05-103416 City of Federal Way `r Mechanical Permit #: 05 - 103416 - 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) 835-3050
Project Name: HURLEY
Project Address: 27834 25TH Z Dr S Parcel Number: 757561 0660
Project Description: Gas furnace changeout
Owner Applicant Contractor
Kathleen Hurley AAA HEATING AND A/C AAA HEATING AND A/C
27834 25TH DRS 11921 SE 212TH PL 11921 SE 212TH PL
FEDERAL WAY WA KENT WA 98031 KENT WA 98031
98003-6930 (253)630-9224
Mechanical Valuation 2684 Over the Counter Permit....... Yes
Mechanical Fixtures
Description Quantity Description IQuantityj j Description Quantity
Furnaces 1
PERMIT EXPIRES January 10,2006.
Permit issued on July 14,2005
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 with the laws,rules and regulations of the State of Washington and
the City of Federal Wa
Owner or agent: XQl r/4!11y Date: iA`���
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community'Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-103416-00-ME •
Owner: KATHLEEN HURLEY
Address: 27834 25TH DR S
FEDERAL WAY, WA 98003-6930
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 By3Date 9- 6 -
•
I
Y
RECEIVED
JUL 1 4 2005CITT OF _ - 1 9 _tk
Federal Way CITY OF FEDE PERMIT SF MF CO ID L PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES�j�ILO G RAS VI/
33325 8T''AVENUE WA 9 A.
PO BOX 971 )N Dip LI CATION
O N - /
FEDERAL WAY WA 98063-9718
253 835 2607•FAN 253 835 2609
.eu,L,-I:0oylecleruitrnt�_cuui
The ollowin• is re•uired in ormation-an incomplete application will not be acce•ted. Please •rint le•ibl (in ink)or t pe.
n �j [� ■ PROPERTY INFORMATION
t' '
SITE ADDRESS 7 D 2-1 - 2$ S F e,AQ w7- c`SUITE/UNIT M
ASSESSOR'S TAX/PARCEL# _ _ LOT SIZE(s_J)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach aeparale pageJor lengthy Legal deac'rlplforr)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING ir"MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Prouiderdetailed description of work included on thus permit only)
ewe
75,
-p,roc.c-c__.
PROJECT NAME(Name of Business or Owner Last Name)
• PEOPLE INFORMATION
PROPERTYPRIMARY PHONE
(
OWNER NAME (7S3) 831 -Itrl S
MAILING ADDRESS' CITY,STATE.ZIP
77g34 - 2644' D S 're- WA ct8 003
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
AAA HEATING & A/C ( 253) 630-9224
MAILING ADDRESS CITY,STATE.ZIP CELL PHONE
11921 SE 212th PL KENT WA 98031 ( ;)
CITY OF FEDERAL.WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ I ( )
-20 E}11-f1- 54OP"RT- - - -- B L 253 -190W E54
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXP ON A E
AAAHTRI971LW 6/49/06
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
SAME AS ABOVE ( ) -
MAII.ING ADDRESS CITY,STATE,ZIP CELT.PHONE
RE!Al IONSH IP 10 PROJECT ( FAX NUMBER
0 Architect ❑Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAM �p5I- PRIMARY PHONE
(RICrgo) 7CS ./V/
E-MAIL ADDRESS
LENDER Per RCW49.27.095:
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 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
Al*
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
Sg.FT. S9.FT. Sg.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT❑
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
1**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $ i)V"I
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS ve FIREPLACE INSERTS RANGES _ MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tib/ShowcrCmnbo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sins) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certunder 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 e city,including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this applicatio r
NAME/TITLE DATE '1 1 14(DI(
(Signature mile)
RELATIONSHIP 0 P' • ECT 0 Owner ❑Agent /Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
u NEW u ADDITION u ALTERATION u REPAIR u TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION CHANGE OF USE? ❑YES a NO
NEW ADDRESS REQUIRED? c YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permit Application