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03-100835t A City of Federal Way Community Development Services 33530 1st Way S Federal Way, WA 98003-6210 Phi 253.661.4000 Fax: 253.661.4129 Mechanical Permit #:03 -100835 - 00 - ME Inspection request line: 253.835.3050 ProiWIs Name: YOUNG Project Address: 30513 5TH 9W Parcel Number: 178890 0190 Projcct;Description: Replace gas furnace and water heater - Owner Applicant Contractor ROGER YOUNG JR. ROGER YOUNG JR. JAKE'S FURNACE REPAIR INC. 4323 NASSAU AVE NE 4323 NASSAU AVE NE JAKE'S FURNACE REPAIR INC. TACOMA WA TACOMA WA PO BOX 594 (253) 840-2445 Mechanical Valuation..........................................2225 Over the Counter Permit ...................................... Yes Mechanical Fixtures Description JQuantiDescription Quantity Description Quantity Furnaces � � I I PERMIT EXPIRES August 26, 2003. Permit issued on February 27, 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 acrdance with the laws, rules and regulations of the State of Washington and the Citv .01 Date2 '7 a (—O—�; Uv V tom° C-i /�-c- ioC� J r.- RECEIVED CONSTRUCTION PERMIT APPLICATION CITY OF RE �w../ APPLICATION NUMBER: - O Federal Way Q _ - � APPLICATION NUMBER: .., z 72003 ------ -- r "APPLICATION NUMBER: **The follo)�irr*i'OI fefFCHiDCcRA& AYion - Please print (in ink) or type** NG Please note: Electrical yst Fire Prevet(ffoADEPT. stems and Engineering permits may require a separate application. SITE ADDRESS: OS S, 0 " ASSESSOR'S TAX/PARCEL #: - LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): PR03ECT INFORMATION TYPE OF PROJECT (This application): o BUILDING o PLUMBING MECHANICAL o DEMOLITION o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): e PROJECT NAME: i�EIIFLL IrWORMATIOr. PROPERTY OWNER: NAL U �� � � DAYTIME PHONE: - i MAILING DDADDRESS �(/STTR'EEEETyA�D (D-R,ESS�CIIT�Y,, �ATE, ZIP): 43 lr CONTRACTOR: NAME: APPLICANT: j MAILING T / ADDRESS©1 (STREET ATE. ZIV4 iEVENING PHONE: - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: i FAX NUMBER: ' CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card require) ���� • ' ' — f % / NAME: DAYTIME PHONE: MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP): EVENING PHONE: RELATIONSHIP TO PROJECT: i FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR0 DETAILED I 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: o YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE n TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE o PRIVATE (SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PROSECT 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 UNIT(S) 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) GAS LOG(S) REFRIG. SYSTEM(S) FAN(S) HOODS)WOODSTOVE(S FIREPLACE INSERT(S) RANGE(S) ,L MISC. FURNACE(S)wo GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC GAS PLUMBING LAVATORY(S) RAIN WATER SYS. SHOWER(S) SINKS) SUMP(S) URINAL(S) _ VACUUM BREAKER(S) ❑ WASH MACHINE OUTLET WATER CLOSET(S) _ ']TSCI_ATMFR/STGNATURF RLC WATER HEATER(S) ELECTRIC ❑ GAS 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 claimses out of the reliance of the city, including Its officers and employees, upon the accuracy of the informationsuppft *w the city a§a part of thl"pplication. NAME/TITLE: - lt�� XPROPERTY OWNER DATE: Z7" -Z-1-03; COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129 www.ctvoffederalway.com