03-100087r
Applicant
City of Federal Way
Lawrence D Minkler
Mechanical Permit #: 03 - 100087 - 00 - ME
Community Development Services
3802 AUBURN WAY N
33530 1st Way S
AUBURN WA 98002
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Inspection request line: 253.835.3050
Project Name: MINKLER p\
Project Address: 29223 13TH�S
Project Description: Chance out of a eas furnace
Parcel Number: 720560 0150
Owner
Applicant
Contractor
Lawrence D Minkler
GATEWAY HEATING & AIR CONDITIO
GATEWAY HEATING & AIR CONDITIO
3802 AUBURN WAY N
3802 AUBURN WAY N
AUBURN WA 98002
AUBURN WA 98002
(253) 931-0610
Mechani cal' V aluation..........................................1997
Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Furnaces
PERMIT EXPIRES July 7, 2003, IF NO WORK IS STARTED.
Permit issued on January 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 Feder a".
Owner or agent: L- Date: 0/— 0 8 -03
,f RECEIVED Gq
CffCONSTRUCTION PERMIT APPLICATION
VV f3YL JAN 0 8 2003 APPLICATION NUMBER:-
PPLICATION NUMBER:
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEPT. - - - - - - - - - -
**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. .
I PROPERTYn INFORMATION
SITE ADDRESS:L3` p-' �� ASSESSOR'S TAX/PARCEL #: � Q66 6 - C� l�
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DEISCRIPTION (Provide detailed description): 0 ]n
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
CONTACT PERSON
EXISTING USE:
PROPOSED USE:
■ PEOPLE INFORMATION
` 0 DAYTIME PHONE:
ADD`RE S; C Si
1.
NAME:
g �� ��
DAYTIME PHONE:
ca ) q 3r -
o
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
�O� !U -
EVENING PHONE:
c -
CITY OF FEDERAL WAY BUSINESS LICENSE NUM BE2 co - 84-
FAX NUMBER: -
O
CONTRACTOR'S REGISTRATION NUMBER:
(copy of card required)
EXPIRATIOJ`N DATE:
NAME:
r�q JJ c'
DAYTIME PHONE:
53) 9 -
C6 101
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
RELATIONSHIP TO PROJECT:
❑ ARCHITECT Q TENANT OTHER (DESCRIBE):-
FAX NUMBER:
(A'55)hryj-
:OR THIS PROJECT: C1PROPERTY OWNER )ZJ�PPLICANT
ONTRACTOR
E-MAIL ADDRESS: '
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
❑ YES
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $ J�l (✓lJ
❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ : PR07ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
r
TOTAL:
FIXTURES
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)
BOILER(S) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) = FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAINS)
GAS PIPE OUTLET(S)
INTERCEPTORS)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOW ER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
■ DISCLAIMER/SIGNATURE BLOCK
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
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. F
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 su lied to the city a art of this application.
NAME/TITLE:
❑ PROPERTY OWNER PLICANT )RCO T CTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
Cn.Nv n IN17Y nFVFI OPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 - FAX: 253-661-4129