02-102954City Federal Way
Community Development Services Mechanical Permit #:02 -102954 - 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: CASSMAN p\
Project Address: 30914 5TH1S Parcel Number: 241330 0140
Project Description: HVAC - Gas to gas furnace changeout & installing new gas log set with 50' associated gas piping.
Owner
Applicant
Contractor
William L & Toni L Cassman
SUNDANCE ENERGY SERVICES, INC.
SUNDANCE ENERGY SERVICES, INC.
30914 5TH PL S
SUNDANCE ENERGY SERVICES, INC.
SUNDANCE ENERGY SERVICES, INC.
FEDERAL WAY WA
10228 MAIN ST
10228 MAIN ST
98003-4013
BOTHELL WA 98011
(425) 481-9660
Mechanical Valuation..........................................3500
Over the Counter Permit......................................Yes
Mechanical Fixtures
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Des€I flci'nnY Quan;1
i fio,1 0 ,G W
6tityj
Furnaces 1
Gas Logs 1
Gas Piping
50
PERMIT EXPIRES January 8, 2003, IF NO WORK IS STARTED.
Permit issued on July 12, 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 bA in accordance with the laws, rules and regulations of the State of Washington and
the City of Federal W
Owner or agent: Date:
Mechanical rough -in:
Gas pipe:
FINAL MECHANICAL:
Date: 1
%k -
Date: L
Date:
07/11/,2002 11:33 FAX 2536614129 CITT" FEDERALFIAY
1%
�"'` CONSTRUCTION PERMIT APPLICATION
RECEIVED BY
COMMUNITY DEVELOPMENT pEPARTMEN� PPLICATiOfd NUMBER: L'�..-- m�
PPLICKHON NUMBER:
AD? PPLICATION NUMBER:
**The following is required information •- Please print (in ink) or typev*
Please note_ Electricalr Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: / �7 AL �• ASSESSOR'S TAX/PARCEL #: Z I 3 3 O
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION TF LENGTHY): // ove" xl�X�Y ar/r c stwy
-PROTECTNFORNIATiON
TYPE OF PROJECT (This application): ❑ BUILDINGL �G ,,SSI MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEFRING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): A/ -C -rQ k4< 1514,41,4ec
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PROJECT NAME: _ �A S JMAr�/
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PROPE-RTYOWNER: NAME; DAYTIMEPIiOL�E:
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MAI(lN(j ADDRESS (STREET ADD CITY, S1ATf, ZIP); _
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CONTRACTOR:
MAILING ADDRESS JS W T AOORtS5; CM. AJV, ZIP):
1001$ G►,
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CONTRACTORS REGISIRAT70N NUMBER:
(COOY Of C&0 M'QUiFtW,
1901/
APPLICANT: NAM[:
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MAILING ADORf•SS (STREET ADORE;;; CI , STAY1 ,
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RELATIONSHIP TO PRO)CCI; -
❑ ARCIIrTECT ❑ TENANT ,OTHER ( DESCRIBE):^ ��—
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER n APPLICANT CONTRACTOR
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FAX UMBER: ( _ �f )Nf9
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EXISTING USC: _. EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: `PROPOSED VALUATION FOR IMPROVEMENTS: $ 3
SPRIN}CLERCD BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: I'] YES LJ NO
WATER SERVICE PROVIDER: ❑ LAKCIIAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER. LJ LAKEHAVEN LJ HIGHLINE 0 PRIVATE (SEPTIC)
07-'11e'2002 11:34 FAX 2536614129 CITY FEDERAD AY 002
NEW RESIDENTIAL CONSTRUCTION ONLY*"
NUMBER dF BEDROOMS: ESTIMATED SEL1xNCi PRICE: $
FLOOR
EXISTING S . FT.
PROPOSED S!2. Fr.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DFSCfURE)
DECK
GARAGE
HOW MANY FLOORS?
TOTALS
Indicate number of each type of fixture
MECHANICAL.
Ails HANDLING UNIT(S) EVAPORATIVE COOLER(S) I GAS LOG(S) _ REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) _ WOODSTOVE(5)
BOILERS) FIREPLACE INSERTS) RANGES) MIS(-- (_
COMPRFSSOR(S) �_ FURNACE(S)
DUCT(S) 3 GAS PIPE; OUTLETS) HEAT SOURCE: ❑ ELECTRIC XGAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) -- WATVR CLOSET(S) MISC. (-
INTERCF_PTOR(S) SUMP(S)
31SCLAIMERISIGNATURR Rt_C
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, inducting 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 s e�1 t lc CRY as a part of this application.
N ME/TITLF_ L t�iR�+�4s>? us;
DATE:
❑ PROPERTY O APPLICANTCONTRILCTOR
ODMMUNITy DOA�_OPMENT SERVICXS .33530 FiRSt WAY --0(M (• PO BOX 4718 • FMEIt.AI WAY, WA 98063-071$ • 20.6661-40W • FA)C253-661A129
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