04-101797pity of Federal Way
community Development Services Mechanical Permit #: 04 - 101797 - 00 - ME
335301st Way S
Federal Way, WA 98003-6210
,?h: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
O d `/O I7 18 —Cx:� � 6�_ Z_
Project Name: MATSUMOTO
Project Address: 32340 19THkSW
Project Description: Installing Aironditioning
Parcel Number: 010454 0630
Owner
Applicant
Contractor
Eric D Matsumoto
BRENNAN HEATING & A/C LLC
BRENNAN HEATING & A/C LLC
32340 19TH CT SW
4601 S 134TH PL
4601 S 134TH PL
FEDERAL WAY WA
TUKWILA WA 98168
TUKWILA WA 98168
98023-5446
(206)248-7900
Mechanical Valuation..........................................2428 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description Quantity Description Qu—an ti tW cription Quanti
Air Handling Units 1
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: _ See Application Date: I loi'--A
NOTE: FINAL INSPECTION REQUIRED UPON
COMPLETION OF WORK
"J
Mechanical rough -in:
Gas pipe:
FINAL MECHANICAL:
Date
Dat
Dat
RECEIVED BY f�``�'��
f dVUNITY DEVELOPMENT D R�iG1ENT COa(A(UNIn'Drpf•WPAfEhTsrRY(Crs
mw
aasao FIRST WAY soon(• 10 BOX 9718
ciry FFI6X(..-R1A4(.1WAY. AW.AC: 96063-9718
7.7Federal PERMIT APPLICATION 2
7
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The (ollowinq is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRI'.SS: 0Aq5qQ I'q-M 1�—,r �W AS$LSSOR'S TAX/PARCEL N:
LEGAL DESCRIPTION (cg: Acine Eslales, Lot 1)
(Attach separate page for Ierfgthy !c rinl cic:;i rljltinn)
SQUARE FOOTAGE OF LOT:
TYPE OF PERMIT (This application): ❑ BUILDING ❑ PLUMBING XMECIIANICAL 1:1 DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTENI
PROJECT DESCRIPTION (Prouide detailed description of work included orf ttlls hermit onh():
1 IJ, `3`CA1.L 1 lS6r AWL C MID C-ri ba I t,jj�r
PROJECT NAME
PROPERTY
OWNER:
CONTRACTOR:
LENDER:
fir rror—d Value > 38,0001.
APPLICANT:
Business/Owner Last
NAME: PRIMARY )'HONE:
621 e-HATSOMO-M I (ASS 835 -527.2
MAILING ADDRESS (STRIiIST ADDRESS;): CITY, STATE. LII' —
NAME
SRr-f1tiLA&199A-il ')-, Pyt
COMPANY -�--
OFFICE 111IONE.:
(Abio) ���8
-79 oa
MAILING ADDRESS (STREIiT ADDRESS;(:
--ruKQ1LA
CITY, STATE. ZIP
CELL 14 ION Ii:
( 1
-
CITY OFFEDERAL WAY IIUSINESS LICENSE NUMIIER:
_ao_ - n 4 t a 1 o 0015L
EDATEXPIRATION �TE
ea. /,31 /Oq
FAN NUMNER.
(ao(p) &4t
-174ID5"
CONTRACI'OR5 RIiGISTRATION NUMDBN: �y�y
> • _ � M
A q'7 1 k �
EXPIRATION
�� / �^�
DATE'
HATE' -
/ 66
(copy of cud required with each •pplica..,
(copy
DAYI IME PHONE:
MAILING ADDRESS (S-1'REE-T ADDRESS;): CITY, STATE, 2111
NAME:
COMPANY
OFFICE: 111IONE:
'$ftE 4K1A)i. 969Ct MiCr «- Ale.
AYp) 649 --71bb
MAILING ADU14ESS (STREET ADDRESS):
7L"u4a) 8 1!54,u 71,
CITY, STATE, 2111
LA q$11Q8'—
EVENING 11IIONIi:
RE.IATIONSIIIPTO I'ROJI-.C`I':
'fen:uu OUfer
FAX NUMDE.^It: p
(a
❑ Architect ❑ ❑ (Describr_):
01,8
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owncr Contractor ❑ Applicant I E•MAILADDRESS:
• I •3 "10 I • 'aft 1 •• •
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORIt: $
SPRINKLERED BUILDING? o YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: O YES O NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN O HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: I I LAKEHAVEN f1 HIGHLINE fl PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING S . FT. PROPOSED Sq. FT. TOTAL
I? SEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DL'SCRIBE)
DECK (COVERED?)
GARAGE/CARPORT
TOTAL EM ING TOTAL PROPOSED T07AL =STING AND PROPOSED
xow MANY FwoRs?
..ArG`w unMF_S ONLY" NUMBER OF BEDROOMS: - ESTIMATED SELLING PRICE: $
installed relocated as part of this project. Do not include existing fixtures to remain.
Indicate number of each type of fixture that is to
be or
MECHAMCALg' QQ
Value of Mechanical Work $
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
ROODS (couuuc.w)
KEFRIG. SYSTEMS
WOODSTOVES
_ BBQS
FANS
FIREPLACE INSERTS
RANGES
MISC (Dcscribe)
BOILERS
FURNACES
GAS WATER HEATERS
A /C,
/-�[J
COMPRESSORS
GAS PIPE OUTLETS
r----�
DUCTS
PLUMBING
SHOWERS
WATER CLOSETS rroskq
MISC (Describe)
BATHTUBS (.r Tub/ShwereumWI
DRINKING FOUNTAINS
DISHWASHERS
SINKS
RAINWATER SYS
GAS PIPE OUTLETS
SUMPS
ROSE BIBBS
WASHING MACHINES
URINALS
ELECTRIC WATER HEATERS
VACUUM BREAKERS
LAVS (Oauv m s"
I certify under penally/ of perjury that the information furnished by nu: is true and correct to the best of lily
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 harrnlcss the City of Federal Way
'may
any claim (including costs, expenses, and
attorneys'Jees incurred in the investigation and defense of such claim), which
m
undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of the city,
including its ofc4�—
ficers and employees, upon the accuracy of the information supplied to the city as a partt this application.
DATE:
NAME/TITLE: (Title)
(Signature)
RELATIONSHIP TO PROJECT: o Property Owner O Applicant ❑ Contractor ❑ Architect ❑
F&R' OFFICE'USE„ONLY:
o NEW o ADDITION
BUILDING SHELL -ONLY?
ZONING DESIGNATION:
NEW. ADDRESS REQUIRED?
PLATTED LOT?”
o ALTERATION o REPAIR o TENANT IMPROVEMENT
o YES o N0 BASIC PLAN? o YES o NO
CHANGE OF USE? o YES o NO
o YES a N0
UP/SEPA/SU? o YES o NO
o YES o NO DEMO PERMIT REQUIRED? o YES o NO
• i'e.t