02-102481City of Federal Way (� f
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: KOZLOWSKI
Project Address: 30462 10TH�S
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Je,
Project Description: MECH - Changeout of gas furnace
Mechanical Permit #:02 -102481 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 091900 0280
Owner
Applicant
Contractor
R Kozlowski
THURMAN'S HEATING AND AIR LLC
THURMAN'S HEATING AND AIR LLC
30462 10TH AVE S
110 179TH ST E
110 179TH ST E
FEDERAL WAY WA
SPANWAY WA 98387
SPANWAY WA 98387
98003-4118
(253) 875-0094
Mechanical Valuation..........................................625
arscri `tion ' ``" ` QUIR '
Furnaces 1
Over the Counter Permit......................................Yes
Mechanical Fixtures
PERMIT EXPIRES December 10, 2002, IF NO WORK IS STARTED.
Permit issued on June 13, 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: IL4 Date:
Mechanical rough -in:
Gas pipe:
Date:
Date:
FINAL MECHANICAL: Date:
•� G CONSTRUCTION PERMIT APPLICATION
• ��
RECEIVED APPLICATION NUMBER:
APPLICATION NUMBER: - -
UN 1 3 20,02 PPLICATION NUMBER:
**Th �c uired information — Please print (in ink) or type*
qr' SCS?QRAL WAY
Please note: Electrical, Fire W441NCma� Rfms and Engineering permits may require a separate application.
J��� •. . '1
SITE ADDRESS: �(�)��� I �1 SSV L- �; ASSESSOR'S TAX/ PARCEL #: V [ ( v 0 - 0 p%Cgo
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING mak, MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
C� In U3 t/�A wv-�r' SSU ID"O"� B i
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
r r 7 ■ ' PEOPLEINFORMATION.
LIN
NAME:DAYTIME PHONE:
�o��rno�d I 2, LOW s�i 9 s3
MAILING ADORES (STREET ADPRESS- CITY, STATE, ZIP):
S , . 9cEe rai t,�a R w 9 003 - —
NA E: _ + n I
�_!�s
t`
(?T-3) S7S
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DAYTIME Pt10N.—_______.
-
va �I-
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MAIIING ADDRESS (STREET ADDRESS; CITY, STAT
S
Z1P): /'�
1/_ NJ 6j
FAX NUMBER:
EVENING PHONE:
-� a
CITY OF FEDERAL WAY BUSINESS LICENSE/NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
(ropy of card required)
EXPIRATION DATE:
(�
APPLICANT: tLA E:
I U rYyl(,�115 't 06'r, LL -C --
MAILING ADDRESS (STREET ADDRESS; CITY, SI Atk, ZIP):
A.Q.13ox 5 3 �� �a�a ►�a
RELATIONSHIP TO PROJECT: Ll
❑ ARCHITECT ❑ TENANT JXOTHER ( DESCRIBE): 6Dy4 r'--c=Tt�f
CONTACT PERSON FOR THIS PROJECT: PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $
DAYTIME PHONE:
(?T-3) S7S
- oC
EVENING PHONE:
FAX NUMBER:
(a5-3) 0L4
-� a
E-MAIL ADDRESS:
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC.)
*sr(EW RESIDENTIAL CONSTRUCTION ONLY** � '
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
. ■ PROXCT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINK(S) WATER CLOSET(S) MISC. ( )
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 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 supplied to the city as a part of this application.
/ /
NAME/TITLE: wa2l a:'� a - } / //�J�%� DATE: L / 1 a`/
El PROPERTY OWNER ❑ VPPLICANT CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 2S3-6614000 - FAX: 253-661-4129