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03-105358 i • City of Federal Way Community Development Services Mechanical Permit #:03 - 105358 - 00 - ME 33530 1st Way S Federal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: CHURCH OF BLESSING Project Address: 1430 S 330TH Parcel Number: 172104 9045 Project Description: In conjunction with Phase I of mechanical work,install gas piping. Owner Applicant Contractor CHURCH OF BLESSING GATEWAY HEATING&AIR CONDITIO GATEWAY HEATING&AIR CONDITIO 31037 44TH AVE S 3802 AUBURN WAY N 3802 AUBURN WAY N AUBURN WA AUBURN WA 98002 AUBURN WA 98002 98001-2610 (253)931-0610 Mechanical Valuation 3000 Over the Counter Permit Yes Mechanical Fixtures C escri tiOt , Quantity Descri ti©rc Quanti„ p ...., . �.� � :::. tY ;111..... ©escripfion ",E; Quantity Gas Piping 1 PERMIT EXPIRES June 5,2004. Permit issued on December 8,2003 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: Date: / 2 — 6 •J !...11 L RSEwED CONSTRUC-ON PERMIT APPLICATION CITY OF iggalimk..-..." APPLICATION NUMBER: () 3- JT '- Federal Way DEC 0 8 2003 APPLICATION NUMBER: -APPLICATION NUMBER: - - CITY OLDER yT*The !c' fl9 d formation-Please print(in ink)or type" Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. <a.';PROPERTY INFORMATION: ... SITE ADDRESS: /730 J ' (..72‘9S1-4, ASSESSOR'S TAX/PARCEL #: / / 0 / - 5202/..c S LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): • PROJECT INFORMATION' TYPE OF PROJECT(This application): 0 BUILDING o PLUMBING MECHANICAL o DEMOLITION o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): a4-s p i P , AI PROJECT NAME: C � a-L (-I G F 13L 5 S 11-7 • PEOPLE INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE• C , ec=am of -/Sse/ MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): ' -3163-7 '/4 f- 6 ,t, CJS 9POo/ CONTRACTOR: NAME: DAYTIME PHONE: C,AiF 1-1F4rtiv 1,- Ili (25'1 )l'j3 MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): EVENING PHONE: '30 ' Z Alai-3 aa, 14) /U 73 c I CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: y e - L o b '7 90°- 1_3 4__ i (z6-3 CONTRACTOR'S REGISTRATION NUMBER: j EXPIRATION DATE: (ropy of card required) G R 7", vJ tf `Z-6- " 8 / 2 0 / 0 5 APPLICANT: NAME: DAYTIME PHONE: G R-rTzvt;4 y #-1>:a r/ F!-/c (Z63) g a 1 -0 Z., /0 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): v � /,n� �ENING PHONE* 3?o /)u rn /r3(2/ 3a/ /� ��O ti/.� - RELATIONSHIP TO PROJECT: j FAX NUMBER: 0 ARCHITECT 0 TENANT 1 -OTHER( DESCRIBE): CDr1>T �Ta-. (26 3) OSI- d4-x,c E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT [i ,t; .i&CONTRACTOR IVlero i hua'hngitbil't -1111 DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 3, D.Tf-20 - t� SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES o NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLO • • NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ . ■ PROTECT FLOOR AREAS ' FLOOR EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: U `FIXTURES :`- Indicate number 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) / 3 GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC ❑ GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) 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) SUMP(S) ■ 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 daim(induding 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 daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE: /*C__ AO r -(4- DATE: / Z - e -z) 7 ❑ PROPERTY OWNER ❑ APPLICANT t ONTRACTOR _FOROFFICE USE.ONLY a NEW ,'..;rfADDmoN': C]ALTERATION ; D REPAIR , fi=t]TENANT IMPROVEMENT x 'CENSUS'CODE w 4. ;*r-.`..k" . r: VA ° rrI }LOTS IZE.W*V ' . k ? ' . 'ZONING DESIGNATION, # , ,W .. , BUILDING SHELL ONLY? 3 YES ;:❑ NO ' COMP PLAN DESIGNATIOIy A 1BASIC PLAN?; j❑YES d NO, .E SECTION m6TOWNSHIP. RANGE` ,NEW ADDRESS REQUIRED? ,, :;❑YES . ❑NOA PLATTE4 LOT?=, q YES ..„.D NO -,,'mtosormtmo,..CiiANGE OF USE?. t5 YES ❑ NO` ` COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www,tityof federdIway.Com