04-105134 4 4
City of Federal Way Mechanical Permit #: 04 - 105134 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305C
Project Name: FOWLER Avt
Project Address: 31529 8THAS Parcel Number: 858800 0085
Project Description: Replace existing gas furnace with new gas furnace
Owner Applicant Contractor
Teresa M Fowler GLENDALE HEATING&A/C GLENDALE HEATING&A/C
PO Box 58463 12462 DES MOINES WAY S 12462 DES MOINES WAY S
SEATTLE WA 98168-2266 SEATTLE WA 98168-2266
PO Box 58463 !Seattle,WA 98138-1463 (206)243-7700
Mechanical Valuation 3997 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description IQuantity Description 'Quantity
Furnaces 1
PERMIT EXPIRES June 18,2005.
Permit issued on December 20,2004
I hereby certify that ,- . .• - information is cone • d th/ ru1es
+7e construction on the above described property and
the occupancy and ,-` - 1 be accordance 't and regulations of the State of Washington and
the City of Federa /
/2 -
Owner or agent: `iii//rte I Illi L�,� Date:
2--0 ' 26°/
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-105134-00-ME
Owner: TERESA M FOWLER
Address: 31529 8TH AVE S
FEDERAL WAY, WA 98003-5303
This art 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 Date Oy/eAr
•
Fede Way �' -. 1 L3 Li
'COMMUPSTSDEVEI.OPMF.NTSERVICES PERMIT SF MF CO ME EL PL DE EN FP
53900 FIRST WAY SOUTH•l0 BOX 97.11
253-6DE6S FAX 253661-1129 WAY,WA 98063-9711 APPLICATION
wwu.dtuoffederofwancor, p
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The ollowin• is . ired in ormation-an into •lete a••lication will not be acce•ted. Please . nt
PROPERTY INFORMATION or �. .
1
z
SITE ADDRESS i I'5 7m ` $�y� 6D , t I q SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# X g V - -(V V 0 x� LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) LI 3 l irrer,,t t NE Q
(Acaah separate page lac langthy!pal d..vipeon)
PROJECT INFORMATION
TYPE OF PERMIT O BUILDING 0 PLUMBING (MECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PRO T DESCRIPTION(Provid detailed descriptio of work included on this permit only)
r,e�to gi5�i- 01,c14 1 arrit(ti L#'I o„14,1) aft26` coria
PROJECT NAME(Name of Business or Owner Last Name)
PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE /�
OWNER Tbr\14ti r�ull�r (21)10 ) f i 146;7
MAILING ADDRESS C ATE,Zh
31 A� f Pll So I Wok INA- C. f 00 ;
CONTRACTOR CO PANY NAME L. r AP CANT NAMEOFFICE PHONE
MAILINGI fi At ',/1111 1 e-10)4A C,Io h 4 ( 2rib) aq3- DOa
C � i�ATE,, IP
CELL PHONE
1lt �'` ; i' N.a41()r(d, I. N111, WA 'f ((pf ( x06) ID19D- Z(o f)
CITY F FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
a 9_-_g g -L a ta Q -B L I z / 3i 'o Li ( ao6 ) )43 gU4 )
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
G. L E 1V .� -t1 .6tZ i (2_ / )I / D ? / D 1
APPLICANT CO P NY NAM r APP,�C•AqT NAME OFFICE PHONE
thdait � �1h 1rtg4 LID Pi ( ?A) * - 1)015
MAIL NG ADD CELL PHONE
lZub2- N iH 1y1,1y I ✓Y+ .b'{ c .itT WV R� 6f ( 200 lobo -Z/v 1
RELATIONSHIP TO P ECT / FAX NUMBS
❑ArchitectN 0 Tenant ❑* nt ❑ Other(Describe) ( ) l L .5 - Z i j
CONTACT NAME G
PRIMARY PHONE E-MAIL ADDRESS /1
• lit Der1i i ( )i) ) WOO- 2
LENDER . :$r RC .19.27.095:•,Lender Information!s- , NAME
',,regWrdred'i 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? O YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER Cl LAKEHAVEN 0 HIGHLINE O TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
}
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL INNITwa TOTALraoroRn TOTAL wSTat]AND FllOMetCD
"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 (�f
Value of Mechanical Work $ ! "l"i 1. 7
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercuq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(crTub/sh.<rcomtol _ SHOWERS WATER CLOSETS troaeil 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. nV�.yl
NAME/TITLEICOO ,& DATE )i 7 1 o LI
ignature) (Title) `
RELATIONSHIP TO PROJECT 0 Owner ❑ Agent ❑ Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? a YES ❑NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application