05-103893 City of Federal Way Mechanical Permit #: 05 - 103893 - 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: KEIFER �J`
Project Address: 29505 7TH SW Parcel Number: 119600 4380
Project Description: Change out of gas furnace
Owner Applicant Contractor
Terel Keifer GENESEE FUEL&HTNG CO INC GENESEE FUEL&HTNG CO INC
29505 7TH AVE SW PO BOX 18206 PO BOX 18206
FEDERAL WAY WA SEATTLE WA 98118 SEATTLE WA 98118
98023-3528 (206)722-1545
Mechanical Valuation... ........................3000 Over the Counter Permit... .. .... Yes
Mechanical Fixtures
Description Quantity Description Quantity Description 'Quantity
Furnaces 1
PERMIT EXPIRES January 31,2006.
Permit issued on August 4,2005
I hereby certify that the abo - • - ation is correct and that the construction on the above described property and
the occupancy and th- . e will be in ac dance with the laws,rules and regulations of the State of Washington and
the City of Federal ,f ay.
Owner or agent 4 . Date: Sit/4C
/—\ C
f '
`0
THIS CARD IS TO REMAIN ON-SITE
• Y
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-103893-00-ME
Owner: TEREL KEIFER
Address: 29505 7TH AVE SW
FEDERAL WAY, WA 98023-3528
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) cS Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date Byt Date ‘Ci V>
RECEIVED
Fe1
deral Wa Q z— 13
Y 200-
COMMNITYDEVELONBNTSERVICES
PERMIT IT AU C� 4 SF MF COLPL DE EN FP
33325Fru AVENUE •FOBOX 9713 APPLICATION FEDERAL WAY,,WAWA 993063-971d FEDERAL AY / /
253-335-2607•FAX 253135-2609
yauar.dtyofcderalway.com BUI DING DEP I
The (Aloud • is -• fired in ormation-an inco •fete • ••lication will not be acce•ted Please •rint le• •I in or
� �f • PROPERTY INFORMATION
SITE ADDRESS 7L/% 5e)� ` - , - S
SUITE/UNIT#
Q
ASSESSOR'S TAX/PARCEL e / l / ( 7 too - C�f tr.L 0 LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Awadi&Vara&pagcfor lenOUW hal desaip ion)
' ■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING NSIECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onitj
.. .....(fr..4.4.1.4t._e_."
PROJECT NAME(Name of Business or Owner Last Name) AE/fE1€
• PEOPLE INFORMATION
PROPERTY NAME -i �p PRIMARY PHONE r!
OWNER ��1 f-6 0`- (?-5 ) gq/ - . 7 I5—
MAILING ADDRESS
CITY,STATE, P
0209'C 2- j4—t-e s (A.) ;cJwxte q .?-
CONTRACTOR COM NY NAME APPLICANT NAME OFFICE PHONE
( .1qp)7aa, -/S-1/S--
MAILING ADDRESSCITY,STATE,ZIP CELL PHONE
3t I(v S S�— q Sl s-� (,. ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER _ EXPIRATION DATE FAX NUMBER
B L / /' ( )
CONTRACTORS REGISTRATION NUMBER(copy of E required with each application( EXPIRATION DATE
G (e iv e S P ti- '3-7 D Cv / // l 4S—
APPLICANT COMPANY NAi,E APPLICANT NAME OFFICE PHONE
! MAILING ADDRESS CITY,STATE,ZIP — CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
❑ Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME .S (J PRIMARY PHONE E-MAIL ADDRESS •
LENDER _
;J. ;(t _Y ei::Z v „a:d` 1.t17)7.,t,.,:1.1,. ,; NAME
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ "1."
SPRINKLERED BUILDING? ❑YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES O NO
WATER SERVICE PROVIDER O LAKEHAVEN 0 HIGHLINE O TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN O HIGHLINE O 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
NUMBER OF FLOORS MUST= raorosso rorty y'• a.�o fir a
..-
"NEW HOkS 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
Value of Mechanical Work $ 3 7' `")
•
AIR HANDUNG UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODSa
� mmeidaq WOODSTOVES
BOILERS IREPLACE INSERTS RANGES ' MISC(Describe)
• COMPRESSORS RNACES GAS WATER HEATERS
DUCTS OAS PIPE OUTLETS
PLUMBING
BATHTUBS(or7ub/Shower Combo) SHOWERS WATER CLOSETS maks MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS IBathroemsinks VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
•I certify under penalty of perjur(j that the i nforma •n 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 p form the work for which the permit application is made. I further agree to hold
harmless the City of Federal Way as to any claim(1 costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which may be made by any person,including '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 • d employees,upon the accuracy of the information supplied to the city as a part of
this application. ¢¢/q(oc
NAME/T LE / DATE U
(Sign, ., (Title)
RELATI NSHIP TO P: •. T/ ❑ Owner o .ent tractor 0 Architect 0 Other
kcw..t_- - - - ;,,,0 e)i'�5(i)�i ',‘t35Htf',l{C`(c)�€..._ .._ _-•� pi.�'.Vit +d�}.F'.u�l'i 1 i;)Z el'.SDJ!,I .t`' . .. . - _ . ..
tl[ zi 4 ,
ae,�€ Pe, :f�`E,c € p.'fi� n :4 ;(t) y.klfe Ti„1 : _ 401
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Pemut Application