03-100088Cor; nity De. 1 Way
Applicant
Mechanical Permit #: 03 - 100088 - 00 - ME
Commuunity Development Services
GATEWAY HEATING & AIR CONDTTIO
GATEWAY HEATING & AIR CONDITIO
33530 Ist Way S
3802 AUBURN WAY N
3802 AUBURN WAY N
Federal Way, WA 98003-6210
AUBURN WA 98002
AUBURN WA 98002
Ph: 253.661.4000 Fax: 253.661.4129
Inspection request line: 253.835.3050
Project Name: JACKSON �K/
Project Address: 30032 8TH S
Project Description: Replace gas furnace
Parcel Number: 515220 0010
Owner
Applicant
Contractor
Thomas C & Elizabeth S Jackson
GATEWAY HEATING & AIR CONDTTIO
GATEWAY HEATING & AIR CONDITIO
30032 8TH AVE S
3802 AUBURN WAY N
3802 AUBURN WAY N
FEDERAL WAY WA
AUBURN WA 98002
AUBURN WA 98002
98003-3723
(253) 931.0610
Mechanical Valuation..........................................1978.93
Over the Counter Permit ...................................... Yes
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 �
Owner or agent: Date: — 8 ��
L Ric
�•°f RECEIVED CONSTRUCTION PERMIT APPLICATION
EDC- Z= _ APPLICATION NUMBER: V S - _ 0 0
� JAN 0 8 2003 _
APPLICATION NUMBER:
CITY OF FEDERAL WAY PPLICATION NUMBER: _ _ - _ — — — — — - — —
**The fthlWYC8 i§Bred information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
,� cPROPERTYINFORMATION
SITE ADDRESS: 30 /-IU�L c�� ' ASSESSOR'S TAX/PARCEL #:,,5 R-5 -DD
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING likaNECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT
■ PEOPLE INFORMATION
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME:
9-
/G
DAYTIME PHONE:
(a15-3) q131 -
a
MAILING ADDRESS (STREET ADDRESS; CTTY, STATE, ZIP): L
ENING PHONE: -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
Iq
FAX NUMBER:
('53)Pnq-
OtIbOl
CONTRACTOR'S REGISTRATION NUMBER:
O ^�](/�
,V,L1
p�
IXPIRATION /ATE:
a
n
(SPY of caro required)
— — —'w—\ — _ b-�
—
a
.. T J0 c DA53)9 - 06 /
MAILING ADDRESS (STREET ADDRESS; CrrY, STATE, ZIP): EVENING PHONE:
( I
RELATIONSHIP TO PROJECT: FAX NUMBER: �(
1-3 ARCHITECT I]TENANT OTHER ( DESCRIBE): (aS�) Q1I -
-�.,/ EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER )6PPLICANT CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE:
PROPOSED USE:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ It
PROPOSED VALUATION FOR IMPROVEMENTS: $
A
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
0 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
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?
TOTAL:
J_
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAINS)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINALS) WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINKS) WATER CLOSET(S) MISC. ( )
SUMP(S)
]TCCI ATMFR/STGNATURE 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. (��`-'"�
NAME/TITLE: \ �Iy` _ DATE: I
❑ PROPERTY OWNER 1_154PPLICA RACTOR
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
rn-Mr-If INITY r,FVFI OPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY. WA 98063-9718 • 253-661-4000 • FAX: 2S3-661-4129