05-104223 o
P". .
City of Federal Way Mechanical Permit #: 05 - 104223 - 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: BENNETT vet,
Project Address: 31029 7TH1SW Parcel Number: 555770 0160
Project Description: Replace gas furnace and hot water tank.
Owner Applicant Contractor
LYNN BENNETT AFFORDABLE GAS SERVICE AFFORDABLE GAS SERVICE
31029 7TH AVE SW 4864 NE SHELTERED BAY LN 4864 NE SHELTERED BAY LN
FEDERAL WAY WA 98023 HANSVILLE WA 98340 HANSVILLE WA 98340
I ill/^ I/0 0 S.."' (360)638-0091
Mechanical Valuation . . . .. . . ...5800 Over the Counter Permit.. ... ........ Yes
Mechanical Fixtures
Description _!LQuantity Description 1Quantity Description . 1Quantity
Furnaces it 1
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 10)and must comply with FWCC,Chapter 22,
Article XIV"Critical Areas" and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES February 15,2006.
- 't issued on August 19,2005
I hereby certify that the above info ••• . •• that the construction on the above described property and
the occupancy and the use wil,:- • . • •awe with 1- laws,rules and regulations of the State of Washington and
the City of Federal Way. I
Owner or agent: .L— ` _ Date: ( F- l 5 (23
7--
„
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104223-00-ME
Owner: LYNN BENNETT
Address: 31029 7TH AVE SW
FEDERAL WAY, WA 98023-4604
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.
❑ Mechanical Rough-in(4165) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By G Dated •f S- O a"
'a deral way PERMIT RECEII{ Dc-- _ .y. .-- )--3
COMMUNITY DEVELOPMENT SERVICES SF MF CO( LPL DE EN FP
33325 Ilm
DERALWAY,WA7I'PO971 8716 APPLICATIONAuG 19 -zoI
FEDERAL WAY,WA seosm-sns /
253435-2607•FAX 253-835.2608
www.cltuoffederalwau corn �'r
The o , is -, -, orination-an ,lete y,licallon Sill i.. ..?a:5 _ . . , ' -, (in ink)or ,,
Dig
e P�
• PR�OPERTY INFOR`LATIO.\
SITE ADDRESS 3 I Di — A S• ". SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# — — — LOT SIZE(sn
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING P ECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PRQJWI DESCRIPTION(Provide detailed description of work included on this permit only)
ecpi _e_e rna e wi , ars 4-n riPar? Si-and, arc/ AtAXo80 _90%
5 e, S c gas -Furnace . f e Q wailer- heQ vv i �
c2 Bat Yd ` hiV, 50 altnr) ire c - Ve- n Qs
via ler -er 9
PROJECT NAME(Name of Business or Owner Last Name) 3Y1 Ike
U PEOPLE INFO'. ,1\I ON
PROPERTY NAME PRIMARY PHONE
OWNERL
WIG 2enhetf (2=53) l4 1 - 4�
MAII)IG ADDRESS CITY,STATE,ZIP
31 02-61 —74% Avc S)Af CcAcroi v\10,14 , v )A g21)23
CONTRACTOR COMPANY NAME.a APPLICANT NAME OFFICE PHONE
� 61 a S)erV v& i, f - , 1A4Sm (app)63 -009 i
MAILING ADDRESS i
IN 1 NI E/�.�1 1..� � A. Si �7E� �� C` 'l� CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE EXPIRATION DATE FAX NUMBER
2 0_-Q -L Q 2 %. (a (e-B L 12- / 31 /2-005 (3(00 ) 0 38' - 0
69 Z
CO 5REGISTRATIONNUMBER(cepel card with each application) EXPIRATION DATE
A � � � g � SOl � �� /n
/2/1/'1/
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE �'�-�O
( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER PerRCW 19.27.095: Lender information is NAME
required(fprrijeet vain,exceeds$6,000
MAILING ADDRESS CITY.STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORE $
SPRIINELERED BUILDING? 0 YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑BIGHWSE ❑TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑LAKEHAVEN o BIG/MUM 0 PRIVATE(SEPTIC)
r
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
TIURD
FOURTH
ADDr11ONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS mnING rworowo TOTAL 'OTALwTus TOTAL row
wareTOTAL Or
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of jixtu a to be installed or relocated as part of this project Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS _ HOODS leatorn.cOn HOODSWOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS I FURNACES / GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS for'Nb/Shower Combo) SHOWERS WATER CLOSETS(>buW MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
IAVS amuse..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 wry knowledge,and further,that I
am authorised by the owner of the above premises to perform the work for which the permit application is made. :further agree to hold
harmless the City of Federal Way as to any claim$ncluding 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 flied 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. ,�o) �n/, ,�/I Q Q�
NAME/TiTIL v� J� AA t 11Z �W /)"`U-/1 GLn DATE O-(3'
—OS
(I*' ) / � le)
RELATIONSHIP TO PROJECT 0 Owner ❑Agent poC;ontractor ❑Architect 0 Other
FOR OFFICE USE ONLT
a NEW ❑ADDITION ❑ALTERATION ❑REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑TES ❑NO BASIC PLAN? ❑TES a NO
ZONING DESIGNATION CHANGE OF USE? a TES ❑NO
NEW ADDRESS REQUIRED? ❑TES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? o TES o NO DEMO PERMIT REQUIRED? ❑TES ❑NO
Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Pennit Application