04-1023404
. I4
v
City offederal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.561.4000 Fax: 253.661.4129
Jr
Mechanical Permit #:04 - 102340 - 00 - ME
Inspection request line: 253.835.3050
Project Name: LANGDON teV
Project Address: 31863 48TH�SW Unit14-C Parcel Number: 661320 0110
Project Description: Install gas furnace
Owner
Applicant
Contractor
Dale W Langdon & Lucille E Langdon
Dale W Langdon
Dale W Langdon
31863 48TH CIR SW #14C
31863 48TH CIR SW #14C
31863 48TH CIR SW #14C
FEDERAL WAY WA
FEDERAL WAY WA
FEDERAL WAY WA
98023-4129
98023-4129
(253)661-6100
Mechanical Valuation..........................................560 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description iiQuantity Description Quantity ascription —� ua t
Furnaces 1
PERMIT EXPIRES December 8, 2004.
Permit issued on June 11 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: Date: ZL�
Federal WayVE—
• JAN q'ERMIT EI�Er�F MF COa�L PL DE EN FP
COMMUMfYDEVELOPMEM'SERVICES y lF" L% /�%
33530 FIRST WAY SO(A PO BOX 9718 ( Y � p L I C A T I �/
FEDERAL WAY, WA 98063-97
253-667-0115• FAX 25366141 ]-y F
www. d[uollederdwau.mm Bv,�a)NGE�pL W, JUN 10 2004
The following is required inform�tSiAirr an i4Atete application will not be acpeh �, Please print legibiy (in ink) or tune -
SITE ADDRESS
TP /' .
ASSESSOR'S TAX/PARCEL # I-) -L J— 3— --2— n - - 0
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) _1 l4 L � fs A d e (- A -r fn i
(Attach-epa.ate page f., lengthy tegd de --;peon)
SUITE/UNIT # j
LOT SIZE (sj)
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Prouide detailed description of work included on this permit onlu)
PROJECT NAME (Name of Business or Owner Last
PROPERTY
OWNER
CONTRACTOR
APPLICANT
R_ (A ?,Lr P
tyh�tPI LAS1
. T7 &4L
CONTACT
LENDER
NAME p
1P L
PRIMARY PHONE
-
MAILIM7ADbRIESS
srI
CITY, STATE, ZIP
\l &-a'CA
COMPANY NAME
S
APPLICANT NAME
&i
OFFICE PHONE
(?C� ) 2'-/3 b/s
MAILING ADDRESS
CITY, STATE, ZIP
CELLPHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
— --- — — — — B L
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER copy of card required with each application) EXPIRATION DATE
COMPANY NAME
`r -
APPLICANT NAME
RJA_
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELLPHONE
QSS
RELATIONSHIP TO PROJECT _
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe) l) I�(� �✓t C U (L
FAX NUM) ER
( ) -
NAME
PRIMARY PHONE
E-MAIL ADDRESS
Per RCW 19.27.095: Lender information is
required ifproject value exceeds$5,000
NAME
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) .
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE (SEPTIC)
e
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
FIRST
BASIC PLAN? ❑ YES
o NO
ZONING DESIGNATION
SECOND
CHANGE OF USE? ❑ YES
o NO
NEW ADDRESS REQUIRED? o YES o NO
THIRD
o NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED? o YES
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL. EXISTING
TOTAL. PROPOSED
TOTAL. FASTING ALtD PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMA D SELLING PRICE $
Indicate number of each
MECHANICAL
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (orTub/Sno—combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
installed or relocated as Bart of this project. Do not include existing fixtures to remain.
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS REFRIG. SYSTEMS
HOODS (co—Dermal) WOODSTOVES
RANGES MISC (Describe)
GAS WATER HEATERS
WATER CLOSETS Iraaeq MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYST
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 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 claimJ, 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 supplied to the city as a part of
this application.
NAME/TITLE
(SLgnature) (Title)
RELATIONSHIP TO PROJECT owner ❑ Agent ❑ Contractor ❑ Architect
DATE La 0 �(
❑ Other �- P/ -_.t �v-'A
FOR OFFICE USE ONLY
❑ NEW ❑ ADDITION
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES o NO
BASIC PLAN? ❑ YES
o NO
ZONING DESIGNATION
CHANGE OF USE? ❑ YES
o NO
NEW ADDRESS REQUIRED? o YES o NO
UP/SEPA/SU? o YES
o NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED? o YES
❑ NO
Bulletin # 100 — March 30, 2004 Page 2 of 4 k\[-Iandouts — Revised\Permit Application