03-104578City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: HOME USA
Project Address: 2030 S 314TH -51f
Mechanical Permit #:03 - 104578 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 092104 9053
Project Description: Install new exposed ductwork with diffusers to existing HVAC units. Add gas line for separate tenant
space.
Owner
Applicant
Contractor
ROSEN PROPERTIES
HEATTRANSFER CO
HEATTRANSFER CO
ROSEN PROPERTIES
P.O. BOX 1268
P.O. BOX 1268
1715 114TH AVE SE UNIT 212
CARNATION WA 98014
CARNATION WA 98014
NfthN]gq.* ia)FAti9%N4....................................1470
Over the Counter Permit..(,ow).885
3247•.......• No
PERMIT EXPIRES April 14, 2004.
Permit issued on October 17, 2003
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: �L Date: a3
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®` RECEIVE6A F -
CONSTRUCTION PERMIT APPLICATION
CITY Of
Federal Way OCT 0 6 2003 PPLICATION NUMBER:
PPLICATION NUMBER:
CITY OF FEDERAL WAY PPLICATION NUMBER: - -
BUILDING DEPT. — — — — — — — -
-The following is required information — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY •. •
SITE ADDRESS: ,?�.�c� / ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): t
PRO3ECT INFORMATION
TYPE OF PROJECT (This application):. o BUILDING o PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME: L 1 U-Vx" J V'%
PEOPLE• •
PROPERTY OWNER: NAME: DAYTIME PHONE'
MAILING ADDRESS (STREET ADDRESS; STATIE, ZIP):
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CONTRACTOR: I NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE. ZIP):
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
l�
CONTRACTOR'S REGISTRATION NUMBER:
. J
APPLICANT: I NAME:
1
�
oOWA S" S
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE)
DAYTIME PHONE:
("z ) 8g
- EVENING PHON
FAX NUMBER:
j EXPIRATION DATE:
DAYTIME PHONE:
EVENING PHONE:
i FAX NUMBER:
+( I
E-MAIL ADDRESS:
j I
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER O APPLICANT /(CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE:
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
PROPOSED VALUATION FOR IMPROVEMENTS:
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE o TACOMA o PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
4
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL Value of Mechanical Work: $
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) _� GAS PIPE OUTLETS) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
]ISCLATMFR/SIGNATURE RLC
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 aris t -of the reliance of the city, including its officers and employees, upon W accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑APPLICANT ONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33S30 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 - FAX: 253-661-4129
www.CntOffederalway.com