04-100912k
City of Federal Way
COhmunity Development Services
3353b 1st Way S
Federal V.ay, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:04 -100912 - 00 - ME
Project Name: PICKETT �JL
Project Address: 33848 35TH1SW
Project Description: Install gas furnace in garage to replace existing
Inspection request line: 253.835.3050
Parcel Number: 536020 0051
Owner
Applicant
Contractor
Bruce D Pickett & Karin S Pickett
ADVANCED FILTER & MECH INC
ADVANCED FILTER & MECH INC
33848 35TH AVE SW
418 VALLEY AVE NW UNIT B115
418 VALLEY AVE NW UNIT B115
FEDERAL WAY WA
PUYALLUP WA 98371
PUYALLUP WA 98371
98023-2934
(253) 770-2440
Mechanical Valuation..........................................1480 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Quantity Description Quantity Description Quantity
FFurnaces
L_
PERMIT EXPIRES September 12, 2004.
Permit issued on March 16, 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 accLZ
laws, rules and regulations of the State of Washington and
the City of Federal y.
r I /
Owner or agent: Date: 3 � � Q
</- /-U SIG C --J
RECEIVED
CITY OF
Federal way MAR 1 6 2RERMIT APPLICATION
For OBice Use Only C
The following is
TD:
WeAlW s�»AN4FAWw_ LE
(�
COMMUNITY DEVELOPMENT SkRWCES
33530 FIRST WAY SOUTH • PO BOX 9718
FEDERAL WAY, WA 98063-9718
253661-4115• FAX: 253661-4129
unuru.citunRe:t 11u0umm
- an incomplete aliplication will not be accepted. Please print legibly (in ink) or
SITE ADDRESS: ;413 s H ?� — ---)5y) me, 5Loy ` SUITE/APT # .
ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ - _ _ _ _ SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (e.g.: Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
TYPE OF PERMIT (This application): ❑ BUltDING ❑ PLUMBING ef MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlUh-
Q-6 2i i1 r_ a /� C GtS(:..e Tf�'J ('P 1)1cc a [3 )'
cy�:.3�!cG1. y�[ 5 CTJ�nCdc.-ICe
PROJECT NAME (Name of Business/Owner Last Namp):
PROPERTY
OWNER:
CONTRACTOR:
LENDER:
(If Proposed Vstoe > $5,000)
APPLICANT:
NAME:
) R 5x -
NAME 'D a 'A d f., 0-% 5
COMPANY
OFFICE PHONE:
MAILING ADDRESS (STREET ADDRESS):
A 4- 1
EVENING PHONE:
( )
(Z63) O
- 491/0
MAILING ADDRESS (STREET ADDRESS;):
CITY, STATE, ZIP
CELL PHONE:
(2
PV %
(L�3)
-
C OF FEDERAL WAY BUSINESS LICENSE NUMBER:
'EXPIRATION DATE:
FAX NUMBER:
) 7
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION
DATE:
(copy of card required with each application) _
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS;): CITY, STATE, ZIP
NAME:
COMPANY
OFFICE PHONE:
MAILING ADDRESS (STREET ADDRESS):
CITY, STATE, ZIP
EVENING PHONE:
( )
RELATIONSHIP TO PROJECT:
❑ Architect ❑ Tenant ❑ Other (Describer
FAX NUMBER:
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner ❑ Contractor ❑ Applicant E-MAIL ADDRESS:
DMAMED BUILDING INFOMATION
EXISTING USE- PROPOSED USE:
EXISTING ASSESSED/APPRAISE PROPOSED WORK $
SPRINKLERED BUILDING? ❑ NO FI SSION SYSTEM PROPOSED/ REQUIRED?: ❑ YES ❑ NO
WATER SER OVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ A ❑ PRIVATE (WELL)
SE
VICEPROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (
■ PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
o NEW ❑ ADDITION
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
FIRST
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
a YES
SECOND
ZONING DESIGNATION:
CHANGE OF USE?
THIRD
❑ NO
.NEW ADDRESS REQUIRED? o YES o NO
UP/SEPA/SU?
FOURTH
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
ADDITIONAL FLOORS (DESCRIBE)
o NO
DECK(COVERED?)
GARAGE/CARPO
HOW FLOORS?
TOTAL EXISTING
TOTAL PROPOSED
TOTAL EXISTING AND PROPOSED
1*�WEWHOMES ONLY" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
Indicate number of each
be installed[4r located as part of this project. Do not include existing fixtures to remain.
MECHANICAL o od
Value of MechanicaLNGUNIT�S
- AIR HAND TIVE COOLERS
BBQS
BOILERS FIREPLACE INSERTS
COMPRESSORS FURNACES
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS (or Tub/sho Combo) SHOWERS
DISHWASHERS SINKS
GAS PIPE OUTLETS SUMPS
WASHING MACHINES URINALS
LAVS (Bathroom sink VACUUM BREAKERS
GAS LOGS
HOODS (comm«cw)
RANGES
GAS WATER HEATERS
WATER CLOSETS (rouoq _
DRINKING FOUNTAINS
RAINWATER SYS
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
I certify under penalty of perjury thatkhe information furnished by me is true and correct to the best of my
knowledge, and ficrther, 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 employee , upon the accuracy of the information supplied to the city as apart of this application.
NAME/TITLE: _ 1rY..�►� DATE:
(Signature)
(Title)
RELATIONSHIP TO ROJECT: ❑ Property Owner ❑ Applicant ❑ Contractor ❑ Architect ❑
FOR OFFICE,USE ONLY: -
o NEW ❑ ADDITION
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
a YES
❑ NO
ZONING DESIGNATION:
CHANGE OF USE?
❑ YES
❑ NO
.NEW ADDRESS REQUIRED? o YES o NO
UP/SEPA/SU?
❑ YES
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
a YES
o NO
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