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04-103699 iry df y Community Mechanical Permit #:04 - 103699 - 00 - ME ity Develel Deopment Services 33530 1St Way S Federal Way,WA 98003-6210 Ph-253 661 4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: ODOM Project Address: 915 SW 346TH 55f Parcel Number: 132171 0030 Project Description: Install new gas furnace Owner Applicant Contractor Michael P Odom &Carol A Odom FIRESIDE HEARTH&HOME FIRESIDE HEARTH&HOME 915 SW 346TH ST 7818 S 212TH ST SUITE 109 7818 S 212TH ST SUITE 109 FEDERAL WAY WA KENT WA 98032 KENT WA 98032 98023-8421 (425)251-3921 Mechanical Valuation 1425 Over the Counter Permit Yes Mechanical Fixtures [ _ Description !Quantity Description IQuantitA Description iQuantity [Furnaces I PERMIT EXPIRES March 14,2005. Permit issued on September 15,2004 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. c Owner or agent: �w Date: — t 1 — d y 04 ',{64t(t) ATHIS CARD IS TO REMAIN ON-SITE CITY OF Community Development Inspection iecord Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 04-103699-00-ME Owner: MICHAEL P ODOM Address: 915 SW 346TH ST FEDERAL WAY, WA 98023-8421 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) 0 Gas Piping(4125) 0 Final-Mechanical(4065) Approved Approved to release test Approved By Date By Date By j) Date 4...,./©/ '-' //ea 7r A. oci_ /",i arr of 1iC,/ 7 7 �FeceralW SEP �; tea PERMIT COMMUNITY DEVELOPME. SF MF CO .' 33530 FIRST WAYSO(!]Tf•1, _,�, jp3�'L DE EN FP 253FED6 1ERAL�5 FAX 253-661-4129 AY,WA ,;. _..�.�L 1 AP.PLI CATI O N www dfe]otkderalwaq corn - t / The ollowin• is re•wired in ormation-an inco •lete a.•lication will not be acce•ted. Please •rint le•ib1 (in ink)or . PROPERTY INFORMATION SITE ADDRESS CA 19V (: � W , Si-. SUITE/UNIT ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy leglegaldesrnpoon) PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL 0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide deta`iled�desscriipti\on of work included on this permit onlu) y�. PROJECT NAME(Name of Business or Owner Last Name) PEOPLE INFORMATION PROPERTY NAME 1 {^�1 � *rA �� Pi MARY) { 1-72— OWNER 'Y/.4` MAt ADDRcos svu 3 /� CITY, ATE,ZIP atm( 1,04 qw2,s CONTRACTOR COMPANY NAME L APPLICANT NAME 1�F ICE �aNEE� /�/ Fl'c6 1�I"Gin-M1�/ •t 1f (FKKJP)I�t_/' - �/' 1 G.ii +�MAIL�I+(NG ADDRESS �V CITY, ZIP CELL PHONE l 0`O S, �� 0 JQ�,/�1 /Ij/�� CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER i EXPIRATION DATE FAX NUMBER CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE S b D L L-P / / APPLICANT COMPANY NAM APPLICANT NAME �1c� OFF CE PHONE MAILING ADDRESS �_�%J�� l ' -r, ��Vt� c� Zsl -321 CITY,STATE,ZIP CELL PHONE 1 ' atl'ICI M ' 1,69l8�•V� c H) O S. CJ RELATIONSHIP TO PROJECT �/� FAX NUMBER 0 Architect o Tenant 0 Agent kOther(Describe) feCR-.)V..9.496 --Js -32271 CONTACT NAME PRIMARY PHONE-MAILADDRESS --10- I^ A MP) e„ — - E- AIL ADDRESS LENDER ' Per RCW 19.27.095: Lender information is NAME ([-�1 V1 required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE 'b EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ i SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. 111.#TOTAL BASEMENT i FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE/CARPORT HOW MANY FLOORS? TOTAL.EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED _ 1 **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. MECHANICAL .� Value of Mechanical Work $ I AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS BBQS FANS HOODS(commermal) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS I FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tab/shovwrcombo) SHOWERS WATER CLOSETS broaeq 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. i DATE i 'R I I NAME/TIT = — (Si_I re) (Title) RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent "ontractor 0 Architect 0 Other FOR OFFICE USE ONLY o NEW o ADDITION o ALTERATION o REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES o NO ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES o NO PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? a YES o NO t r Bulletin#100—March 30,2004 Page 2 of 4 k\I-landouts—Revised\Permit Application