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04-104339 • City of Federal Way Mechanical Permit #: 04 - 104339 - 00 - ME Community Development Services P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)535-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050 Project Name: MYERS poi, Project Address: 29835 11TH/SW Parcel Number: 195460 0080 Project Description: Replacing existing oil furnace with new gas furnace,including approx.30 lineal feet of gas piping, stubbing out gas line for future gas logs. Owner Applicant Contractor David B Myers David B Myers David B Myers 29835 11TH AVE SW 29835 11TH AVE SW 29835 11TH AVE SW FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA 98023-8210 98023-8210 Mechanical Valuation 1800 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description 1Quantity Furnaces 1 Gas Piping 30 Number of Gas Outlets 1 PERMIT EXPIRES April 19,2005. Permit issued on October 21,2004 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. )114r4"."-= n,, /okOwner or agent: '9[4`11,'9[4`11,41,//��0�` - Date: O THIS CARD IS TO REMAIN ON-SITE • CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 04-104339-00-ME Owner: DAVID B MYERS Address: 29835 11TH AVE SW FEDERAL WAY, WA 98023-8210 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) •uw] Gas Piping(4125) Final-Mechanical(4065) Approved / Approved to release test Approved ll 1 r By Date B i ,��O Date It By 1,1,, Date k� c/ an�: � • 0q-- / o 3L 3 3-2 PERMIT Federal Way RECEIVED COMMUNITY DEVELOPMENT SERVICES SF MF CO OgfPEL PL DE EN FP 3332d�SVI6EFSOA2 P3-97181docT 2" 1 ,PLICATION _�° FEDERAL WAY,WA 94063-9714 / / www.dtuofederalwau.com p The following is regiO i d o P.1.13,/L• 'incom.Tete a••lication will not be acce•ted. Please .rint legibly(in ink)or type. / / IN PROPERTY INFORMATION /, SITE ADDRESS 218;s" !1/1( Je✓v • fs��'0i' �1 > INA- gQZ?SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal description) • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu) 4!wto tie o/c rvt2•,✓A-r.0 ,AJVO iZ Yi 4- '.- 0/rl� PROJECT NAME(Name of Business or Owner Last Name) N'(�9 PEOPLE INFORMATION PROPERTY NAME �/ PRIMARY PHONE �y �.. OWNER 1)A1/�D ,p �(�/• / ilei (Z53) 1# -&t / MAILING z35AS S.1/4. CITY,oW 1 •w4-- q 8©Z3 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER - - - / / ( ) - B L CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE O,✓ ( ) A ING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) - RELATIONSHIP TO PROJECT • FAX NUMBER 0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) - CONTACTNAM PRIMARY PHONE E-MAIL ADDRESS f LENDER r"•Pei RCW 19.27•.095: Lenderinfonnation is NAME required if project value exceeds$5,000 • MAILING ADDRESS CITY,STATE,ZIP ■ DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE '� • EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ /FO U r j SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YXS ❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC) • . PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING SQ:FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE/CARPORT TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED HOW MANY FLOORS? "NEW HOMES 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 $ AIR HANDLING UNITS I EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(Commercial) WOODSTOVESB ) PRS ` FURNACES FIREPLACE INSERTS RANGES l/ MISC(Describe) COMPRESSORSOT GAS WATER HEATERS Q�/�+/ �'C 2 DUCTS I GAS PIPE OUTLETS ,J J PLUMBING WATER CLOSETS Roa�q MISC(Describe)BATHTUBS(orTub/show<r combo) SHOWERS DISHWASHERS SINKS DRINKING FOUNTAINS RAINWATER SYST SUMPS GAS PIPE OUTLETS HOSE BIBBS WASHING MACHINES URINALS LAVS(Bathroom Sulks( 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 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. • C (Title) / NAME/TITLE /`4e6/x � DATE (Signature) ( t I RELATIONSHIP TO PROJECT ❑ Owner 0 Agent 0 Contractor ❑ Architect 0 Other E i FOR OFFICE USE ONLY o NEW a ADDITION a ALTERATION o REPAIR a TENANT IMPROVEMENT ( BUII.DING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO f ZONING DESIGNATION CHANGE OF USE? a YES a NO til NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES a NO PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES o NO I. Bulletin#100—March 30,2004 — Page 2 of 4 k\l-landouts—Revised\Permit Application