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I"Federal Way Mechanical Permit #: 04 - 104136 - 00 - ME
Commul:ity 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: FLEMING
Project Address: 1606 SW 322ND 54- Parcel Number: 010450 0830
Project Description: Install gas furnace.
Owner Applicant Contractor
Leonard G Flemming &Barbara L Flemming Leonard G&Barbara L Fleming Leonard G&Barbara L Fleming
1606 SW 322ND ST 1606 SW 322ND ST 1606 SW 322ND ST
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-5424 98023-5424 (253)815-0273
Mechanical Valuation 3300 Over the Counter Permit Yes
Mechanical Fixtures
( Description JQuantity L Description !Quantity ; Description iQuantity
i Furnaces 1
L — — J
PERMIT EXPIRES April 9,2005.
Permit issued on October 11,2004
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 W a
Owner or agent: `�i� i it_ ffa.,-,..„.(,)• Date: /OA y
FINALED
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104136-00-ME
Owner: LEONARD G FLEMMING
Address: 1606 SW 322ND ST
FEDERAL WAY, WA 98023-5424
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) L Final-Mechanical (4065)
Approved Approved to release test pproved
By Date By Date B Date
. .
of` . RECEIVED PERMIT
- j. 0 3
Federal Way PERMIT
' COMMUNITYDRVELOPMERTSERV/CES SF MF CO LPL DE EN FP
33325 8TH AVENUEFEDERAL WAY, 98063-9718•PO 9 71 d OCT 11 0!P L I C A T I O N To
111 253-835-2607•FAX 253-835-2609 / /
uwuadt,ol%deralwau.com CITY OF FEDERAL�� WAY
The following is requireRYIR ItttAgaten incomplete ap•lication will not be acce•ted. Please •rint legibly(in ink)or type.
■ PROPERTY INFORMATION
SITE ADDRESS //66 SW 32? S?-
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ _ LOT SIZE(sj)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
.. .. ■ PROJECT INFORMATION .
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onit)
Qepk cecT cii h� S -rft-h da‘do' i fh +acv
PROJECT NAME(Name of Business or Owner Last Name) nem) t q
J
- • . . • - N PEOPLE INFORMATION
PROPERTY NA E PRIMARY PHONE
OWNER eoi,arc( Flerr,1Y11 (253 ) S 15 -0223
LING ADDRESS CITY,STATE,ZIP
1 dab SEA) 322 Sr
Pde,clf l.aa� �i}- '8023
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Fk4y. rn Sj4e,+rle->T( (253) %/3 -3560
MAILING ADDD`RESSSS CITY,STATE,ZIP I c n /�Q CELL PHONE
ictPD O�DERAL WAY BUSINESS LICENSE NUMBER sOnne.y/ EXPIRATION DATE 390
FAX NUMBER
- - -B L / / ( )
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME
OFFICE PHONE
( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT • FAX NUMBER
❑ Architect 0 Tenant ❑Agent 0 Other(Describe) ( ) _
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER V zl•I'' RCW 9.2'70 5:4encf information is NAME
iegidred,1f proJect va(ue,exceeds$5,000 ; •
MAILING ADDRESS CITY,STATE,ZIP
h
a
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES a NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS • •
• AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL"
BASEMENT
FIRST
SECOND 4
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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 �n
Value of Mechanical Work $ 3 3: I
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS 1WOODSTOVES '
BBQS FANS HOODS(come roim�
• BOILERSFIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS 1 FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/ShoaerCombo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
--.."-7:'::::::-:-1.--..--' - ` 2-',--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 1
this application. ��y /� �j
J.
15 're j � J2�^ DATE <</////C/
NAME/TITLE �� � ,
i (Signature) ( (Title)
i RELATIONSHIP TO PROJECT ,4l Owner 0 Agent "Contractor ❑ Architect 0 Other 1
SI '
I
1 :FOR OFFICE USE ONLY i
a NEW a ADDITION o ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES a NO
1 ZONING DESIGNATION CHANGE OF USE? o YES o NO ,
t NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? a YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES a NO
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Bulletin 0100—March 30,2004 — Page 2 of 4 k\Handouts—Revised\Pcrmit Application