02-105379I
City unity Developnxnt Services Federal Way
mmun
CoMechanical Permit #:02 —105379 — 00 — ME
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: PAULSON PvG
Project Address: 31033 10TH�SW Parcel Number: 024800 0030
Project Description: MEC - Relocating existing gas furnace and installing and relocating gas water heater.
Owner
Applicant
Contractor
MIKE PAULSON
BRENNAN HEATING CO INC
BRENNAN HEATING CO INC
31033 10TH AVE SW
4601 S 134TH PL
4601 S 134TH PL
FEDERAL WAY WA 98023
TUKWILA WA 98168
TUKWILA WA 98168
(206) 248-7900
Mechanical Valuation..........................................3550 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
a_0011010' FT
Qescrlptlon .,. . m P st hti s
Furnaces 1 Number of Gas Outlets 2
PERMIT EXPIRES May 31, 2003, IF NO WORK IS STARTED.
Permit issued on December 2, 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 Federal Way.
Owner or agent: See Application Date:
a
p Y01, RECEIVED BY CONSTRUCTION PERMIT APPLICATION
ED�AL COMMUNITy� EVELOPMENT DEPA CATION NUMBER. _
RECEIVED BY - -
uV FnY COMMUNITY DEVELOP�.�PN A
- MV Rd1EIr002 PPL:ICAn6N.:NUMBER t - L
DEC 0 2 2002 *KATION LVUMgER: ' -
**The foflo j is -required information —Please print (in ink) or type**
Please not e:ie 1, Fire:PreventionSystems:and Engineering permits may require a separate application.
'?� 10-T44
� �j PROPERTY•. •
SITE ADDRESS: O �/ �✓� �`f SIX -)ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
Sr
JECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING PLUMBING MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
�is�fti` a
PROJECT DESCRIPTION (Provide detailed description).' RE Lb Cali KI t GL1-& 1 OMT
"STA -1-L i rS tT ANO R:CLo LA _ i, I ,6-4 Ism U3 tom; R 03T
r-Lrcf(ZlCA1, = A-, bkW ti3 Fo(L Fu Iz P-,C:E V- kLo
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
■ PEOPLE INFORMATION
NAME: M I , , S -PA
P U L� I DAYTIME PHONE:
f+ ►1�1 (a53) 941 -`Ili(p
MAILING ADDRESS (STREET ADDRESS; QTY, STATE, ZIP):
31033 tC�-�++ a�� Sud �7.0. q$oL�_3
NAME:
BtZO YJA-)J kCA-Tttd6p
DAYTIME PHONE:
( ) a+�
- T7cloo
MAILING ADDRESS (STREET ADDRESS; QTY, STATE, ZIP):
4WI 3 (5+ -r44FL- -To KL3t L A 9 RA4:P8
EVENING PHONE:
( )
-
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX ,NUMBER: 9,+9
CONTRACTOR'S REGISTRATION NUMBER:� /1
}�
v K� _ N Mt � C f c-7 —1 KI C,
EXPIRATION DATE:
3/ )
/04
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
-ff512C►11\jar\1 kCAMM((ate) a g - 7ryiCb
MAILING ADDRESS (STREET ADD ; CITY, STATE, ZIP): EVENING PHONE:
1001 S t3a,, -7 L -TUKtk)t LA 91 iGU ( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANTYTHER ( DESCRIBE): �O&r AL.T�i �" (vo ) ot.46 - '7�Cj 1)sj
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT %CONTRACTOR
,p
DETAILED BUILDING INFORMATION
EXISTING USE: gi t� EXISTING BUILDING ASSESSED/APPRAISED VALUATION r-
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 5, l Q •
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
ti ,
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT 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) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( )
—� FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC yp GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINALS)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
DISCLAIMER/SIGNATl1R1F RIC,
WAT HEATERS)
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 claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information su plied to the city as a part of this application.
NAME/TITLE:jn_DATE: /� g Xn';—
i
In PROPERTY OWNER o APPLICANT CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.citvoffederalway.com