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02-101535 �aH • • r 1111111 City of Federal ay Building - Single Family Permit #:02 - 101535 - 00 SF Community Development Services 33530 1 st Way S Federal Way,WA 98003-6210 Ph:253 661 4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: FABIANKOBICK Project Address: 35811 6TH AVE SW Parcel Number: 302104 9089 Project Description: MECH/PLUMBING-Gas pipe meter to furnace &AWH,install gas furnace,and gas AWH Owner Applicant Contractor Lender John A&Jane S Fabiankovich NORDIC HEATING,INC. NORDIC HEATING,INC. NONE 35811 6TH AVE SW 3411 C ST.NW BAY 8 FEDERAL WAY WA AUBURN WA 98002 3411 C ST.NW BAY 8 98023-7211 AUBURN WA 98002 NONE Includes: Census category: 434-Reside #1 #2 #3 #4 Occupancy Group: IR-3 Construction Type: Type VR--03 -One-HR j pancy Load:F.,=,irArea(Sq.Ft.): L Census Category 434-Residential alt/add-no Mechanical Yes Occupancy Group#1 R-3 Plumbing Yes Plumbing Fixtures L Description Quantity Description Quantity Description 'Quantity Gas Pipe Outlets 2 Water Heaters Mechanical Fixtures Description , IQuantty Description Quantity Description [Quantity Furnaces 1 PERMIT EXPIRES October 8,2002,IF NO WORK IS STARTED. Permit issued on April 11,2002 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: A Date: 7l-0ma_ asp/per' o/< I • • Me L Ca•r CONSTRUC I ION PERMIT APPLI TON VV FEY - APPLICATION NUMBER: b 2- L 1)JS13$ APPLICATION NUMBER: - - APPLICATION NUMBER: - - **The following is required information—Please print(h1 ink)or type** • Please note: Electrical, Fire Preventi,n Systems and Engineering permits may require a separate application. :-.-.,'.., 7..,,":';'::--,:;.::::-(•=!,..4'-':-).1 PROPERTY INFORMATION -:-Ti. - - yN SITE ADDRESS: 75--- /1 641-2:141C: CCS, ASSESSOR'S TAX/PARCEL #: 36,21 - 9 6/7 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): : • _'.5 a PROJECT INFORMATION 1 TYPE OF PROJECT(This application): ❑ BUILDING AQ PLUMBING J MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING IA FIRE PREVENTION SYSTEM X. PROJECT DESCRIPTION (Provide detailed description):As r! e. if Ai ' Ia . i`` - .I .. PROJECT NAME: -- ': C1',PEOPLE INFORMATION <>. PROPERTY OWNER: NAME: R . • ek. -^1 A(/IJ�V) DAYTIME PHONE: /r�// AINf LING ADDRESS(STREET Aolas�,STATE,ZIP):) (� )�7 ' • �� I� 33°"g// AO'dori CONTRACTOR: NAME: `,©��4� ` ` ' DAYTIME PHONE: MAILING ADDRESS(ST A DRESS;;CITY,STATE,ZIP / EVENI PHONE 31 - O� 3wi [e;- 04E. e 4 bJ W �-o " - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBFAX N • I Q - 28- MS-02' -Go-x 1, ( ) - CONTRACTOR'S REGISTRATION NUMBER: � ) /� /� EXPIRATION DATE: (copy of card required) /r/I A t)r t 0 V V Bi- I / APPLICANT: N • , F� s� -f -(- DAYTIME PHONE: c iU. �( eC� - ( ) - MA ING ADORES REET ADDRESS' TE,ZIP): EVENING PHONE: / �` 5r,, i k_igo3/ ( ) - RELAIIO HIP TO ROJECT: FAX NUMBER: ❑ ARCHITECT U TENANT ELOTHER(DESCRIBE): ( ) - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT 1U-CONTRACTOR -11 'DETAILED BUILDING INFORMATION -" EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED V• . •TION I., vi PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA Cl PRIVATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONL** III NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ---. ■.PROSECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT' • FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) - DECK - GARAGE HOW MANY FLOORS? { TOTAL: I Indicate n tuber of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC I44 GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) f WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC GAS DRINKING FOUNTAIN(S) _ SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( _) INTERCEPTOR(S) S MP(S) • P'1.'DISCLAIMER/SIGNATURE BLOCK I certify under penalty of perjury rat the information furnished by me is true and correct to the best of my knowledge,and further,that I am authorized by the owner if the a.ove 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 daim(including costs,expenses,and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person,induding 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: _ /�f� `ii��. . /� - L"e- DATE: '/�/1 -/�2 El PROPERTY OWNER ❑ APPLI •NT ❑ CONTRACTOR FOR OFFICE USE ONLY: El NEW ❑ ADDITION ❑ ALTERATION ❑.REPAIR fl TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718-FEDERAL WAY,WA 98063-9718•253-661-4000•FAX 253 661-4129 wwwatyoffedera twat'.com