03-104622tty Of
' Commuanity Development Services Federal Way Mechanical Permit #: 03 -104622 - 00 - ME
Com
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: MAUZEY
Project Address: 1347 SW 348TH 54 -
Project Description: Gas furnace changeout
Parcel Number: 542242 0400
Owner
Applicant
Contractor
Jeffrey J Mauzey & Karen M Mauzey
ROSSOE ENERGY SYSTEMS INC
ROSSOE ENERGY SYSTEMS INC
1347 SW 348TH ST
9367 RAINIER AVE S
9367 RAINIER AVE S
FEDERAL WAY WA
SEATTLE WA 98118
SEATTLE WA 98118
98023-7028
1
1 (206) 725-7555
Mechanical Valuation..........................................2577 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description�Quanti q I Deschpti n lQuantityl I Description �Qlaanti
Furnaces 1
PERMIT EXPIRES April 5, 2004.
Permit issued on October 8, 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.
See ApnnliCat uollrxidd as
Owner or agent: Y lh Date: S
11�19�03
RECEIVED BY /V e- -
G
COMMUNITVDEVELOPMENT DEPARTMEM CONSTRUCTION PERMIT APPLICATION
ter. of
OCT U 8 2003 APPLICATION NUMBER: �- i i
— —
APPLICATION NUMBER:
APPLICATION NUMBER:
**The following is required information — Please print (ih ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY• •
SITE ADDRESS: 71 l S� 3� O S� ASSESSOR'S TAX/PARCEL #:542- 4 2- ?—A+ 2 - Lk 0 C)
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROIECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
-"EL'ECTRICAt❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): (�
PROJECT NAME:
INFORMATIONPEOPLE
PROPERTY OWNER: NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CrrY, STATE, ZIP):
St
CONTRACTOR:
NAME,
DAYTIME PHONE:
a8
MAILING ADDRESS EET ADDRESS; CITY, ST4V ZIP V � - • � �
EVENING PHONE: _ I
CITY OF FEDEPk WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
-00-
( Le) `I23 -5i&-4-IR
EXPIRATION
CONTRACTOR'S REGISTRATION NUMBER: , �.^ ^^
(copy of card required)
/ATE: /
APPLICANT:
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
RELATIONSHIP TO PROJECT:
FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):
( -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
DETAILED BUILDING INFORMATION
� c70
EXISTING USE: eSl�e Oma` EXISTING BUILDING ASSESSED/APPRAISED VALUATION` -
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
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)
i
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
- - ■ PRO=ECT 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
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAINWATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
; rther, that I am authorized by the owner of the above premises to perforin the work for which the permit application is made. I
Ar ther agree to"hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the
bvestigation 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
the information supplied to the city as a part of this aPplication.
A-
tkME/TIT, nATF- 17)_ 1 '03
C PROPERTY OWNER ❑ APPLICANT CONTRACTOR
-FOR:OFFICE USE ONLY:
❑ ,NEW: -:_❑ A66ITION
C1 ALTERATION
:CENSUS CODE:`
_ZONING_DESIGNATION
-COMP PLAN DESIGNATION
SECTION TOWNSHIP RANGE
PLATTED LOT? ❑ YES ❑ NO
❑=REPAIR:.: ❑ TENANT..
...._ ......
LOT SIZE:
BUILDING SHELL..ONLY? ❑ YES
BASIC PLAN? =' ❑ YES ❑ NO
NEW ADDRESS REQUIRED?
CHANGE OF USE?' ❑ YES
=MENT
NO
❑ YES Cl NO
❑ NO
COMMUNITY DEVELOPMENT SERv10E5 • 33530 FIRST WAY SOUTH - PO BOX 9718 . FEDERAL WAY, WA 98063-9718 - 253661-4000 • FAX: 253-64G 1-4129
www.0tvoffedera lwaY.Com