02-105490City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: FORBES
Project Address: 2222 S 291ST 5�
Project Description: MECH - Replace gas furnace
Mechanical Permit #: 02 - 105490 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 422270 0250
Owner
Applicant
Contractor
Fred W & Alice H Forbes Jr.
UNITED AIR COMFORT INC
UNITED AIR COMFORT INC
2222 S 291 ST ST
897 INDUSTRY DR
897 INDUSTRY DR
FEDERAL WAY WA
TUKWILA WA 98188
TUKWILA WA 98188
98003-3820
1
1 (206)575-9128
Mechanical Valuation..........................................2390 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
t,
Furnaces
PERMIT EXPIRES June 7, 2003, IF NO WORK IS STARTED.
Permit issued on December 9, 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: Date:_g�
1 12/04/2002 17:09 3609452091 NWPERMIT PAGE 09
CONSTRUCTION PERMIT APPLICATION
�itIR�I
" Pw Following is t"ukvd Inf4matlon— Plea Print (is ink) ortyWv.
Fi— note: E lea wkW, Firms PreverMon Systems aAd Engkwwbng Pwmft MXY ragulm a sgmmteappamtba.
SITE ADDRESSo 2222 S 291 ST 98003 ASSESSOR'S TWPARCEL A: 4 2 2 2 7 0 _ 0 2 5 0
LEGAL DESCRXPTLON OF SUWECT PROPERTY (ATTACH SEPARATE DESMPTION IF LENGTHY)z
TYPE OF PR02ECT (This appll®tion)-. 0 BUILDxNG = PLUMuws 0 MECHANWAL 0 DEMOLITION
0 ELECTRICAL, = ENGINEERING 0 FIRE PREVENTD0/1 SYSTEM
PRWWr DESCRIPTION (Provide detailed deecrvtbo]� REPLACE 100 MBTU FURNACE
Kan= NAME
PROPERTY OWNER: NAMe FRED FORBES
aatraM9 vroom:
253 ) 839 2221
MnuavGs;p0xeEraookEs,SC7lY, A7E,'JP)- ----.. --
2222 S 291 ST 98003
CONTRACTOR:
NUNS (Arms pmw:
UNITED AIR COMFORT
(206 ) 575 94.2$
(UMEF S7AlE, Z fw%G ute;
897 INDUSTRY WAY, TUKWIL A. wA 98188 ( )
aTy U FEp81AX WAY SUBRI S,5 UCENSE N IC ......... FAX NUMBEit:
— — — — ( )
— ^" -- — —
OGNTWmCtWS FECQSMA17 Pi NUMBER: EXn)RAT1oN
(c of oro wwl") U N ITEAC013CA /30 104
APPLICANT.
E DFIDiE.... ---
NPM FRED FORBES
( 253 ) 839 =1
MAt.M6 AMIMS 45TREEi ACOft clivi sm7F, i(P): tlfEftlRo16 PFpNE
2222 S 291ST 98003 ( )
RMAT10B W T'0
n ARCHITECT 1 TENANT "1 OTHER ( DESC HI6E7: ( )
CONTACT PERSON FOR TJJIS, PROTECT: o PROPERTY OWNER =APPLICANT O OONTRACfOR
INFORMATIONDETAILED BUJLDING
EXISTING USE: _ . "MING iKM DING ASSESSEDIAPPRAISED VALUATION t _
PROPOSED USE:
SPRINKLERM BummTNs?
WATER SERVICE PROVMM
SEWER SERVICE PROVIDEW
PROPOSED VALUATION FOR IMPROVEMENTs- $2390.00 ,
J YES u NO FIRE SUPPRESSION OfSTEM PROPOSWIREQUIRED1 L YES J NO
"1 LAKEHRVEN n HWHLINE
:1 LAKEHAVEN m HM L.INI;
n TACOMA " PRIVATE (WE'LL)
n PRIVATE (SEPTIC)
12/04/2002 17:09 3609452091 NWPERMIT PAGE 08
RESIDENTIAL CONSTRUCTION ONLY**
!NUMBER OF WOR00145: - ESTMATED SELLING PRICE
PROJECT F► -COR AP.EAS
Ant HANDLING UNITS)
$BQ(S)
_... BOILER(S)
COMPRESSO(S)
DUCTS)
BATHTUBS)
DISHWASHER(S)
DRINKING FOUNTAINS)
GAS PIPE OUTLETS)
INTl!RCWMR(S)
Indicate number of each type of Fixture
MRCMANICAL
EVAPORATrM COOLERS) GAS LOs(S) REFRIG. SYSTEM(9)
FAIM(N) HOODS) WOODSrOVE(s)
FIRS UCE INSERTS) RANGE(S) NISC. ( )
FURNACE(S)
GAS PM OUTLETS) HEAT SOUKC Et m ELECTRIC a GAS
PLUMBDNGi
LOATORY(S)
RAIN WATM SYS.
SHOwat(S)
SINK(s)
SUM P(S)
URINALS)
VACUUM BREAKER(S)
WASE! MACHINE OUTLET
WATER CLOSEt(S)
WATER HEATERS)
O MECTPJM o GAS
MISC. (
Dl5Ct-AJMEP/SlrNATURE BLOCK
I certify under penalty aF perjury that the inforr► iMm furnished by nit is bw and correct to the best of my 1[aowkdgre, and
hAMh r, ttlat i ben 41WOK riaad by the ®softer of the atm pMMbM tg perform OR wort[ for wAfch the permit appllrswn (s made. i
fuFUwagree to TOM harmless the Cliy of Federal Way as to any dahn (lucluding ants, expenses, and attonr W fees bKmnw fathe
imestlgatlon and dafOWR Of such daim), whkh awry be made by any parson, ior;Fuding the undersigned, and f4ed against the Qtr at
Federal Lltay, M+t oniy M1h sorb tiaQn arir reliarwe of the diy, bu hiding ks hers and empbyeee, u(wu M w aecwacy
of the information supeI c ty as is n,
ZI
E.
NAME/TIFL71.1 j DATA '2fa102
U PROPERTY OWNER -j APR U CONTRACTOR
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COFF%PM OEVELCPWNT SERVIC S • 37530 FLCST WAY SOIT71 • FO ECK 9718 • FEDERAL WAY, WR 9W63.9718 . 253.661-40M • FAR: Lr%+6U-4169
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