05-104592 � 1
City of Federal Way Mechanical Permit #: 05 - 104592 - 00 - ME
Community Development Services
P O Box 9718
Federal-(25Way,WA 98063-(253 Inspection request line: (253) 835-305€
Ph�(253)835-7000 Fax:(253)835-2609 P 9
Project Name: TAYLOR
Project Address: 1330 SW 353RD S1 Parcel Number: 502860 0970
Project Description: Installation of gas furnace.
Owner Applicant Contractor
Sue Taylor RELL'S REFRIGERATION RELL'S REFRIGERATION
1330 SW 353RD ST PO BOX 18422 PO BOX 18422
FEDERAL WAY WA SEATTLE WA 98118 SEATTLE WA 98118
98023-6948 (206)484-6466
Mechanical Valuation 3100. Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description Quantity Description Quantity
Furnaces 1
PERMIT EXPIRES March 8,2006.
Permit issued on September 9,2005
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 Vv.
3401-4.., àLt
Owner or agent: 6'• j{ le Date: `50 y0� ltd
J �
I
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104592-00-ME
Owner: SUE TAYLOR
Address: 1330 SW 353RD ST
FEDERAL WAY, WA 98023-6948
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) 1,11 Final-Mechanical(4065)
Approved Approved to release test Approved
A,�
By Date By Date B 441: Date (14 b�
I a
...A _ RECEIVED
Federal Way —0—— 2;2_
COMMUNITY DEVELOPMENT SERVICES P E R M I T S E P 0 9 2005 SF MF COEL PL DE EN FP
3332E AVENUE SOUTH•PO BOX""
FEDERAL WY,WA 98063-9718 APP LI C AA
• E DE RAL VAR( / I
253-835-2607.FM 253.835-2609 •I I N G DEPT, •
f
yww.dfvoffedemfway.canl J
The oilowi • is ired in ormation-an Inco •fete • ••lication will not be acce•ted. Please •rint le• •1 in or •e.
/� Q - PROPERTY INFORMATION
SITE ADDRESS I�J D S SVC 353 ' 0 I 1 , _ ` vLi \c... SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
GIS ra&F•Defor 18n80W& a► W
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ LUMBINc ,�_ T�,I RANICAL
0 DEMOLITION*ELECTRIC . NGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed • - - • of work included on this permit only)
/l
a
PROJECT NAME(Name of Business or Owner Last Name) t'1 lc S ���`: .-...\—.`,-0‘...i IA-c-A- �"71.6.. , ..Ls -
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE83S-
`
OWNER 0 JC a.1t0Y (5,3) �'3S- 11(er
MAILING ADDRESS
ZIP
1330S� 3S3 .Of ST l VLIVIA 5 $o9-i
CONTRACTOR COMPANY NAME ,ABBLICANT NAME
NE
gett's 141-.-/-:, �' I4rec1.r 4.'e0, Si- - (o')G`( 't -t�Yt�4
MAILING ADDRESS `1 2 CITY,STATE,ZIP CELL PHONE
P o F e WAY BUSINESSIna/
NUMBER cctet a 11 8 (9%1/4e) Lt .- LI V e
EXPIRATION DATE FAX NUMBER
- - -B , i,...ti_
6j/ 9 / 9 ) ( ) -
CONTRACTORS REGISTRATION NUMBER(copy of card r - 'J(� application) EXPIRATION DATE
C-oP F - E- L-'- /2- Aq(v l T &/ // /otoo
APPLICANT PANY NAME whiz APPLICANT NAME OFFICE PHONE
ADDRESS _
CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
a Architect a Tenant a Agent a Other(Describe) ( ) -
CONTACT NA PRIMARY)PHONE E-MAIL ADD
C4-cz + t.\ J �.t r. (o1O(o ) �t `I - 4y�4 rebs�c a Co►:csy1*.yitr*
LENDER ,. ;1. ,r• ,u:= ,;,,r.e.- g4171rrA,a.gra,. x /�NAME 1 J
MAILING ADDRESS CITY,STATE,ZIP
• ■ DETAILED BUILDING INFORMATION
EXISTING USE in/a PROPOSED USE ►a"� t t-
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 3) ,/C-C-' • C)C)
SPRINKLERED BUILDING? a YES XNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES A NO
WATER SERVICE PROVIDER LAKEHAVEN 0 HTGHLINE
0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER LAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC)
It
•
- 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
NUMBER OF FLOORS =sum
PROPOSED TOTAL
**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 n, r
Value of Mechanical Work $ d
•
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS X REFRIG.SYSTEMS
BBQS FANS HOODS(c*mmaa.y WOODSTOVES
BOILERS • FIREPLACE INSERTS RANGES ' MISC(Describe)
• COMPRESSORS X FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(miles MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sulu) 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 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 officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE pS"^ '
.a• ( JJL C)-n `(i1C' DATE 0
L
(Signature) (Title)
RELATIONSHIP TO PROJECT a Owner a Agent ikContractor a Architect ❑ Other
•' E '.'f •,`a e'€)E�r`(c)jj .',a l,.'S (l,\I (iNg .._ -4:.1/.,) .%!;• q,;,)4.,‘4[•t• 11s) cFtfi. ',I 3Mt`•
._i0;1!,�c;ic, zi:t;it,� e);lt,•f? •,ii