05-102741 City of Federal Way Mechanical Permit #: 05 - 102741 - 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: HOFSTRAND
Project Address: 28701 26TH$. Ave 5 Parcel Number: 746690 0030
Project Description: New gas water heater
Owner Applicant Contractor
Kraig J Hofstrand &Marilen 0 Hofstrand Kraig J Hofstrand Kraig J Hofstrand
28701 26TH AVE S 28701 26TH AVE S 28701 26TH AVE S
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-3305 98003-3305
Mechanical Valuation 800 Over the Counter Permit Yes
PERMIT EXPIRES December 7,2005.
Permit issued on June 10,2005
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: Date: /140/0--‹
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-102741-00-ME
Owner: KRAIG J HOFSTRAND
Address: 28701 26TH AVE S
FEDERAL WAY, WA 98003-3305
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) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By.C. \ DMA-2O
I
i
ptr� l Q. 2 7 qi.
Federal Way PERMIT
COMMUNITY DEVELOPMENT SEPV S SF MF CO Q L PL DE EN FP
J33258TMAVENUE SDU7Tl•1'OBOX l7/. APPLICATION
FEDERAL WAY,WA 98063-9718 r
/ /253-835-2607•FAX 253135-2609 I
www.ciguoffederalway.com
The ollowi • is • ired in ormation-an i c, •fete • ••iication will not be acce•ted. Please •rint le•ibl n or
1 PROPERTY INFORMATION
SITE ADDRESS �G 2O/ .2.6' �K /lii/P --‘ iit. j14, SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acmo•Estates,Lot 1)
(Attach separate page for lengthy heal desaipdonl
^
IA PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 'MMECHANICAL
0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
*v 6-44 bva , zat' r _ -
PROJECT NAME(Name of Business or Owner Last ame) fief"S F{°`
Li PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER K -a i ilv6ira,ra (2-53) 9YS a l a
MAIWNO ADI ESS CITY,STATE,ZIP
'•$7L)6 �' 4'f`v- Feder-Al 1A/0 lam- gems
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Oldric -
MAILINO ADDRESS CITY,STATE,ZIP CELL PHONE
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE - FAX NUMBER
— — —B L / / ( )
CONTRACTORS REGISTRATION NUMBER(copy of card reonird with each application) EXPIRATION DATE
I /
APPLICANT COMPANY NAME APPUCANT NAME OFFICE PHONE
o yt//)P.ADj/ ( )
FWLINO DRESS CITY,STATE,ZIP —
CELL PHONE
(
RELATIONSHIP TO PROJECT FAX NUMB ER
❑ Architect a Tenant a Agent a Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
k0 vt/A.er" _ ( ) -
LENDER 44 ;..,,,,' i::,Z t-4,raa" {'.'i%-tniri:r._r;77, s NAME
a.,r,'-t ,t.I-,a • ..•bto rr.G=,-{C..;45_,,,We
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
i I 4. . III\ PROPOSED USE
ykt I, GASS a.S' t ..• •RAII.T.ALUE`_
VALUE OF PRO:40: 0 WO•+
SP• t• ERED B -1 DING? a YES a NO ' t• SUPPRESSION SY- •:4, PROPOSED/REQUIRED? ■ ••-_ a NO
WATER v CE PROVIDER a LAKERAVEN a HIG:1 I 0 TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION • EXISTING P• • '•SED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEME
FIRST - •
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 0
R7QenR0 PROPOSED TOTAL • ry IMAM NUMBE F FLOORSSi
"NEW HOMES ONLY'* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type o • re to be instal=•br elocated as part of this project. Do not include existing factures to remain.
MECHANICAL
Value of Mechanical •rk $ 0
•
AIR HANDLING UNITS EVAPORATIVE COOLERS OAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS mmad.q WOODSTOVES
BOILERS • FIREPLACE INSERTS RANGES MISC(Describe)
• COMPRESSORS FURNACES / GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS I
PLUMBING
BATHTUBS(orT4b/Sbo.ercombo) SHOWERS WATER CLOSETS poet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(e.ou.om salmi VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify wider penalty of perjury that the ormation 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 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 � IPiller( DATE eC.,P D
(Signs re) (Title)
RELATIONSHIP TO PRO D- a 0 er ❑Agent a Contractor ❑Architect 0 Other
,ea)e)E'd(e)�F ''1t'!tiD).d',tiC?(4 :E
). .., •-- '• V,V1,1' - - 40:Ao..'u't
$oE 1t,c o7 �E,a, �:: (fi ; +:)(c ,,TI,e;
5)�:y(c)4`k'e(c) f •0-4„ ;(0_,f.: 6'-
;I ;'( ,�[)I);J r:+:t-0-6f Olt f.7,4 �}=,1 .�k:1 16 [I i!J stty !�1 [irr _, f n ;re) .•
:'z) r+i) S(c:); i?,¢Nr :d ,.r.i7:Js
Bulletin#100—January 7,2005 Page 2 of 4 k Handouts\Permit Application