05-100866 t City of Federal Way
Community Development Services Mechanical Permit #: 05 - 100866 - 00 - ME
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax.(253)835-2609 • Inspection request line: (253) 835-3051
Project Name: HARTMANk/�
Project Address: 30855 8T1IrS Parcel Number: 082104 9105
Project Description: Gas furnace changeout
Owner Applicant Contractor
Harold Hartman GATEWAY HEATING&AIR CONDITIO GATEWAY HEATING&AIR CONDITIO
30855 8TH AVE S 3802 AUBURN WAY N 3802 AUBURN WAY N
FEDERAL WAY WA AUBURN WA 98002 AUBURN WA 98002
98003-4701 (253)931-0610
Mechanical Valuation 1500 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description `Quantity Description Quantity
Furnaces II 1
PERMIT EXPIRES August 22,2005.
Permit issued on February 23,2005
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 and
the City of Federal Way.
Owner or agent: Date: J D
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100866-00-ME
Owner: HAROLD HARTMAN
Address: 30855 8TH AVE S
FEDERAL WAY, WA 98003-4701
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 Approved
By Date By Date By "Z/ Date 21243/05-
i
CITY OF 05= i _o V V \V
Federal Way PERMIT
SF MFC al, L PL DE EN FP
CDMMUNnY DEVELOPMENT SERVICES
33325d°1 AVENUE A771•PO BOX 9718 APPLICATION To
FEDERAL WAY,WA 9d063-97171 d /
253-835-2607•FAX 253-835-2609
tewta.dttaffederalwag o,m
The ollowi • is re• ired in ormation-an Inco •lete • ••lication will not be acce•ted. Please •rint le•ibl (in or . .
.�7� • PROPERTY INFORMATION !_
SITE ADDRESS Op p s3� -kw S a Te_acti Q �Q4(�/�I W9/��y�
, SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# D 4 c I 0 9 - q t 0 S t LOT SIZE(sfl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desaiptionl
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING CHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
XZ.--.5K 7 S vvl,Le.
PROJECT NAME(Name of Business or Owner Last Name) ('.{&JI+ - ieliVi
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER 1.---D -c (N3 ) S39 -7
2'3
MAILING TE,ZIP
3o$5S ADDRESS�`�LA. � S r S i:4',e \,►O-L 1/ ) q
` OwS
CONTRACTOR PANY NAME APPLICANT NAME OFFICE PHONE
Q-�t,tt9a�-.14 � (�S3 )i 3( -Cc-4 0
MAILINGO ��A�n 4' ) ]/I,(, f A L cm,STATE,ZIP i CX�` Z (CELL PHONE -
CITY OF 1FEDERAL IN
BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER Q���
--_I b - Q-B L / / ) r1,4 -040
CONTRACTOR'S REGISTRATION NUMBER(coPy of card required with each application( EXPIRATION DATE
sAPPL ' k'' t ti- PC & 2 _C--3 or 2,0 ' os-
APPLICANT
ICANT d1PANY NAME
APPLICANT NAME OFFICE PHONE
LIN RESS/ — ( 23)53( - 062'D
pp�� CITY,STATE,ZIP CELL PHONE
`� U-U.64/ra<Ll '� Wk �� n �W� ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect ❑Tenant 0 Agent ❑ Other(Describe)( (Z ) fi>04 -✓c oo
CONTACTPRIMARY PHONE E- IL ADDRESS
tJ o t �t.hk>�k (0`813) 0131 - �oltD V, o� v
AMim..
LENDER ` ? ;t, r v , n ormatio ir NAME
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 ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA a PRIVATE(WELL)•
SEWER SERVICE PROVIDER 0 LAKEHAVEN a 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
EXISTING PROPOSED TOTAL TOTAL EXISTING Sr TOTAL PROPOSED SP ;TOTAL Sr
NUMBER OF FLOORS
**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 t}0
Value of Mechanical Work $ I SOT)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS I FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(rode) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sides) 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),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.
NAME/TITLE f7/1,-"1------- DATE 2 — Z
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner ❑ Agent o Contractor 0 Architect ❑ Other
SMY._ AIP ON,.7 - " p`ALTERATION n REPAIR _: .+,a i TENANT IMPROVEMENT
!YOKOi HE'S NLY? : rr4 r. BASIC PLAN?„<" '1::. t:V>. D YES
IG ON t r .< CHANGE OF,USE. ;:f .n.: ❑YES,•.
,.., r AESS REQUIRED?'; ;; ptYES a NO> UP/SEPA/SU?:' `•a',,. ;E o YES;.",`axRR O
.DEMO.PERMIT4:0370 JIRED?z ,. o YES:z• ;10/$040150
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application