03-105474City'of FoWeral Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: POT
Project Address: 3111 SW 313TH Sir
Project Description: Replacing gas furnace
Mechanical Permit #:03 -105474 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 438801 0250
Owner
Applicant
Contractor
Toshiba Pot & Sheryl Lynn Pot
AFFORDABLE GAS SERVICE
AFFORDABLE GAS SERVICE
3111 SW 313TH ST
AFFORDABLE GAS SERVICE
AFFORDABLE GAS SERVICE
FEDERAL WAY WA
12955 22ND AVE NE
12955 22ND AVE NE
98023-7862
SEATTLE WA 98125
(206) 367-5333
Mechanical Valuation..........................................3000 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description Quanti Description Quantity DescriptionQuantity
Furnaces I I
PERA UT EXPIRES June 15, 2004.
Permit issued on December 18, 2003
I hereby certify that the above information is cow 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._4JJ
Owner or agent: Date:
graI y�OIDW /���1�
4%
�.�6 RECEIVED CONSTRUCTION PERMIT APP ICATION
CITY OF , PPUCATION NUMBER: - - _
Federal Way DEC 1 9 2003 APPLICATIONNUMBER:
�;I ��//��►►ppAPPLICATION NUMBER:
*'The follo�nrirr6fWdyPTtiation — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: (� l S(,`) 3 t 3 c>T ASSESSOR'S TAXIPARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
O ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESSCRIPTION (Provide detailed description): A24C - t j!tS-,14ej) Gj Gf—16,4oGL Lc -//I
e -,L L70
PROJECT NAME:
PROPERTYOWNER: NAME:
C ij P•Y I 6
MAILING ADDRESS (SMEET ADDRESS; CITY, STATE, ZIP):
.3/// SW 3/ 3 -'-7-
CONTRACTOR:
T
CONTRACTOR:
DAYTIME PHUNE:
(Zs3) 8/-S- - 7z
LcJ�y L�J� S'g oL
I
NAME*
'%//'d7�j GAS �t✓vets
_✓�G�LJ/G
DAYTIME PHONE:
� (zc,(-} 367 - 5333
i MAILING ADDRESS (STREET ADDRESS; CITY, STATE. ZIP):
EVENING PHONE'
I29S-5- ZZ N= /72..,- W4.
��/zs ( 706 ) 367 - S5 3 -3 I
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
i FAX NUMBER:
�(Zn6) 36'7- S33
CONTRACTOR'S REGISTRATION NUMBER:
1 EXPIRATION DATE:
(cDPY of card required) F o I Z G-5
D-7 L 3/ i 7/ o
APPLICANT: NAME: f DAYTIME PHONE:
`✓�vs i (��) 367 - s'333
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
17-,75-5— Z z viz ". &.), qS/,Z 5 ; ( 2-06) 367 - S-3 3 3
RELATIONSHIP TO PROJECT: i FAX NUMBER:
O ARCHITECT ❑ TENANT THER ( DESCRIBE): CO -1 �vs i ( 2o6 N 36-7 5 3 -33 i
EMAIL ADDRESS:
I
CONTACT PERSON FOR THIS PROJECT: O PROPERTY OWNER ❑APPLICANT NT
R
A
CTOR
DETAILED BUILDING • •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION ;
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE O PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNITS)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S)
FAN(S)
FIREPLACEINSERT(S)
FURNACE(S)
GAS PIPE OUTLET(S)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
w
Value of Mechanical Work: $
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
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 information supplied to the city a art of this application.
NAME/TITLE: C,, ii -C." DATE: �V10 �
❑ PROPERTY OW R APPLICANT TRACTOR
FOR OFFICE USE ONLY;
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www CirvOffederalway.c—
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CITY OF
Federal Ways
May 19, 2004
Toshiba and Sheryl Lynn Pot
3111 SW 313th Street
Federal Way, WA 98023-7862
CITY HALL
33530 1 st Way South • PO Box 9718
Federal Way, WA 98063-9718
(253)661-4000
www.cityoffederalway.com
RE: 03 -105474 -00 -ME; POT
3111 SW 313th Street; Expiration of Permit, Notice to Extend
Our records indicate that on Thursday.. December 18, 2003, the City of Federal Way
issued permit 03 -105474 -00 -ME. This permit expires by limitation and becomes null
and void if the building or work authorized by the permit is not commenced within 180
days from the date of issuance, or if the building or work authorized by the permit is
suspended or abandoned at any time after the work is commenced for a period of 180
days. The building official may extend the time for action by the permittee for a period
not exceeding 180 days upon written request by the permittee showing that
circumstances beyond the control of the permittee have prevented action from being
taken. No permit may be extended more than once.
To avoid expiration of your permit, you may call the inspection request line (253-835-
3050) to set up an inspection; or request an extension of your permit by submitting a
written request to the building official by Tuesday, June 15, 2004. This request may
be submitted via the regular mail or e-mail at buildingofficialoci.federal-way.wa.us.
The request should include information indicating that circumstances beyond your
control have prevented you from taking action on this permit.
If you choose not to request an extension for this permit, your permit will become null
and void on Wednesday, June 16, 2004. Work shall not continue at any time after
expiration of the permit until a new permit is obtained.
If you have any questions, please call 253-661-4115.
Sincerely,
WK Wartin
Building Official
cc: Affordable Gas Service; Attn: Permits; 12955 22nd Avenue NE; Seattle WA 98125
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