03-104705City Federal Way
Community Development Services Mechanical Permit #: 03 -104705 - 00 - ME
un�
33530 1st Way S
Federal Way, WA 38003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: LAURENT
Project Address: 30456 3RD * AVGS Parcel Number: 232970 0400
Project Description: Remove and replace gas furnace
Owner
Applicant
Contractor
Jonathan G Laurent
GLENDALE HEATING & A/C
GLENDALE HEATING & A/C
30456 3RD AVE S
12462 DES MOINES WAY S
12462 DES MOINES WAY S
FEDERAL WAY WA
SEATTLE WA 98168-2266
SEATTLE WA 98168-2266
114 tVA3Valuation..........................................3115
Over the Counter Permit.
.(206)•243-7700......•• Yes
Mechanical Fixtures
11iii
Furnaces
PERMIT EXPIRES April 12, 2004.
Permit issued on October 15, 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: T„�� � - �o� � ,% Date: lo 14 � %� j k ,
r
`CITY OF
Federal Way
March 11, 2004
Jonathan Laurent
30456 3rd Avenue S
Federal Way, WA 98003-4004
CITY HALL
33530 1 st Way South • PO Box 9718
Federal Way, WA 98063-9718
(253)661-4000
www.cityoffederalway.com
RE: 03 -104705 -00 -ME; LAURENT
30456 3rd Avenue S; Expiration of Permit, Notice to Extend
Our records indicate that on Wednesday, October 15, 2003, the City of Federal Way
issued permit 03 -104705 -00 -ME. This permit expires by limitation and becomes null
and void if the building or work authorized by the permit is not commenced within 180
days from the date of issuance, or if the building or work authorized by the permit is
suspended or abandoned at any time after the work is commenced for a period of 180
days. The building official may extend the time for action by the permittee for a period
not exceeding 180 days upon written request by the permittee showing that
circumstances beyond the control of the permittee have prevented action from being
taken. No permit may be extended more than once.
To avoid expiration of your permit, you may call the inspection request line (253-835-
3050) to set up an inspection; or request an extension of your permit by submitting a
written request to the building official by Monday, April 12, 2004. This request may
be submitted via the regular mail or e-mail at buildingofficial@ci.federal-way.wa.us.
The request should include information indicating that circumstances beyond your
contra have prevented you from taking action on this permit.
If you choose not to request an extension for this permit, your permit will become null
and void on Tuesday, April 13, 2004. Work shall not continue at any time after
expiration of the permit until a new permit is obtained.
If you have any questions, please call 253-661-4115.
Sincerely,
9144. 914artin
Building Official
t
cc: Glendale Heating & A/C; Attn: Permits: 12462 Des Moines Way S; Seattle WA 98168-2266
file
R'EIVE-D
1 ��� CONSTRUCTION PERMIT APPLICATION j
CITU OF PPLICATION NUMBER: - - _ M
Federal Way, -Y JF � =RAL. WAY PPLICATION NUMBER: - - - - - - -
BUILD IN!G DEPT, PPLICATION NUMBER: - -
**The folknring is required information - Please print (in Ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
III PROPERTY INFORMATION
SITE ADDRESS: I� Y�!2 A, V I - �0 ASSESSOR'S TAX/PARCEL #: Z - D Y—o
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): "
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING HANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
NAME:{) DAYTIME P,)o'kv, `)HO,y7nNE:'g
MAILING AD ESS STREET ADDRESS; CITY, ATE, ZIP): uloy
NAME:
NAME:
DAYTIME(
DAYTIME PHONE:
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MAILING A�DRE (STREET A SS; C��STATE, IIP):
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�
ENING PHONE:
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CITY OF FEDE\RRAL WAY BUSINESS LICENSE NUMBER:
`,
FAX NUMBER:
7
_ _ -
_ _ _ _ _ - _
( 20 6)
/
CONTRACTORS REGISTRATION NUMBER:
FAX NUMBER:
EXPIRATION DATE:
y
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11 / 0? U
(copy of card required)
E-MAIL ADDRESS:
APPLICANT:
NAME:
DAYTIME(
'► S i
"' i,
0
( a� )
-
MAILING ADDRE .(STREET ADDRESS;ATE,ZIIP):
EVENING PHONE:
`,
RELATIONSHIP TO PROJECT:
FAX NUMBER:
❑ ARCHITECT ❑ TENANT
CHER ( DESCRIBE):
( )
-
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER VA4LICANT ❑ CONTRACTOR
PROJECT•R•
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
II
�, �•�
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS: $
1
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)
rl
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
NONE
7� ■ 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:
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC w-dAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOW Ek(S)
SINK(S)
SUMP(S)
URINAL(S)
WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC.
BLOCK0 DISCLAIMER/SIGNATURE
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 suppiito the city as apart of is application./ 1
NAME/TITLE: DATE:_
❑ PROPERTY OWNER moKPPLICANT ❑ CONTRACTOR
rno rmcrrr: "S!F nm v-
❑ 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
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.citvoffederalway.com