03-100507City of Federal Way
Community Development Services Mechanical Permit #: 03 - 100507 - 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: LEE t
Project Address: 30006 2ND S G
Parcel Number: 891420 0160
Project Description: Gas furnace changeout
Owner
Applicant
Contractor
Douglas C & Helen Lee
GATEWAY HEATING & AIR CONDITIO
GATEWAY HEATING & AIR CONDITIO
30006 2ND CT S
3802 AUBURN WAY N
3802 AUBURN WAY N
FEDERAL WAY WA
AUBURN WA 98002
AUBURN WA 98002
98003-4302
(253) 931-0610
Mechanical Valuation..........................................1667 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
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Furnaces
PERMIT EXPIRES August 4, 2003.
Permit issued on February 5, 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 Wa .
Owner or agent: Date:
Feb` 05 03 04:44p GRTEWRY HTG 25380404GO p.2 C
�'0' CONSTRUCTION PERMIT APPLICAT O
F—=
C-=�� PPLICATION NUMBER:
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:Jt ' �� _ O _ ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROIECf INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME.
f . f
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
EMS''i
NAME:��E
O�
Q
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): Lt
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER.'
� � - � - S4—
AX NUMBER:
(-
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CONTRACTOR'S REGISTRATION NUMBER: T- C I 1 \1 {�. /�''•�f�
O �
EXPIRATION DATE: ^/
/'Q c
i
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(copy of card required) f C� vv l _ `� '
❑ ARCHITECT ❑ TENANT MOTHER ( DESCRIB
CONTACT PERSON FOR THIS PROJECT: 13 PROPERTY OWNERPPLICANT CONTRACTOR
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
Feb 05 03 04:44p GATEWAY HTG 2538040460 p.3
—NEW RESIDENTIAL CONSTRUCTION ONLY"
err I"pz;=R nF RFnROOMS:
FLOOR
BASEMENT
FIRST
I
CSECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOO
TOTAL:
ESTIMATED SELLING PRICE: $
—noncFrn cn FT- I TOTAL
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNITS) EVAPORATIVE COOLERS) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S)
FAN(S) HOOD(S) WOODSTOVE(S) BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) �� FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S)
HEAT SOURCE: C3 ELECTRIC (GAS
PLUMBING
BATHTUB(S)
LAVATORY(S)
DISHWASHER(S)
RAIN WATER SYS.
DRINKING FOUNTAINS)
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
INTERCEPTORS)
SUMP(S)
URINALS) WATER HEATER(S)
VACUUM BREAKER($) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
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 n 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 su lied to the city as,,a part of this application.
I J2,NAME/TITLE: ^DATE:
❑ PROPERTY OWNER C�PPLICAN7 XCONTRACTO -
C-
6
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION C3ALTERATION El 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
rn—it imiTY nPVFI OPMENT SERVICES- 33530 FIRST VJAY SOUTH • P.O. BOX 9718 - FEOERAL WAY. WA 93063-9716 - 253-661-1000 - FAX: ?Sl•6i.1•a129