04-103941 CiT of Federal Way Mechanical Permit #: 04 - 103941 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph (253)835-7000 Fax.(253)835-2609 Inspection request line: (253) 835-305C
Project Name: THORSON •.�
Project Address: 2321 SW 339TH St Parcel Number: 330620 0255
Project Description: Changeout gas furnace
Owner Applicant Contractor
M L Thorson NORPAC HEATING&A/C INC NORPAC HEATING&A/C INC
2321 SW 339TH ST 3414 A ST SE SUITE 102 3414 A ST SE SUITE 102
FEDERAL WAY WA AUBURN WA 98002 AUBURN WA 98002
98023-7730 (253)931-0608
Mechanical Valuation 2100 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description Quantity L_ Description (Quantity
I Furnaces 1
PERMIT EXPIRES March 26,2005.
Permit issued on September 27,2004
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: L/�'�, �• Date: 7/,7 o ��
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103941-00-ME
Owner: M L THORSON �.
Address: 2321 SW 339TH ST
FEDERAL WAY, WA 98023-7730
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
0 Mechanical Rough-in(4165) ❑ Gas Piping(4125) Iv! Final-Mechanical (4065)
Approved Approved to release test Approved
By Date By Date By kt‘,14 Date%' +� LAO
d
W/FL 0 C(- 4_b3 ? (--( L
• Federal Way PERM
SF MF CO40 EL PL DE EIV FP
33325 ED Nf E �S97X9 s AP P LI CAtf UN7 'gin TD
FEDERAL WAY,WA 98063-9718 /
253-835-2607•FAX 253-835-2609 /
wtaw.tituofederalwau.com CITY OF FEDERAL WAY
ILDING
The following is required information-an incomplete a••liraBUon wi noDt EbPeTa.cre•ted. Please •rint legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 5 3 Vi 1 5 LA, 3 3`s S T SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attadt sepamtepagefor knot::legal desmpeon)
■ PROJECT INFMATION .
TYPE OF PERMIT 0 BUILDING 0 PLUMBING yLMECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
C km....{c 40 t.c.r EX,...s u.N.td u-t !.'•t4. Ale Fcr' 7tiS' C.v.r Xic S
PROJECT NAME(Name of Business or Owner Last Name) ,v p s o.d
- I1 PEOPLE INFORMATION
PROPERTY NAME / ��/ Q PRIMARY PHONE
OWNER MI'rL.f �r 0 if 56 / (d53) 7'7'70 5--y.3f/
MAILING ADDRESS CITY,STATE,ZIP
A3, 1 S w 3 3 ie` sr- �f.4-Az/ Gc -may tvnf ? $D,: 3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
A310 A-- Pi4c f.4.,S y��c r/,
. Dt, vrs tsL/,.� (r'L-3) y3 -a6cue
MAILING ADDR CITY,STATE,ZIP CELL PHONE
3y/'1 4 sr SE At lop- 1Q••c, ti-e ." Gc%, 96.047. ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
1 t-.Y Q-1 Q L Eb-s�i^ %I �i /oY (--.35-3) 93 -04 y>
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each applications EXPIRATION DATE
dlrz >� P_ A1igi_ in / l
APPLICANT COMPANY NAME APPLICANT NAME OFFICE-PHONE
MAILING ADDRESS GS ��✓ CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT • FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER Per ROW 19.27.095:'Lender information is NAME
required trim-eject value excee is$5,000
MAILING ADDRESS CITY,STATE,ZIP
- - .■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ a
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
• ' • PROJECT FLOOR AREAS •
___________----.....----__—_________------------------
\
s__ -----__ TOTAL
AREA DESCRIPTION EXISTING S•.FT. PROPOSED S•.Fr.
•
SECOND IIIIIIIIIIII
THIRD 111111111111111111111111111
FOURTH IIIIIIIIIIIIIIIIIIIIII
ADDITIONAL FLOORS(DESCRIBE)
111111111111111111111111111
DECK(COVERED?) 1111111111111
GARAGE/CARPORT 111111111111111
TOTAL LXISTDfG AID rROtOSLD
TOTAL EXISTING
HOW MANY FLOORS?
"NEW HOMES ONLY" NUMBER OF BEDROOMS
ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
• MECHANICAL
' Value of Mechanical Work $___(,21: 1—
REFRIG.SYSTEMS
EVAPORATIVE COOLERS GAS LOGS REFWOG.SYSTEMS MR HANDLING UNITS FANS HOODS(commr<,all MISC(Describe)
VES
BOAS FIREPLACE INSERTS RANGES
BOILERS FURNACES GAS WATER HEATERS
DUCTS
COMPRESSORS �— GAS PIPE OUTLETS
----
PLUMBING
BATHTUBS(or tub/showerCombol WATER CLOSETS(roue) MISC(Describe)
SHOWERS
DISHWASHERS SINKS DRINKING FOUNTAINS
DSUMPS RAINWATER SYST
GAS PIPE OUTLETS URINALS _ HOSE BIBBS
WASHING MACHINES VACUUM BREAKERS ELECTRIC WATER HEATERS
LAVS Bathroom Sinks _ _ _ _ __ _
_ , _ ..:":-11-; -= -----, :-DISCLARIER/SIGNATUREBLOCK- -: _�:, ; _-:-•-,= _ _
that I
^ `under penalty of perjury that the information furnished by rne is true and
k for which the correct
to permitthebest of application is made.knowledge,
e, an further
agree further,thold
I certify to perform
am authorized by the owner of the above premisess'fees incurred in the investigation and defense of
harmless the City of Federalm Way as anyto any claim(includingdingte understs, ignexpe , es, and attorney
such claim),which may be made by 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. j� 7/pY
E S DATE /__�--
NAME/TITLE A.._ �� (Title)
(S,gnaturel
S RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent
Contractor 0 Architect 0 Other
I
I
I ,FOR OFFICE USE ONLY
( a REPAIR o TENANT IMPROVEMENT
o NEW o ADDITION ❑ALTERATION a YES 0 NO
a YES ❑NO BASIC PLAN? ❑NO
BUILDING SHELL ONLY? CHANGE OF USE? o Y'S
ZONING DESIGNATION o YES o NO
1 NEW ADDRESS REQUIRED? ❑YES a NO
UP/SEPA/SU?
O
PLATTED LOT? ❑YES ❑NO
DEMO PERMIT REQUIRED? o YES a N
4
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Bulletin#100—March 30,2004 — Page 2 of 4
k\handouts—Revised\Permit Application
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