03-100532City of Federal Way
Community Development Services Mechanical Permit #:03 -100532 - 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: ADAIR pJV
Project Address: 28811 19TH'S Parcel Number: 422300 0020
Project Description: Replace gas furnace
Owner
Applicant
Contractor
Marie E Adair
ACE HEATING
ACE HEATING
28811 19TH AVE S
ACE HEATING
ACE HEATING
FEDERAL WAY WA 98003-3811
2300 S 118TH
2300 S 118TH
SEATTLE WA 98168 1
(253) 839-9051
Mechanical Valuation..........................................2828 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
m.- X30
Furnaces 1
1 71
PERMIT EXPIRES August 5, 2003.
Permit issued on February 6, 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: (—f —_ w�---� Date: r. V �U
/ e - 4, F, tvLc- ` ')1 2— ( 8--v3 ci
/1(&,rfl
CONSTRUCTION PERMIT APPLICATION
CITY OF 1PPftftZ� PPLICATION NUMBER: — 2--
Federal Way[APPLICATION NUMBER:-
PPLICA N NUMBER: - -
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevent)
SITE ADDRESS: ,Mc)
and Engineering permits may require a separate application.
4SESSOR'S TAX/PARCEL #: _ _ _ _ _ _ - _ _ _ _
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING o PLUMBING XIMECHANICAL 'o DEMOLITION
❑ ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): �v/VKt�Q_ �e)�aGL LQ,t \
PROJECT NAME: 0 -to -Lr AT)��C--
PROPERTYOWNER: NAME: �^
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
C%
CONTRACTOR:
APPLICANT:
DAYTIME PHONE:
(a53) F39 -gas
NAME:
`C
DAYTIME PHONE: �
Q5 3) a-55 - 1c)5
MAILING ADDRESS.(STREET ADDRE S' , STATE, ZIP):
c S t I Fr� R0 t3v
EVENING PHONE:
c (af3 ) 5-39 - qusr
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
I FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
Ci
i EXPIRATION DATE:
(cwy of card required)
S.,
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
I
RELATIONSHIP TO PROJECT: I FAX NUMBER:
❑ ARCHITECT o TENANT o OTHER ( DESCRIBE): ! ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT ❑ CONTRACTOR
EXISTING USE:
I -PROPOSED USE: k�
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROV ENTS: $ CJ
❑ YES - ."o FIRE SUPPRESSION SYSTEM PR FQIITRFn- r-1 YF -c. C1
❑ LAKEHAVEN o HIGHLINE
o TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY"
OF BEDROOMS:
ESTIMATED SELLING PRICE:
FLOOR
EXI . FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
FIRST
, SUMP(S)
SECOND
THIRD
FOURTH
OTHE RS (DESCRIBE)
CK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S)
BBQ(S) FAN(S)
BOILERS) FIREPLACE INSERTS)
COMPRESSOR(S) FURNACE(S)
DUCT(S) T GAS PIPE OUTLET(S)
PLUMBING
BATHTUB(S)
LAVATORY(S)
DISHWASHER(S)
RAIN WATER SYS.
DRINKING FOUNTAIN(S)
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
INTERCEPTORS)
, SUMP(S)
GAS LOG(S) REFRIG. SYSTEMS)
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 thaft 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 as a part of this application.
NAME/TITLE: Ur,�, DATE: �-) _b — C--�,
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129
www•dtgMeralway.com