11-103813 Mechanical
City of Federal Way •
Community Development ServicesPermit #. 11-103813-00-ME
P.O.Box 9718 1712411 p
Federal Way,WA 98063-9718 '-- i-! 7,
Ph:(253)835-2607 Fax:(253)835-2609 , Inspection Request Line: (253)835-3050
R
Project Name: SMITH
Project Address: 4222 SW 338TH ST Parcel Number: 921152 0270
Project Description: Like for like furnace replacement
Owner Applicant Contractor
DANIEL ROBERT SMITH VALLEY FURNACE INC VALLEY FURNACE INC
HILDE I SMITH PO BOX 507 VALLEFI161R6(12/26/11)
4222 SW 338TH ST PUYALLUP WA 98371 PO BOX 507
FEDERAL WAY WA 98023 PUYALLUP WA 98371
3 „s,'nr;
•
Mechanical Valuation 3141.56 Is this an Online or O.T.C.application? Yes
It
Furnaces 1
PERMIT EXPIRES Monday, March 19, 2012
Permit Issued on Wednesday, September 21, 2011
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 t City of Federal Way.
Owner or agent: A _ Date: `I' , IZ/-J/
` 0 THIS CARD IS TO MAIN ON-SITE
crrr OF
`
Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 11-103813-00-ME Address: 4222 SW 338TH ST
Project: DANIEL ROBERT SMITH FEDERAL WAY, WA 98023-3209
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) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date B Date (1�2 kr‘a i i
0 Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
*4 ,Att.
y - 1O3i3 3
Federal - MDP
wYYUMIYDEVELOPMR IM r r�s E �I —"—I T SF MFC E PL DE EN FP
33325 Sri AVENUE SOUTH• a :'• 8 (�%
FEDERAL WAY,WA 98063.9718 APPLICATION TD
253435-2607.FAX 253 835-2609rL
c� 1
Wwa.dtuo/kleralunu.com E P L i; Av g,
The follow' , is „ .,,Cax lydnpiete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS '/2 2-2• 5 t i/ 33Z+1 !?b /6chr*/14 ?go 2> SUITE/UNIT$- a%17 41
ASSESSOR'S TAX/PARCEL it - _ _ LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach=Panda Page for len"legal
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING Alt MECHANICAL
0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit oral()
Ftir>ie c0- /2e p I,ice# e.1t/ Gi'ke 4r L,ke.
PROJECT NAME(Name of Business or Owner Last Name) 11,161e-/dam 14
El PEOPLE INFORMATION
PROPERTYNAME CJJ / PRIMARY PHONE
OWNER / /, /c lit 714 ( Z5.3 )g;j - 92/9
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
°/222 !,c./ 3. it4 F. AV- /✓f1Z3
CONTRACTOR 9) COMPAX Y NAMg
"�CA NAME / OFFICE PHONE
Pl V ,ff- Furvtace / ,ti - A' der5cF, (Lfj))S9 - 3c/7
MAI O ADD _ CITY,STATE,ZIP CELL.PHONE
I /�J' Q l/v.r cU c<}�<ij/ �A 1�17( ( ) -
0 Y l� ITY OF FEDERAL WAY BUSINESS LICENSE NUMBER ` (EXPIRATION DATE FAX NUMBER
�� ` ' /I / "'''
Io' °,I�, `3'-ro�� --00-PLl2-,1-11 (Z ) ) GYM - -714'
_/. CONTRAC1401M1 RVA 1-1-Efil6 I b EXPIRATION DATE E-MAIL ADDRESS3
APPLICANT COMPANY N APPUSANT E �i J OFFICE PHONE�7�/B
I' c/f e ce ft r rwl c 4 /T A'l ter a y (2�j ) 1[v - ;5o
MAILING P G UDR�ESGs- 5-c7 STATE,y� , C�3?/ C(ELL PH)NE -
11 " 11/�f� (j1 J
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent ❑ Other C'>h-t rC c r ( 7.0 ) - $-7`G
PROJECT NAM / PRIMARY PHONE
7ADD
CONTACT (t 3) M - 35/7 ��(`i] ey {,+r.>ace.Cc P s
LENDER NAME x/ A �/ Per RCW 19.47.095:
/(O 1`� Lender information is required ijproject value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
. ( ) _
• DETAILED BUILDING INFORMATION 1
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
in PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST __.._......._.
SECOND '--''^—
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 U k 's VERED?)
GARAGE ❑ "e' ❑
RUSTLES PROPOSED TOTAL TOTAL MST SF ALPROPOSso al TOTAL Sr
NUMBS' = 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
emain.I ANICAL 1,//,5G
Value of Mechanical Work$ (A COPY OF BID OR EST IMA1E MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
•
BOILERS FIREPLACE INSERTS HOODS Icommadq
COMPRESSORS I FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Butbroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roues •
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that I ant the property owner or authorised agent of the property owner.I certify that to the best of my
knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorised by the issuance of a permit.I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local,state,or federal laws regulating construction or environmental laws.
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,but only
where such claim arises out of the reit•• .- of the city, ding its officers and employees,upon the accuracy of the information supplied to
the city as a part of this application.j/ / /
r.
SIGNATURE: /_ DATE -2 G f//
• .. 'a r and/or Authorized Agent
•
•
a NEW a ADDITION Cl ALTERATION o REPAIR a.TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a,YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? • a YES a NO
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Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Applicatio/
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