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05-101049 i - ` t City of Federal Way Mechanical Permit #: 05 - 101049 - 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: AHLSTROM Project Address: 2656 S 300TH 5t Parcel Number: 798500 0050 Project Description: Replacing a gas furnace Owner Applicant Contractor Amy C Ahlstrom FIRESIDE DISTRICT OF OREGON FIRESIDE DISTRICT OF OREGON 2656 S 300TH ST FIRESIDE DISTRICT OF OREGON FIRESIDE DISTRICT OF OREGON FEDERAL WAY WA 18862 72ND AVE S 18862 72ND AVE S 98003-4226 KENT WA 98032 (425)251-3921 Mechanical Valuation 1850 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description Quantity 11 Furnaces 1 PERMIT EXPIRES September 4,20058, Permit issued on March 8,2005 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 th4 State of Washington and the City of Federal y. Owner or agent: -JOJ(JUOL,�CA-U d Date: ' 'Yr ZC ' THIS CARD IS TO REMAIN ON-SITE CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 05-101049-00-ME Owner: AMY C AHLSTROM Address: 2656 S 300TH ST FEDERAL WAY, WA 98003-4226 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) 0 Final-Mechanical(4065) Approved Approved to release test Approved By Date By Date By F Date 3-1-o5' a • a-s3 33S-- • �q cm or , sescoVED �� - ( o L o f Federal Way p 'E R M IT COMMUNITY TP GS MAR U g 20 SF MF C ®EL PL DE EN FP 33325 DER L WA SWATH N. 63 BOX 9718 jetI C AT I ON FEDERAL WAY,WA 98063-97]8 � 253-835-2607•FAX 253-835-2609 toww ntuoffederalway.rom CITY pF FE UILDING DEPT. The ollowin• is re•wired in ormation-an incom•fete a••lication will not be acce•ted. Please •rint ler ibl in ink or t •e. n • PROPERTY INFORMATIONjI I �n SITE ADDRESS 1iX� S° 3� : S-( , i NFecle I r Ja_o Li SUITE/UNIT# ASSESSOR'S TAX/PARCEL# ` J Q CJ - L) Q t/ LOT SIZE(sf) L,_5;2.5 LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal descnplmn) • PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING 0 PLUMBING "I-MECHANICAL 0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only) fl--r I bAS PROJECT NAME(Name of Business or Owner Last Name) �11 I S I V/r • PEOPLE INFORMATION PROPERTY NAME ' j PRIMARYRI� PH•NE OWNER �' OtALST P V55) ` GAD ESSS' �t _ n CITY Lu� 4,301).z._ CONTRACTOR COMPANY NAME � Com' (� APPLICANT NAME OFFICE PHONE l Ce i(:- "� ckk �IA P IPtto-( (t-12,51 -q1-10 MAILING ADDRESS CITY STATE,ZIP CELL PHONE ' l�S S' �irL-F l, '( Z )11 S-Cet05 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER ( EXPIRATION DATE FAX NUMBER Lg-3 -1 Q 51 5:9- B L /Z.IDS-3IZ9692.0-'3Z5l CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE EL.V-�SQQLSOL ©t / to /2136-1 APPLICANT COMPANY NAME c APPLICANT NAME OF ICE PHONE liPt/1/4N V144-to-r. VMAILI1�G ADDRESS . 2_1 ` CI .STATE,ZIP �ab� CE )N` s_ z1,73 RELATIONSHIP TO PROJECT Th 137 FAX NUMBER ❑ Architect ❑ Tenant 0 Agent )(Other(Describe M (lk-ia)l.SS b-az-7 CONTACTME�� I _ _ PRIMARY��NF� I` `^UXu Il.k/1� E-MAIL ADDRESS 2.1a0LENDER iPer RCW 19.27.095: Lender information is l`NAME required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP ■ DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC) '/ * • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE ❑ CARPORT❑ NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SP TOTAL SF **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type offacture to be installed or relocated as part of this project. Do not include existing fixtures to remain MECHANICAL Value of Mechanical Work $ 1 S� AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(coo merew) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS f FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or rah/shower combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAYS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK 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), iy be made by any per on,including the undersigned,and filed against the City of Federal Way,but only where such claim arises out of ce of the city,inclu ng its officers and employees,upon the accuracy of the information su plied to the city as a part of this applicat � ��NAME/TITL �II�/�� aAicte DATE 27'12-4-1/(� (Signature) (Tile) RELATIONSHIP TO PROJECT 0 Owner 0 Agent Contractor 0 Architect 0 Other FOR OFFICE USE ONLY 0 NEW o ADDITION o ALTERATION ❑REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? o YES o NO ZONING DESIGNATION CHANGE OF USE? ❑YES a NO NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES ❑NO PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? a YES a NO • Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application