05-106047 rrncervices
Mechanical Permit #• 05-106047-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
4
Project Name: GUNDERSON
Project Address: 2340 SW 341ST PL Parcel Number: 330630 0030
Project Description: Replace oil furnace with gas furnace; includes gas piping.
Owner Applicant Contractor
GERALD L GUNDERSON NORDIC HEATING,INC. NORDIC HEATING,INC.
TAMMY S GUNDERSON P.O.BOX 2581 NORDIHI099BJ (1/9/06)
2340 SW 341ST PL AUBURN WA 98021 P.O.BOX 2581
FEDERAL WAY WA AUBURN WA 98021
98023-7736
Additional Permit Information
Mechanical Valuation 2500 Over the Counter Permit Yes
Mechanical Fixtures
Furnaces 1 Number of Gas Outlets 2
CONDITIONS:
PERMIT EXPIRES Saturday, May 27, 2006
Permit Issued on Monday, November 28, 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 the State of Washington
nd the City of Federal Way.
Owner or agent: _ A� -0- Date:
THIS CARD IS TO REMAIN ON-SITE
CITY Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106047-00-ME
Owner: GERALD L GUNDERSON
Address: 2340 SW 341ST PL
FEDERAL WAY, WA 98023-7736
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) 0 Final-Mechanical(4065)
Approved Approved to release test Jr /'. ')i Approved
By Date By Date 14,291 ar By Q ej Date4'4/Z.- c7 ,
i
A . s _ / • G 0 _.7
Federal Way RECEIVEDPERMIT — —"SERVICES
ODAfAlUM7YD8VELOPIBIY7 SF MF • ME L PL DE EN FP
333 FEDERAL$Y,WA ZNOov 2 8 20 p p LI CATI O N
253435-2607. 253435-2609t
waw-914 dff"wimmtuiTy D dmil
OF FEDERAL WAY
The ollowi • is re• • , F '. 71-an Mco •tete , ••lication will not be acce•ted. Please •Tint le• ,1 n in or
■l PROPERTY INFORMATION J�
SITE ADDRESS 2 39 `, 6e . e/i�� SUITE/UNIT I r '-�J
ASSESSOR'S TAX/PARCEL 13 3o4:2. 3 Q_ Do 3LOT
— SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
/Attach+ekPaala hapehy kgal desapdonl
■ 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 f work included on this 01/ 15permit only)
Q4S Gr 21 9 „ / lyc� . f r/ri/,,
�y
-6u,v(A C€_
PROJECT NAME(Name of Business or Owner Last Name) ...-1,44 et e Q 5) 'f -
PEOPLE INFORMATION
PROPERTY NAME g
PRIMARY PHONE -
OWNER ,� 7 ( )
MAILINGADD/ESS S, to, yi? G ..TY STA 4x,
�,t//,
CONTRACTOR COMPANY NAME `/ 1 APPLICANT NAME OFFICE PHONE
/VDd cr•( /1` T Ii'� rf di OFFICE
x,31 4 / -c'57 3
MAILING ADDRESS CITY,STATE P CELL PHONE
dCJ. ?/ !S-31:26/ � .-
C�� RAL WAY SINS LICENSE NUMBER `
«� EXPIRATIO DATE FAX NUMBER
— — — — — — B L / / ( ) -
CONTRACT�REGISTRATION�BER(copy cardrequired t><each application) EXPIRATION DATE
APPLICANT COMPANANAAME / 1 APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect ❑Tenant ❑Agent ❑ Other(Describe) ( )
CONTACT NAM4r, PRIMAPHONE
Urnil f I bel p5 ) (y1/ -Oc0 3 E-MAIL ADDRESS
LENDER � ;d:r r, ,r..:..-,,r..:..-, i r;., 44.Y ••
,r . 1,,. NAME
MAILING ADDRESS CITY,STATE,ZIP
•
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINK .ERED BUILDING? a YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER a LAIELIAVEN ❑HIGHLIYE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 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 0 CARPORT 0
NUMBER OF FLOORS =STOPS TOTAL
AL teb '=ir w�
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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.
MECHANICAL 42g2(2ori
Value of Mechanical Work $
•
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commerci*y WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
• COMPRESSORS / FURNACES OAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(roueq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathroom Sink.' 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 authorised 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,upon the accuracy of the information supplied to the city as a part of
this application. ri
NAME/TITLE -AC..CA/ _
i / DATE
(Signat / Critic)
RELATIONSHIP TO PROJ 0 Owner 0 :ent 0 Contractor ❑Architect 0 Other
P?lYP 01),,f F Lt 1 .. ,
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Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permit Application