16-100972 •
.�.F tY Mechanical
CityofFceral Way Permit #: 16-100972-00-ME
Community
E
y&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 A ILEp �
Project Name: SIMPSON
Project Address: 2622 SW 340TH PL Parcel Number: 010920 0460
Project Description: Replace gas furnace
•
Owner Applicant Contractor
DAVID L SIMPSON SUSAN DUNHAM BLACK HILLS INC(GENERAL)
LORNA W SIMPSON BLACK HILLS INC BLACKHI066JL(7/19/17)
2622 SW 340TH PL 1003 85TH AVE SE UNIT A 1003 85TH AVE SE UNIT A
FEDERAL WAY WA 98023 OLYMPIA WA 98501 OLYMPIA WA 98501-5706
Additional Permit Information
Mechanical Work Valuation 3820.18 Is this an Online or O.T.C.application? Yes
Mechanical Fixtures
Furnaces 1
PERMIT EXPIRES Monday, August 22, 2016
Permit Issued on Wednesday, February 24, 2016
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
oL I N E Date:
•
. THIS,CARD IS TO MAIN ON-SITE
CITY 111A. Construction In ection Record - • ~
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 16-100972-00-ME Address: 2622 SW 340TH PL
Project: DAVID L SIMPSON FEDERAL WAY, WA 98023-7733
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) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date
0 Rough Electrical Final Electrical ID Right of Way
Approved Approved Approved
By Date By Date By Date