05-103656 f •
City of Federal Way Mechanical Permit #: 05 - 103656 - 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) 835-305C
Project Name: BROWN
Project Address: 2162 SW 322ND Si' Parcel Number: 932430 0010
Project Description: Remove existing gas furnace&replace with new gas furnace
Owner Applicant Contractor
Raymond E Brown &Patsy Brown HERITAGE ENTERPRISES INC HERITAGE ENTERPRISES INC
2162 SW 322ND ST 9001 PACIFIC AVE 9001 PACIFIC AVE
FEDERAL WAY WA TACOMA WA 98444 TACOMA WA 98444
98023-2516 (253)539-8709
Mechanical Valuation 2348.90 Over the Counter Permit Yes
Mechanical Fixtures
Description IQuantity 1 Description Quantity Description Quantity
Furnaces 1
PERMIT EXPIRES January 22,2006.
Permit issued on July 26,2005
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 Way.
Owner or agent: pais ,( Date: 741(,S
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ATHIS CARD IS TO REMAIN ON-SITE
CITY of Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-103656-00-ME
Owner: RAYMOND E BROWN
Address: 2162 SW 322ND ST
FEDERAL WAY, WA 98023-2516
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) 0 Gas Piping(4125) 14 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date B8t/ Date 1HeK
1071,63-1335-•?a 01
REC°VEa
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Federal Way 200 - `"� �
COMMUNITYDEVELOPMENTSERVICES
PERMIT RM I`I` jut_ 2 s SF MF C i( �I EL PL DE EN FP
33325 m AteiMS SOUTH•PO BOX 171: ,
FEDERAL WAY,WA 910634715 AY
A P P LI C AT
253435.2607•PAX 253435.2609 �6I / /
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www. hr Thds u- BU► DING DEPF•FEDERAL-
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The o ilowi • is -• fired in ormation-an i c•hj j,.fete • • •lication will not be acce•ted. Please •rint le•ibi in in or p .
/ r 4 PROPERTY INFORMATION
SITE ADDRESS A16 2 3 Cv '
3 i e- SUITE/UNIT
ASSESSOR'S TAX/PARCEL# - _ _ _ _ LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot I)
(Mad'Womtepes•firSin"War e w4,uo„1
' in PROJECT INFORMATION
TYPE OF PERMIT • 0 BUILDING ,1J PLUMBING XMECHANICAL -
• 0 DEMOLITION")`LECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des ',lion of work included on this permit only)
�i• , •
- / ', /..:t /„..., ... i/e,., . ,:[t.it L:-: � / .
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PROJECT NAME(Name of Business or Owner Last Name) .
• IN PEOPLE INFORMATION
PROPERTY NAME • PRIMARY PHONE
OWNER MAILI OAI R�" (2S 3) 83g- • !•733
CITY,STATE,ZIP
g21(0.2 S cv 3.� - AL � - i li/n r'ke.2 3
CONTRACTOR •• PANT NAME APPLICANT NAME OFFICE PHONE
9
1 a - n C�.
Q.49-,. s L ¢ (12 0) 9
a- . .-.2az
/
, 1O rt.— ' STAZP CELL PHONE
/ .1 ,'f/ /` TEgii d3jl014ZYOOF�EDRBUSINESS LICENSE NUMBER , XIRA). �-.42-1 Q 2_6 4 2- . / /
(.2S3)5-39-SPo9
CONTRACTORS REGISTRATION NUMBER(e.Py.f esti requ red with each appfoatiea) EXPIRATION DATE
14-e g T s _I4 1' L:1 .e 4)7/ dee /oG
APPLICANT
irjr4:42diatE n CANT OFFICE PHONE
oma' ' (253) y?a=wattMAILINSE,ZIP - CELL PHONE
Gvf- 9t3 yyif ( ate 377 /a6,/7
TIONS P TO P ECT ` FAX NUMBER
n
o Architect o Tenant o Agent Other(Describe)F.1 PL p�!'6g (a r3).5.339- 7&
CONTACT7: PRIMARY PHONE B MAIL ADDRESS
,aiAg& (ate) gaa,- ?- it .
LENDER :& ,.d;i; E,. ; ,arra- Etat,,r.-.;a.1r NAME
,d:•d«t! ,!t-,J4 •I' -'4'- - r.r.-t;C :,•,u,,,
MAILING ADDRESS CITY,STATE,ZIP
• • . •• • . • • • • ■ DETAILED BUILDING INFORMATION •
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED W a RK -e1 2 U CP' '
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQ I :- • • - 'I>
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE 0 TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE . a PRIVATE(SEPTIC)
fir 1.4
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. ' SQ.FT.
BASEMENT •
FIR • •
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
•
DECK(COVERED?)
GARAGE 0 CARPORT 0 '
•
NUMBER OF FLOORS =nowrRoroseo mem
***NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ —
• FIXTURES
Indicate number of each type offacture to be installed or relocated as part of this project Do not include existing fixtures to remain.
MECFIANICAL
Value of Mechanical Work $
•
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(csd.,dq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES ' MISC(Describe)
• COMPRESSORS - '• 1FURNACES OAR WATER ItEATEFtE"
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(.r7ub/Shower Combo, SHOWERS WATER CLOSETS(dues MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
OAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS - HOSE BIBBS
LAVS VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK V
•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 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 claims,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 4,
, '//sf' p ��� U SATE 7 per/S~
(Signature)
m c)
RELATIONSHIP TO PROJECT a Owner a Agent 0 Contractor 0 Architect kOther cjpL,'' rif.
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cp,i t,Llt4c,• 4.Pv11.f €F tt...: "[r"a • ;0) • ' a:±=1(c ,Te,;� r' rry. 40
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in :fr' ;, r.� -Tr-cV .
' +`u;e+ '1.,plp r.:(4i' 4e ;:156p,-:(0 Z
•
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Bulletin#100—January 7,2005 Page 2 of 4 klHandoutsTemhit Application