02-105045City 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: RUGGLES
Project Address: 5209 SW 324TH Pl
Project Description: MECH - Change out of gas furnace
Mechanical Permit #:02 - 105045 - 00,- ME
Inspection request line: 253.835.3050
Parcel Number: 189831 0400
Owner
Applicant
Contractor
Carol A Ruggles
GATEWAY HEATING & AIR CONDITIO
GATEWAY HEATING & AIR CONDITIO
5209 SW 324TH PL
3802 AUBURN WAY N
3802 AUBURN WAY N
FEDERAL WAY WA
AUBURN WA 98002
AUBURN WA 98002
98023-3605
1(253)931-0610
Mechanical Valuation..........................................2086
Over the Counter Permit ...................................... Yes
Mechanical Fixtures
PERMIT EXPIRES May 12, 2003, IF NO WORK IS STARTED.
Permit issued on November 13, 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 W, t�
Owner or agent: A21"
Date:
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CONSTRUCTION PERMIT APPLICATION
PPLICATION NUMBER: -
APPLICATION NUMBER:
APPLICATION NUMBER: - -
**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.
PROPERTY INFORMATION
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SITE ADDRESS: J Cy l r!LLASSESSOR'S TAX/PARCEL #: 0 � - — C ��
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING �tECHANICAL C1 DEMOLITION
C1 ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT: NAME: DAYTIME PHONE:
Rv � c s )93/
MAILING ADDRESS (STREET;DDRElf�; CITY, ATE, ZIP): rEVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER
❑ ARCHITECT ❑ TENANT HER ( DESCRIBE): FF -
-E-MAIL ADDRESS: -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER C1APPLICANT CONTRACTOR
DETAILED . • •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $_'a
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: $
■ .: PRONG 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:
`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 INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) = FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINALS)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
7TC[9 ATINVOICTPNATIIRF RI C
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, ccuracy
of the informatio upplied to the city as a part of this application
_ ] //
4NAME/TITLE: J "`+ ` DATE: _U1177
❑ PROPERTY OWNER ❑ APPLICA k6 LyCONTRACTOR
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.11r.11 INITY nFVFI OPMFPJT SERVICES - 33530 FIRST WAY SOLMH - P.O. BOX 9718 - FEDERAL WAY. WA 98063-9718 - 253-661-4000 - FAX: 2SI.661-4129