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02-104321cityFederal Way' M Community Development Services echanical Permit #: 02 - 104321 - 00 - ME � 33530 1st Way Federal Way, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050 Project Name: PAYNE Project Address: 4128 SW 314TH Sr Project Description: MECH - Gas furnace changeout Parcel Number: 873199 0690 Owner Applicant Contractor JERRY PAYNE ALL STAR HEATING & APPLIANCES ALL STAR HEATING & APPLIANCES 4128 SW 314TH ST PO BOX 1923 PO BOX 1923 FEDERAL WA WA 98023 GIG HARBOR WA 98335 GIG HARBOR WA 98335 (253)853-2088 10116A2--- Mechanical Valuation..........................................826 Over the Counter Permit...................................... Yes Mechanical Fixtures Furnes 1 ac PERMIT EXPIRES April 1, 2043, IF NO WORK IS STARTED. Permit issued on October 3, 2002 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and :tA a use will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal W Owner or Date: �c-c `�;`� G CONSTRUCTION PERMIT APPUCATIO �jV 9 �L APPLICATION NUMBER: 2 - L D Z ( -61t APPLICATION NUMBER: - _ _ _ _ - _ _ APPLICATION NUMBER: - - **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. / O.ERTY INFORMATION SITE ADDRESS:! Z� -3� S C ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ — _ _ , LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ©MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): Cl) N A -r G y v�`��.C� PROJECT ■ PEOPLE INFORMATION r - PROPERTY OWNER: CONTRACTOR: N DAYTIME PHONE: (L75T ) 9A - `MAILING ADDRESS (STREET ADDRESS; CITY STATE, ZIP): mg S w SI4 Z -V F-4-1Vim►+\,_ #�• e1 �dZ� N J�VDAYTIME Sktliz, 3 PHONE: (zsz) � -ma+ MVNG ADDRESS �ET ADDRESS; CITY, STAQ%TE; P): EVENING PHONE: CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) APPLICANT: NAME: DAYTIME PHONE: ( ) MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: ( ) RELATIONSHIP TO PRO)ECr: FAX NUMBER ❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( ) - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR EXISTING USE: PROPOSED USE: ■ DETAILED BUILDING INFORMATION EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED VALUATION FOR IMPROVEMENTS: $ �Z S SPRINKLERED BUILDING? 1 ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED• ❑ YES ❑ NO WATER SERVICE PROVIDER: SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC) **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 AIR HANDLING UNITS) EVAPORATIVE COOLER(S) GAS LOGS) 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 ❑ 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) '1i5CLATMFR/SiGNOTURF 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 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. DATE: ( 0— G 3 1 C) I ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR ODMMUNUY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •753-661-4000 • FAX: 253-661-4129 www.~ederalway.com