03-105013City or Federal Way
Community Development Services Mechanical Permit #:03 -105013 - 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: OLSON
Project Address: 2601 SW 323RD SA' Parcel Number: 873180 1010
Project Description: Install gas furnace, air conditioning, fireplace insert, fireplace gas logs w/gas piping to furnace, insert
and logs.
Owner
Applicant
Contractor
Glenn W Olson
INDUSTRIAL COMM ELECTRIC INC
INDUSTRIAL COMM ELECTRIC INC
2601 SW 323RD ST
4601 S 134TH PL
4601 S 134TH PL
FEDERAL WAY WA
TUKWILA WA 98005
TUKWILA WA 98005
98023-2521
(206)248-7900
Mechanical Valuation..........................................10336 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
.; -001000.._ rr MON .. tl
.., ... ,_GSGC!j tlCitl _. ;. Quin.:.
s-51", rl tions '45'' :.
Ii Coif
Air Handling Units 1
Fireplace Inserts 1
Furnaces
Gas Logs I
Gas Piping 1
Number of Gas Outlets
PERMIT EXPIRES May 4, 2004.
Permit issued on November 6, 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 n'-fi
Owner or agent:Date: tA0 ks
/� / �V cCJ
l CA a- (/ l vl-
C
CONSTRUCTION PERMIT APPLICATION
CITY 0 -
ID6
PPLICATION NUMBER: �j�
Federal a ��� + PPLICATION NUMBER: _ _ - _ _ _ _ _ _
PPLICATION NUMBER:
**The following is r.egvi: ed kiformation - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
0 PROPERTY INFORMATION
SITE ADDRESS: OIiPO ` L3 39-�s V'r ST ASSESSOR'S TAX/PARCEL #:q -7 - I v d
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): J�
PROJECT•
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL o DEMOLITION
❑ ELECTRICAL ❑ ENGIaNIEERING o FIRE PREVENTIO/N� SYSTEM
PROJECT DESCRIPTION (Provide detailed description): t ��� I w J �U��A w a,
CTD -f 12G P LA C e
S -PI-PI TD fit) -0 ACS, LDCZ S x- WS r, e:r
PROJECTNAME•
PROJECT•• •
PROPERTY OWNER:
CONTRACTOR:
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
C�-60 t nuu 3 a- 10
NAME:
DAYTIME PHONE:
(ob) a4K---7`Ioa
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
01 S 13 .fit, IbWtLA W 9
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
- 00 loir�3�,� - ��
FAX NUMBER:
(.-106) a49 --I OOT
CONTRACTOR'S REGISTRATION NUMBER:
�j L ( (- -°-�
4Z Cr Kt 1\' 14 L � (..�
EXPIRATION DATE:
311 / 0+—]
(copy of card required)
_
APPLICANT: NAM:
i✓R i � r�
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
t4 (0()l
f3�-� t L �UKIJIIA �$l�g
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT OTHER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
EXISTING USE:
PROPOSED USE:
DAYTIME PHONE:
FAX NUMBER: �7 �}
(-., +F' ) aF yiS/ - — C l
EMAIL ADDRESS:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $h 12 , o
PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE (SEPTIC)
f
"NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
'
I FIREPLACEINSERT(S)
RANGE(S)
FIRST
l FURNACE(S)
PLATTEDLOT? o YES ❑ NO
CHANGE OF USE? o YES o NO
SECOND
HEAT SOURCE:
❑ ELECTRIC GAS
PLUMBING
THIRD
LAVATORY(S)
URINAL(S)
FOURTH
RAINWATER SYS.
VACUUM BREAKER(S)
o ELECTRIC o GAS
OTHER FLOORS (DESCRIBE)
WASH MACHINE OUTLET
SINKS)
DECK
MISC. ( )
SUMP(S)
GARAGE
HOW MANY FLOORS?
TOTAL:
I FAIR ANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAINS)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S)
I GAS LOG(S)
REFRIG. SYSTEM(S)
FAN(S)
HOOD(S)
WOODSTOVE(S)
I FIREPLACEINSERT(S)
RANGE(S)
MISC.( )
l FURNACE(S)
PLATTEDLOT? o YES ❑ NO
CHANGE OF USE? o YES o NO
_ GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC GAS
PLUMBING
LAVATORY(S)
URINAL(S)
WATER HEATER(S)
RAINWATER SYS.
VACUUM BREAKER(S)
o ELECTRIC o GAS
SHOWER(S)
WASH MACHINE OUTLET
SINKS)
WATER CLOSET(S)
MISC. ( )
SUMP(S)
BLOCKDISCLAIM ER/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 informatio pplied to the city as art of this application.
NAME/TITLE: DATE:
❑PROPERTY OWNER ❑APPLICANT CONTRACTOR
o NEW o ADDITION 0 ALTERATION
o REPAIR o TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY?'' o YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YESo NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? o YES o NO
PLATTEDLOT? o YES ❑ NO
CHANGE OF USE? o YES o NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www•citvoffederalwa -&Qm