04-104925 .
r •
City of Federal Way Mechanical Permit #: 04 - 104925 - 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: MELIN ,,r`
Project Address: 31722 49TH/SW Unit5-A Parcel Number: 864800 0130
Project Description: Replace existing gas furnace.
Owner Applicant Contractor
Shirley Jo Melin GLENDALE HEATING&A/C GLENDALE HEATING&A/C
31722 49TH LN SW#A 12462 DES MOINES WAY S 12462 DES MOINES WAY S
FEDERAL WAY WA SEATTLE WA 98168-2266 SEATTLE WA 98168-2266
98023-2087 (206)243-7700
Mechanical Valuation 2349 Over the Counter Permit Yes
Mechanical Fixtures
Description ,Quantity Description 1Quantity Description Quantity
Furnaces 1
PERMIT EXPIRES June 4,2005.
Permit issued on December 6,2004
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.
Owner or agent: \-v1 z Date: lA-0 44" - p ci
THIS CARD IS TO REMAIN ON-SITE .s' •
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104925-00-ME
Owner: SHIRLEY JO MELIN
Address: 31722 49TH LN SW Unit 5-A
FEDERAL WAY, WA
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 FL./ Date /-
• ECElVEQ) - 0 .,
Federa�,Way PERMIT
COINUN DEVE1DP B:NrSERVICES ,,t SF MF CO L PL DE EN FP
33530 FIRST WAY SOUTH•FO BOX 97.18 0 6 200
5AY,WA 98063-9718 3-66 RAL_5•FAX 253661-4129 A P P L I C AT I
tw,a,.92.w►tgbra�ta_skism CITY OF FEDERAL Ay _ / /
The o llowi • is re•uired in ormation—an Inco •fete • ••lication Will BUILDnot be aGEcee%ted. Please • nt le• ,
or i• .
PROPERTY INFORMATION
SITE ADDRESS 3/7aa LI tat, 5_ td
) - � ( SUITE/UNIT��
(
ASSESSOR'S TAX/PARCEL# S. P =1 60 0 / -j 0 LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
Plum*separate page For IvnWr legal deaaipcioaj
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 1;
•
PROJECT FLOOR AREAS
- — — — —
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ,FT. TGTAL�
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL cwSTora TOTAL PROPOSED TOTAL MOST=AND PROPOSED
**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 uuq
Value of Mechanical Work $ L , 3 T
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercul) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS I.-----FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(.rw
Tab/shoer combo) SHOWERS WATER CLOSETS Relict) 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 t iance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this applic• '• '
NAME/T , - / . ....JI!/ DATE
al—) ()Li
(Stnature) (Title)
RELATIONSHIP 0 PROJECT 0 Owner o Agent ❑ Contractor ❑ Architect 0 Other
FOR OFFICE USE ONLY
a NEW a ADDITION a ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES o NO
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Bulletin#100—March 30,2004 6 Page 2 of 4 k\Handouts—Revised\Pcrmit Application