02-104939City of Federal Way
Community Development Services
33530 Ist Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: CORKEN
Project Address: 506 S 303RD 5'
Project Description: MECH - Changeout of gas furnace
Mechanical Permit #:02 - 104939 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 064310 0260
Owner
Applicant
Contractor
Mark Kriskovic
GATEWAY HEATING & AIR CONDITIO
GATEWAY HEATING & AIR CONDITIO
506 S 303RD ST
3802 AUBURN WAY N
3802 AUBURN WAY N
FEDERAL WAY WA
AUBURN WA 98002
AUBURN WA 98002
98003-4016
1 (253)931-0610
Mechanical Valuation..........................................2212
Furnaces
Over the Counter Permit ...................................... Yes
Mechanical Fixtures
PERMIT EXPIRES May 6, 2003, IF NO WORK IS STARTED.
Permit issued on November 7, 2002
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 Fede A
Owner or agent: ti Date:
Mechanical rough -in:
Date
Gas pipe:
FINAL MECHANICAL: z
Date
CI..o.
ECENED
. � CONSTRUCTION PERMIT APPLICATION
�jv y PPLICATTON NUMBER: Q _
NOV U I LUUL PPLICA-RON NUMBER: - _ _ _ _ _
CITY OF FEDERAL WAY APPLICATION NUMBER:
Bt)MD Q5ft is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. .
SITE ADDRESS:
ASSESSOR'S TAX/PARCEL #: D& 13 1 -0-6126r-)
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROTECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING -%2--MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): \ C
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
■ PEOPLE INFORMATION
NAME: � � /
(AYTIME PHONE: -
S `) /- /x
MAI NG ADDRESS (STREET ADDRESS; CITY, STATF- ZIP): Q )
7 ,V
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSEN R-
L 9_ - �' g �a5 8 —�0
FAX NUMBER:
(,s3 , -6� 6 �
CONTRACTOR'S REGISTRATION NUMBER: \ ,L y� (�
(Copy of card required)l v !7 % UV (�� CJ d
EXPIRATION GATE:
/ -
APPLICANT: NAME: DAYTIME PHO
BE-
C1� l -
AAIUNG ADDRESS (STREET AOORESS; CITY, STATE, IIP): EVENING PHONE: _
RELATIONSHIP TO PROJECT: n n FAX NUMBER:
C3 ARCHITECT ❑ TENANT OTHER ( DESCRIBE): COA-1 K.
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ) CfONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ f�\
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $yy
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 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
RAIN WATER SYS.
DRINKING FOUNTAIN(S)
SHOWER(S)
FIRST
SINKS)
INTERCEPTORS)
SUMP(S)
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
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
URINALS)
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. 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 applic70zer�
4L��'
X
NAME/TITLE: - DATE: ! /16 /4-d
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION
PLUMBING
BATHTUB(S)
LAVATORY(S)
DISHWASHERS)
RAIN WATER SYS.
DRINKING FOUNTAIN(S)
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
INTERCEPTORS)
SUMP(S)
URINALS)
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. 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 applic70zer�
4L��'
X
NAME/TITLE: - DATE: ! /16 /4-d
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
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!Nf tl INFTY nFVFi OPMENT SERVICES - 33530 FIRST WAY SOLMI - P.O. BOX 9718 - FEDERAL WAY. WA 98063.9718 - 2S3-661-4000 - FAX: )S1-661-4129