02-100287City of Federal Way
Conmiunity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: GRAYSON oQU
Project Address: 32012 26TH'SW
Mechanical Permit #:02 - 100287 - 00 - ME
Project Description: MECH - Change out out of a gas furnace
Inspection request line: 253.835.3050
Parcel Number: 873190 0040
Owner
Applicant
Contractor
Thomas C & Betsey J Grayson
GATEWAY HEATING & AIR CONDITIO
GATEWAY TING & AIR CONDITIO
32012 26TH AVE SW
GATEWAY HEATING & AIR CONDITIO
GATEWAY HEA G & AIR CONDITIO
FEDERAL WAY WA
3802 AUBURN WAYS..
AUBURN WA N
98023-2509
AUBURN W 002
(253) 931-0610
Mechanical Valuation...................................4.... 2792.30
Furnaces
Over the Counter Permit ................... ...............Yes
Mechanical Fixtures
Description IlQuanti DescriptionQuantit I Description Quantity
PERMIT EXPIRES July 21, 2002, IF NO WORK IS STARTED.
Permit issued on January 22, 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
Owner or agent: Date: —4,?j 0
�TOF �_ CONSTRUCTION PERMIT APPLICATION
• PPLICATION NUMBER: 1- 1 0 i1 -0-"? -
uV FAY �-
PPLICATION NUMBER: - -
PPLICATION NUMBER: - -
**The following is required information — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: �V C ((J' 3� cSw ASSESSOR'S TAX/PARCEL #:z5 ( 9 b - 00 ��
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING QfMECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
a"
0
M
MAILING ADDRESS (STREET ADDRESS; CITY, ST.IE, ZIP):
-2,'7 r--,(-7 -- ?1nr�A41 )�;-7 ) v, fi,�,,.,W�Z
NAME'
4
DAYTIME PHONE:
C610
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
Boa U /f /0, v 1c
EVENING PHONE:
> -
CITY F FEDERAL WAY BUSINESS LICENSE NUMBER:
�- 1 9 - qy l o57r,9- 01 LTEXPIRATIONCONTRACTOR'S
FAX NUMBER:
REGISTRATION NUMBER:
^ kTeI,,�����
/L(j W
DATE:
�"� /
(Copy of card required)
L
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER: j
❑ ARCHITECT ❑ TENANT OTHER ( DESCRIBE): CD/i�C-�%4 [�Q� ( 3) gb q _
EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 4 x
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
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)
r BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ElELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
'%TCL'1 ATFAFR/C=fdATURE RLC
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 Applied to the city as a part of this application.
NAME/TITLE:
❑ PROPERTY OWNER ❑ APP
FOR OFFICE USE ONLY:
)XCONTRACTOR
TE: Q
❑ NEW ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ 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
(-nm1r,11 iNfTY f)FVFI OPMENT SERVICES - 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX' 253-661-4129