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04-104534 . - 1 City utiederal way Mechanical Permit #: 04 - 104534 - 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)835-305(1 Project Name: LARSEN will Project Address: 31609 41ST/SW Parcel Number: 873198 2670 Project Description: Replace gas furnace Owner Applicant Contractor Larry J Larsen BRENNAN HEATING&A/C LLC BRENNAN HEATING&A/C LLC 31609 41ST AVE SW 4601 S 134TH PL 4601 S 134TH PL FEDERAL WAY WA TUKWILA WA 98168 TUKWILA WA 98168 98023-2117 (206)248-7900 Mechanical Valuation 3335 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description Quantity Description Quantity Furnaces 1 PERMIT EXPIRES May 4,2005. Permit issued on November 5,2004 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: See Application Date: (( 15(01 A . THIS CARD IS TO REMAIN ON-SITE r CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 04-104534-00-ME Owner: LARRY J LARSEN Address: 31609 41ST AVE SW FEDERAL WAY, WA 98023-2117 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) 0 Gas Piping(4125) ❑ Final-Mechanical(4065) Approved Approved to release test Approved By Date By Date By fel' Date /0kr- 4 ` race PMEvi ovt8 well �� - 5._q Federal W.15500-•°E� © ( 0 .1( 5 mow' Zoo4PEIMIT � COMMUNITY DEVELOPMENT SERVICES NpV 5 SF MF CO EL PL DE EN FP 33325 D AVENUE SOUTH•63 BOX 9718 APPLICATION r FEDERAL WAY,WA 98063-9718 / / 253-835-2607•FAX 253-835-2609 www.atuofederalwau oma The following is required information-an incomplete a••lication will not be acce•ted. Please •rint legibly(in ink)or Q 1 type. � • PROPERTY INFORMATION SITE ADDRESS 31& Oct 41 471" A/ 3i +-� SUITE/UNIT# ASSESSOR'S TAX/PARCEL# O 3 [t L 2 - ( 0 LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) JF12,_ (Attach separate page for lengthy legal deunp000j s :; ■ PROJECT INFORMATION - TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) -EpLAO__e' 1't_5 > c PROJECT NAME(Name of Business or Owner Last Name) Ljt i k- - - U PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER LA ) ( ) (oil q l - 3-794 MAILING ADDRESS CITY,STATE,ZIP 31/c001 Lk cr Aug SiFED r"ZAL u-)=\- --' --' CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE ISRe u JAK1 ilEaccrtar, aiC - xywk.1" (Ae')al-E-$ -7'100 MAILING ADDRESS I CITY,STATE,ZIP CELL PHONE 14(0D) S t -n4171. `Tc.s l LP C:1 1 ( ) - CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER EXPIRATION DATE FAX NUMBER 6 —B L / / (0'10(o)oZ-b --Mos CONTRACTORS REGISTRATION NUMBER(copy of card regnired with each application( EXPIRATION DATE APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE ( ) - MAILING ADDRReS CITY,STATE,ZIP CELL PHONE ( ) - RELATIONSHIP TO PROJECT • FAX NUMBER ❑ Architect ❑Tenant a Agent 0 Other(Describe) ( ) - CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS LENDER . •!Per=RCW 19.27.095:-Lender Information is NAME iegtiired ifproject value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP - , - -• - .■ DETAILED BUILDING INFORMATION - EXISTING USE PROPOSED USE • EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ -5)33 5 - SPRINKLERED BUILDING? 0 YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? O YES O NO ' WATER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) PROJECT FLOOR AREAS • -- PROPOSED S¢.FT. TOTAL • AREA DESCRIPTION EXISTING S•.FT. VaIIIIIIIIIIIIIIIIIIIIIIII 111111111111 IIIIIIIIIIIII SECOND 111 THIRD 1111111111111 FOURTH 111111111111111111111111111111 ADDITIONAL FLOORS(DESCRIBE) 1111111111111111111111111 DECK(COVERED?) 11111111111 Mill GARAGE/CARPORT TOTAL EXISTING AXE,rROWSGD TOTAL PROPOSEDTOTAL txisufG HOW MANY FLOORS? ESTIMATED SELLING PRICE $ `'NEW HOMES ONLY** NUMBER OF BEDROOMS = . _ -= =...FIXTURES - - ._ _ _ - Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.. MECHANICAL3 55.s� Value of Mechanical Work $__ _L!____—_ REFRIG.SYSTEMS EVAPORATIVE COOLERS GAS LOGS W FKIG.SYSTEMS AIR HANDLING UNITS FANS HOODS(comm<rc.11 MISC(Describe) BOASES FIREPLACE INSERTS RANGES COMPRESSORS• OPRS FURNACES GAS WATER HEATERS GAS PIPE OUTLETS DUCTS PLUMBING BATHTUBS iorTub/Shower comeol WATER CLOSETS(roue) MISC(Describe) SHOWERS SINKS DRINKING FOUNTAINS DISHWASHERSSUMPS RAINWATER SYST GAS OUTLETS URINALS HOSE BIBBS WASHING MACHINES VACUUM BREAKERS ELECTRIC WATER HEATERS LAYS Bathroom Svilcs : _ - _:,.-_, :...!:7-1-:-F-' - : ' MCLAIN:ER/SIGNATUREBLOCK - _- :- --.. 1-_ ' _ :• �-_ : ' t e -,:1-.)'!-:---': ownerof perjury the work for which the permit application is made.investigation agree deJo hold I certify under penaltyr u that the information furnished by me is true and correct to the best of my knowleI dge,and further,that I antfy nd authorized by theFederal ofW ty ase above premises to perform f such claim), the Cityofand filed against the City of Federal Way,but only where such claim Way to any claim(including costs, expenses, and attorneys'fees incurred int e less ding such et aimo the may be made by any persolulling,is o leer the employees, 9 arises out of the reliance of the city,including its o tcers and employees,upon the accuracy of the information supplied to the city as a part of this application. Ai (1�� f l/3/4 SAO , DATE NAME/TITLE / �"� — " (Title) (Si nature) i RELATIONSHIP TO PROJECT 0 Owner ❑ Agent ontractor ❑ Architect 0 Other f I :FOR OFFICE USE ONLY ( ❑REPAIR a TENANT IMPROVEMENT o NEW o ADDITION o ALTERATION o YES ❑NO BASIC PLAN? BUILDING SHELL ONLY? ❑YESo NO a NO CHANGE OF USE? o YES ZONING DESIGNATION Up/SEPA/SU? o YES a NO t NEW ADDRESS REQUIRED? o YES o NO o YES a NO PLATTED LOT? o YES ❑NO DEMO PERMIT REQUIRED? i. F v k\[{andouts—RcviscdU'amit Application ' Bulletin#100—March 30,2004 — Pagc 2 of 4 - i