05-104919 •6 . ►
City of Federal Way Mechanical Permit #: 05 - 104919 - 00 - ME
Community Development Sennces
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: KAUER
Project Address: 122 S 296TH PI Parcel Number: 718300 0030
Project Description: Gas furnace changeout
Owner Applicant Contractor
Sheila R Kauer Sheila R Kauer Sheila R Kauer
122 S 296TH PL 122 S 296TH PL 122 S 296TH PL
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-3626 98003-3626
Mechanical Valuation 2800 Over the Counter Permit Yes
Mechanical Fixtures
Description liQuantity Description Quantity Description Quantity
Furnaces
I
PERMIT EXPIRES March 22,2006.
Permit issued on September 23,2005
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 a laws,rules and regulations of the State of Washington and
the City of Federal Wa
Owner or agent: Date: ,�� ' I _
THIS CARD IS TO REMAIN ON-SITE
CITY OF A. Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104919-00-ME
Owner: SHEILA R KAUER
Address: 122 S 296TH PL
FEDERAL WAY, WA 98003-3626
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) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By �- Date3• ( 7 • OO
A • . . 05-i - 10c
Federal Way — -- 1.2 .� i_
33325 VW AVENUE
SOU171NP
�EGEI\!E' PERMIT SF MF CO ME EL PL DE EN FP
333258TMRALWA .WA9.rpBOX 9719718 �ppLICATION
FEDERAL WAY,WA 98063-9718
253-835.2607•FAX 253435-2609 S E p 2 3 _ .
www.dtuefederahaay.a,n
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The ollowi • is re; Y
..az► V:' �%_Agit{ o,y•iete . ••libation will not be acce•ted. Please •rint ie• •i n in or
Imo' PRO�PERTY INFORMATION
SITE ADDRESS \C_. g...., 1 .kk V ` 1 V\�J SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Asad,separate page far lengthy legal desai
1IY1 PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING siNIiECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTI (Prouide detailed description of work included on this permit onlgj
PROJECT NAME(Name of Business or Owner Last Name)
N I PEOPLE INFORIILATION
PROPERTY NAME ' PRIMARY PHONE ii fnf 'Q
OWNER `( \\� Vo j )� \ .M(o&
MAILING ADDRESS Cl STAT ZIP 4.\.....,..... i.,i\oi,‘
,,,,,,\scs,., s
CONTRACTOR MPANY NAMEAPPLICANT NAME
OFFICE PHONE
MAILING ADD � CITY,STATE,ZIP CELL PHONE
(
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER _ DATEF
EXPIRATION FAX NUMBER
_B. L / / I ( ) -
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application' EXPIRATION DATE
/ /
APPLICANT MPANY NAMEAPPLICANT NAME OFFICE PHONE
�� l -
CITY,STATE,ZIP -
CELL PHONE
1
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant ❑Agent 0 Other(Describe) ( ) _
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
LENDER ,_ ;z;,.-. ,,•hz NAME
11,*(1- 1]frT;4(•,:i,14. ,t,
MAILING ADDRESS CITY,STATE,ZIP
:1 DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $S VALUE OF PROPOSED WORK aS C.
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOS
• F`D/REQUD2ED? ❑YES 0 NO
WATER SERVICE PROVIDER a LAKEHAVEN a HEMLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH • .
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
TOTAL
NUMBER OF FLOORS ctasrwO PROPOSE, -. u 4.:
.
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Ur
FIXTURES
Indicate number of each type offixture to be instal:• • 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(C.mmeretae WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS ">C FURNACES OAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(.r7ub/Shower Combo) SHOWERS WATER CLOSETS(toRetI MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks, VA UUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
•I certify under penalty of perjury that t ormation furnished by me is true and correct to the best of my 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. 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 o cars and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLEDATE 9
13.4o
(S 2LP
(Title)
RELATIONSHIP TO PROJECT ❑ Owner a Agent ❑ Contractor a Architect a Other
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application