04-101795City of Federal Way
4tomm4nity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: BASSETT
Project Address: 4120 SW 322ND St
Project Description: Installing gas furnace and new A/C
Mechanical Permit #:04 -101795 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 873196 0430
Owner
Applicant
Contractor
Byron F Bassett
BRENNAN HEATING & A/C LLC
BRENNAN HEATING & A/C LLC
4120 SW 322ND ST
4601 S 134TH PL
4601 S 134TH PL
FEDERAL WAY WA
TUKWILA WA 98168
TUKWILA WA 98168
98023-2417
(206) 248-7900
Mechanical Valuation..........................................7641 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Quanti Description Quanti Description Quantity
Air Handling
,its I Furnaces
PERMIT EXPIRES November 6, 2004.
Permit issued on May 10, 2004
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: Coo A ninlie-atenrDate: - `=i 0i
NOTE: FINAL INSPECTION REQUIRED UPON
COMPLETION OF WORK
Mechanical rough -in:
Date
Gas pipe:
D e 4FINAL MECHANICAL: 6t
DJte
�q,�y��(�p
RECEIVED BY� ey �otm! �ro laa 9718
DEVELOPMENT 0 j FRAI. IVA Y. Y KA 9ROGL971R
<ITYOF ?:.76(14-111.5-FA�':25 1."1412%
►Nedera) waY PERMIT APPLICATMI ......,,.;I,,J,.,1...,In,.:,, ,..
_ ;SAY �. Q
�ar bnirr Urr. O01y,. _ --� / — I 77? ---
I�W c Number: V � - � l�' LG- 31 — f
The following is required information -an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITEADDRESS: 4101,D LO 3495 C1 � 1 ASSESSOR'S TAX/PARCL•'L a: - - - - — - — -- --
LEGAL DESCRIPTION (eg: Acme 13stutes, Lot 1)
(Aitacll separate page fnrlerlrltllJ Icycrl clracriptiorlJ
SQUARE FOOTAGE OF LOT:
TYPE OF PERMIT (This application): r BUILDING o PLUMBING MECIIANICAL 1:1 DEMOLITION
I] ELECTRICAL U ENGINEERING[0 FIRE PREVENTION SYSTEM)
PROJECT DESCRIPTION (Prouide detailed description of work included on this t)ermit onllLJ:
PROJECT NAME (Name OfBusiness/Owner Last Name):
PROPERTY
OWNER:
CONTRACTOR:
LENDER:
(if Prvpwed V.I.. a 3s.0001
APPLICANT:
NAMIi:
�fAhY 111 IONS:
MAILING ADDRESS (STRIi1 I AIIUILF.SS:): CITY. STATE. %II'
•�IC( i�`•
COA,-1'AN,• ----
OI'F,i'I:I'IIONI::
(a -qv) IR
- -Tf m
MAILING ADDRESS (STREET AD1)14FSS:C
CITY. STATE, ZII' r
CELL 1'I ION E:
CITY, STATE, ZIP
CITY OF PIiDEI.AI. WAY I)USINESS LICHNSE NUMI)ER:
04 -
EXI'wxnON D:ATI'.:
FAX NUMIJEW
CONTRACTOR'S RP,GISfRATI.N NUMDEIl'� j A ,fQCl --I
t V 1 d f4 7� I ( )
EXVIRATION
I "i / `_!3t
DATE:
/ C)5—
(copy of Card required with each application-
NAME: �I' 11').41'TI�SI:I'UONE:
NiA11.ING ADDRESS ()7RI:IiT ADDRESS:I: CITY, STATE. 7.11'
NAME:
COMPANY
OFFICIi PHONE:
MAILING ADDRESS (STREET ADDRESS):
�- W 1 " l 3"-T1, _ L
CITY, STATE, ZIP
EVENING I'IiONIi:
_) -
KEIATIONSI1111TO PROJECT: `eT T�.�
❑ Architect O 'fcn:u7t 0 Olhcr (Describe): i ry � > 1 ��
PAX NU\1DI:R: 5
(907 �= - �f li
CONTACT PERSON FOR THIS PROJECT: O Property Owner Contractor 0 Applicant E-MAIL ADDRESS:
EXISTING usr•.� _ PROPOSED USE:
EXISTING ASSESSED/ APPRAISED VALUE $
VALUE OF PROPOSED WORK: $ 6D
SPRINKLERED BUILDING? 0 YES D NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: 0 YES D NO
WATER SERVICE PROVIDER: 0 LAKEIiAVEN 0 HIGHLINE O TACOh%A 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER: I I LAKEIIAVEN [1 IIIGIILINE ri PRIVATE (SEPTIC)
� I:SftJ Li....�• . .
FIRST
SECOND
IRSTSECOND
THIRD
FOURTH
ADDITIONAL
(DESCRIBE)
TOTAL
FT.
TED
TOTAL
TOT
E%15TIN0 AND PROPOGED
as part of this project. Do not include existing fixtures to remain.
Indicate number of each type of fixture that is to be installed or relocated
MECHANICAL `X -A j .DO
Value of mechanical Work S
GAS LOGS REFRIG. SYSTEMS
_ AIR HANDLING UNITS EVAPORATIVE COOLERS HOODS WOODSTOVES
_ BBQS FANSRANGESMISC (Describe)
BOILERS FIREPLACE INSERTS `
— FURNACES GAS WATER IIL•'ATERS 1
_ COMPRESSORS �'— GAS PIPE OUTLETS — KI
DUCTS
PLUMBING
BATHTUBS (or7ub/shwereomtwl
SHOWERS
DISHWASHERS
SINKS
_•
GAS PIPE OUTLETS
SUMPS
_
WASHING MACHINES
URINALS
VACUUM BREAKERS
LAVS (I3.UU omsi,k
WATER CLOSETS (ro,kq MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYS
HOSE BIBBS
ELECTRIC WATER HEATERS
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my
the owner of the above premises to perform the work for which the permit
knowledge, and further, that I am authorized by any claim
application is made. I further agree to hold harmless the City of Federa�W chasaoJ made by any persotT, including the and
attorneys' fees incurred in the investigation and defense of such claim),
undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of the city,
including its ofL4:C
sand employees, u the accuracy of the information supplied to the city as a part of this application.
ATE: 4
NAME/TITLE: (Titicl
gnatuRELATIONSHIP TO PROJT: O Properly Owner o Applicant ontractor O Archilecl O
F..OR OFFICE USE;;ONLY:
o NEW o ADDITION
BUILDING SHELL ONLY?
ZONING DESIGNATION:
NEW. ADDRESS REQUIRED?
PLATTED LOT?''
o ALTERATION o REPAIR a TENANT IMPROVEMENT
o YES ❑ NO
BASIC PLAN? o YES o NO
CHANGE OF USE? o YES o NO
UP/SEPA/SU? o YES o NO
o YES o NO
DYES D NO DEMO PERMIT REQUIRED? o YES o NO