03-102856City unity Development Services Federal Way
Community Mechanical Permit #: 03 -102856 - 00 - ME
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: WESTERDAHL
Project Address: 31621 32ND�W Parcel Number: 438800 0170
J!i
Project Description: Replacing gas furnace
Owner
Applicant
Contractor
Jack W Westerdahl
AFFORDABLE GAS SERVICE
AFFORDABLE GAS SERVICE
31621 32ND AVE SW
AFFORDABLE GAS SERVICE
AFFORDABLE GAS SERVICE
FEDERAL WAY WA
12955 22ND AVE NE
12955 22ND AVE NE
98023-2252
SEATTLE WA 98125
(206) 367-5333
Mechanical Valuation..........................................2490
Over the Counter Permit ...................................... Yes
Mechanical Fixtures
PERMIT EXPIRES January 7, 2004.
Permit issued on July 11, 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: 4kDate:,
41
R r RECED'E'D CONSTRUCTION PERMIT APPLICATION
CITY OF �� PPLICATION NUMBER:
Federal Way JUL 1 1 2003 1APPLICATION NUMBER: _ _ - — — -
PPLICATION NUMBER:
CITY OF FEDERAL WAY
*'The afftoff"MCO-fted information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY• •
SITE ADDRESS: 3/6 2'1 32- ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): o BUILDING o PLUMBING c31AECHANICAL o DEMOLITION
❑ ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): �I.f u s
PROJECT NAME: We 54,de 1 /
NPEOPLE INFORMATION
PROPFRTYOWNFR- NAME: DAYTIME PHONE
CONTRACTOR:
APPLICANT:
.& We s-�. c/4 4 (ZS3 ) 239 - 37 -)Cl
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): '
3/6 zi 3 z 4,
NAM /J /
DAYTIME PHONE:
f rD/Gi 4_5
31. -533 i y
MAILING ADDRESS (STREET ADDRESS; CITY. STATE. ZIP):
EVENING PHONE:
/Z4Ss Zy S we, 5glzs
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
- _ _ _ _ _ _ _ - _ _
I(7o6) 367- X333
CONTRACTOR'S REGISTRATION NUMBER:
(c)py of oro required)
i EXPIRATION DATE:
MAIL]
vS
f /2 9 5S 7-2- tiE �., %� u�y 5
RELATIONSHIP TO PROJECT: //
❑ ARCHITECT O TENANT THER ( DESCRIBE): eOr 4,otrw Fy 1
CONTACT PERSON FOR THIS PROJECT: U4,eOPERTY OWNER O APPLICANT
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
EXISTING BUILDING ASSESSED/ APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROVEMENTS: $
( -2216) 367 - S-3 3 3i
EVENING PHONE-
( 206
HONE•(206 ) �3f.ST aYo 3
FAX NUMBER:
(zo6) 3/6-7- -73334
E-MAIL ADDRESS
I
O YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/F
❑ LAKEHAVEN ❑ HIGHLINE O TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
o YES -----o NO
"NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
FIRST
SUMP(S)
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNITS) 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 OUTLET(S) HEAT SOURCE: ❑ ELECTRIC W6AS
PLUMBING
BATHTUB(S)
LAVATORY(S)
DISHWASHER(S)
RAIN WATER SYS.
DRINKING FOUNTAIN(S)
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
INTERCEPTORS)
SUMP(S)
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 a out of the reliance of the city, including Its officers and employees, upon the accuracy
of the information supplied to the city as�f this 46piication.
NAME/TITLE: { r 6-114-C'61- DATE: /(
❑ PROPERTY OWNER❑' PLICANT W606N CTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.dtvoffederalway.com