permit Issued on Wednesday, November 16, 2011
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
ando. tecitYof,jeral
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Owner or agent: Date: t
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THIS CARD IS TO MAIN ON-SITE
CITY OF4111&' • Construction I ection Record
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT #: 11-104595-00-ME Address: 1134 SW 296TH ST
Project: PETER N EDWARDS FEDERAL WAY, WA 98023-3456
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 Byfif Date /0,--30 r j f
CI Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
�.�A _ 13 3 3 -- 3
DIVED PERMIT 0
COMMJNITYDE DEMENT SERVICES F CO ME EL PL DE EN FP
33325 8m AVENUE SOUTH•FY)BOX 9718
FEDERAL WAY,WA 98=1 Q n v a'', APPLICATION
753-835-2607•FAX 253- / /
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The f , g0Fe irnation-an incomplete application will not be accepted. Please print legibly(In ink)or type. ,$wt
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• PROPERTY INFORMATION
SITE ADDRESS 1405 SW 296th st SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 5153200036 _ __ __ LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descrynon)
Mil PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
RESIDENTIAL REROOF. REPLACE 35.7 SQUARES OF ROOFING. REPLACE 5 SHEETS DECKING.
NO STRUCTURAL CHANGES
f}° i' asat d-e
PROJECT NAME(Name of Business or Owner Last Name) John Bronger
III PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER John Bronger ( 253 ) 6537033-
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
1405 SW 296th st Federal Way, WA 98023
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Home Depot At Home Services ( 800 ) 381 -5699
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
140 County Line Rd#101 Pacific WA 98047 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
\. /3(11Alt.
20-03-101448-00-B 12/31/2011 ( ) -
CONTRACTOR'S REGISTRATION NUMEER EXPIRATION DATE E-MAIL ADDRESS
HOMED**972RQ 02/01/2011
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Northwest Permit Inc. Naida Khan ( 360 ) 945-2787
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1345 Gulf Road Point Roberts, WA ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant VI Agent 0 Other (360 ) 945-2091
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT Naida Khan/ Northwest Permit (360 ) 945-2787 naida@nwpermit.com
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE Residential PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 15663.42
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
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• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS MATING rwPOU*D TOTAL SOTALsffiRTh n
TOTAL torosrar 1OAw
T
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHAMCAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS)Commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/shower Combo) LAVS(Bathroom Sulk.) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the best of my
knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local,state,or federal laws regulating construction or environmental laws.
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, 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 pa applicatio
SIGNATURE: (36;e DATE 1 I2([1/2-6
d/or Authorized Agent
FOR OFFICE USE ONLY
o NEW ❑ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? o YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100—January 1,2008 Page 2 of 4 k\I-Iandouts\Pennit Application